Is there a role for telemedicine in adult allergy services?

Telemedicine refers to the application of telecommunication and information technology (IT) in the delivery of health and clinical care at a distance or remotely and can be broadly considered in two modalities: store-and-forward and real-time interactive services. Preliminary studies have shown promising results in radiology, dermatology, intensive care, diabetes, rheumatology and primary care. However, the evidence is limited and hampered by small sample sizes, paucity of randomised controlled studies and lack of data relating to cost-effectiveness, health related quality of life and patient and clinician satisfaction. This review appraises the evidence from studies that have employed telemedicine tools in other disciplines and makes suggestions for its potential applications in specific clinical scenarios in adult allergy services. Possible examples include: triaging patients to determine the need for allergy tests; pre-assessment for specialised treatments such as allergen immunotherapy; follow up to assess treatment response and side effects; and education in self-management plan including training updates for self-injectable adrenaline and nasal spray use. This approach might improve access for those with limited mobility or living far away from regional centres, as well as bringing convenience and cost savings for the patient and service provider. These potential benefits need to be carefully weighed against evidence of service safety and quality. Keys to success include delineation of appropriate clinical scenarios, patient selection, training, IT support and robust information governance framework. Well-designed prospective studies are needed to evaluate its role. This article is protected by copyright. All rights reserved.

Measuring employee innovation:a review of existing scales and the development of the innovative behavior and innovation support inventories across cultures

Purpose - The paper develops a model of employee innovative behavior conceptualizing it as distinct from innovation outputs and as a multi-faceted behavior rather than a simple count of ‘innovative acts’ by employees. It understands individual employee innovative behaviors as a micro-foundation of firm intrapreneurship that is embedded in and influenced by contextual factors such as managerial, organizational and cultural support for innovation. Building from a review of existing employee innovative behavior scales and theoretical considerations we develop and validate the Innovative Behavior Inventory (IBI) and the Innovation Support Inventory (ISI). Design/methodology/approach – Two pilot studies, a third validation study in the Czech Republic and a fourth cross-cultural validation study using population representative samples from Switzerland, Germany, Italy and the Czech Republic (N=2812 employees and 450 entrepreneurs) were conducted. Findings - Both inventories were reliable and showed factorial, criterion, convergent and discriminant validity as well as cross-cultural equivalence. Employee innovative behavior was supported as comprising of idea generation, idea search, idea communication, implementation starting activities, involving others and overcoming obstacles. Managerial support was the most proximal contextual influence on innovative behavior and mediated the effect of organizational support and national culture. Originality/value - The paper advances our understanding of employee innovative behavior as a multi-faceted phenomenon and the contextual factors influencing it. Where past research typically focuses on convenience samples within a particular country, we offer first robust evidence that our model of employee innovative behavior generalizes across cultures and types of samples. Our model and the IBI and ISI inventories enable researchers to build a deeper understanding of the important micro-foundation underpinning intrapreneurial behavior in organizations and allow practitioners to identify their organizations’ strengths and weaknesses related to intrapreneurship.

Why (and When) are Preferences Convex? Threshold Effects and Uncertain Quality

It is often assumed (for analytical convenience, but also in accordance with common intuition) that consumer preferences are convex. In this paper, we consider circumstances under which such preferences are (or are not) optimal. In particular, we investigate a setting in which goods possess some hidden quality with known distribution, and the consumer chooses a bundle of goods that maximizes the probability that he receives some threshold level of this quality. We show that if the threshold is small relative to consumption levels, preferences will tend to be convex; whereas the opposite holds if the threshold is large. Our theory helps explain a broad spectrum of economic behavior (including, in particular, certain common commercial advertising strategies), suggesting that sensitivity to information about thresholds is deeply rooted in human psychology.

Haitians Released from Krome: Their Prospects for Adaptation and Integration in South Florida (Dialogue #24)

Excerpt from EXECUTIVE SUMMARY This report examines the situation of the Haitians in Miami who were formerly incarcerated during 1981 and 1982 in the Immigration and Naturalization Service's Krome Detention Center or other Federal detention centers in the U.S. and Puerto Rico. For convenience, the report refers to all of them as Krome Haitians. This study is based upon a sociological survey of the Krome Haitians and intensive anthropological fieldwork conducted by Dr. Alex Stepick of the Sociology and Anthropology Department of Florida International University with support from the Catholic Services Bureau of Miami. It is the only scientific study of the Krome Haitians and the scientific procedures of the survey complemented by the anthropological fieldwork combine t o produce highly reliable results . To provide context to the conditions of the Krome Haitians, the report compares the characteristics of this population to that of the Haitian Entrants who arrived in 1980 or earlier and provides an update to earlier studies by this author (Stepick 1982) and another by the Behavioral Science Research Institute (1983). The report describes the conditions of the Krome Haitians, including their background in Haiti, experiences in the U.S., past and present employment status , experience with discrimination and social isolation , and adaptation to American society. The report concludes with some specific policy recommendations to state and local agencies and individuals that will assist the Haitians' integration into American society.

Variables motivating parents to choose a specific type of private school

The purpose of this study was to investigate the reasons associated with parents' choices of specific types of private schools. The researcher hoped to determine if there were any significant differences in the reasons parents reported for enrolling their child in a specific private school. Studies in the past have explored why parents choose private schools. This study focused on why parents chose a specific type of private school, what were the variables involved, and were there any significant differences in the motivation of parents with children enrolled in different types of private schools.^ The study gathered data using a survey instrument which centered on 14 variables generally associated with the choice of private schools. The survey asked parents to rate the variables using a Likert type scale. The Likert rating was used because it does not require respondents to choose between variables. The general areas of emphasis were (a) academics, (b) religion and values/morals, (c) nurturing educational environment, and (d) proximity and convenience of the school. The survey also gather qualitative data in the form of comments volunteered by over a third of the respondents.^ The survey was mailed to 560 randomly selected families from 30 private high schools in a 50 mile radius of Miami, Florida. The 10 high schools, represented five types of private schools, Roman Catholic, Episcopal, Independent, Jewish, and Fundamentalist Christian. After four mailings a total of 401 surveys were returned for a rate 72%.^ Significant differences appeared as the data was analyzed using ANOVA and Tukey's HSD pairwise analysis. The variables showing significant differences between types of schools were (a) quality of instruction, (b) commitment of teachers, (c) emphasis on religion, (d) small class size, (e) well-defined academic goals, (f) proximity of the school's location, (g) preparation for desired secondary schools/colleges, and (h) convenience of school's operating schedule.^ Parents appeared to have specific reasons for choosing a particular private school. They appeared to look for a school that would satisfy the special needs of their child and would be compatible with their own values, morals, and personal philosophy. ^

Safety habits promoted by Hispanic parents for school-aged and adolescent children

Accidents are the leading cause of death among children. Compliance with safety measures have been shown to reduce morbidity and mortality in children. However, Hispanic parents and children have not been adequately studied in the literature in regard to trauma and safety habits utilized. In this exploratory-descriptive study, a convenience sample of 48 Hispanic parents were questioned about their child's activities. The purpose was to determine what safety equipment was used during these activities and how often they were used. Responses to an English/Spanish questionnaire were summarized by frequencies and percentages. Findings suggested that these Hispanic children were at risk for injury due to a low percentage of children wearing the necessary protective equipment. Therefore, education must stress consistent use of safety equipment if injuries are to be prevented. ^

Language maintenance and use in south Florida Hispanic university students: Do educational programs matter?

This study examined the long-term effects of bilingual education/ESOL instruction on Hispanic university students' subsequent Spanish language maintenance using sociolinguistic methodology as its framework. The study investigated whether or not Hispanic university students who had participated in bilingual or ESOL classes in their elementary schooling maintained Spanish as young adults. Maintenance included using Spanish in their personal and professional lives and demonstrating written competence in Spanish, as well as whether subjects considered themselves to be bilingual, how they rated their ability in different skill areas for the two languages, and if they exhibited positive attitudes toward language and education as compared to Hispanic students who had experienced an all English classroom situation. A Language and Education Survey was developed to collect data pertaining to these areas. ^ A convenience sample of 202 Hispanic undergraduate university students enrolled in education classes at Florida International University during the 2000–2001 academic year participated in the study. Subjects were grouped according to the type of program they had experienced at the elementary school level, Bilingual/ESOL and All English. ^ Statistically significant differences were found between the groups in subjects' self-ratings of their abilities in speaking, reading, writing, and comprehension. No statistically significant differences were found with respect to the continuation of Spanish language study at the secondary school or college levels although there was a significant difference in number of semesters for those who planned to do so. ^ In language use, there were statistically significant differences overall as there were in the personal domain, but none were found in the professional domain; nor were there any statistically significant differences between the groups with respect to attitudes regarding education and language. There were statistically significant differences between the two groups for communicative competence in written Spanish. These statistically significant findings in language ability, language use and written communicative competence indicated that Hispanic university students who were enrolled in bilingual programs/ESOL in their earlier schooling did maintain Spanish as their native language as compared to Hispanic students who did not participate in such programs. ^

The health and nutritional status of multiethnic perimenopausal women

An integrated, dual-phase study design assessed the health and nutritional status and practices of African-American (A-A), Caribbean (A-C), and white non-Hispanic (W-A) women during perimenopause (40–55 years). During Phase I, four focus groups (n = 37) of male and female participants discussed the health and social implications of perimenopause. A conceptual framework for the main study (Phase II) was developed from the focus groups' findings, in concert with the main study's specific aims and objectives. ^ The main study, a cross-sectional survey, quantitatively assessed the health and nutritional status of a convenience sample of 109 women (25 A-A, 31 A-C and 53 W-A), who met specific eligibility criteria. Using seven instruments, sociodemographic, dietary, medical, reproductive health, health practice and anthropometric data were collected. ^ The groups were of comparable age, education, and socioeconomic status (SES). Despite these similarities, statistically significant interethnic nutritional status differences were found. Significantly more total energy and energy from fat were consumed by A-A than W-A and A-C women. Also, significantly more A-A and A-C than W-A women were overweight or obese with android-type weight patterning. ^ Overall, iron and calcium Recommended Dietary Allowances (RDA's) were not met by 35% and 68% of participants, respectively. Iron deficiency anemia was reported by 29% of participants while 33% reported heavier menstrual bleeding. Coupled with suboptimal iron intakes, this is likely to present a serious public health problem. Similarly, increased bone demineralization characteristic of perimenopause, coupled with suboptimal calcium intakes could precipitate another public health problem, osteoporosis. ^ Participants had different expectations about the role of medical care during perimenopause. Significantly more white (57%) than black (38% [A-A and AC]) women sought medical attention for symptoms. Whereas Hormone Replacement Therapy (HRT) was prescribed for 25% of them, only 13% were compliant at enrollment. ^ The trends and statistically significant findings of this study have huge public health policy implications. It is imperative that appropriate policies are formulated to ensure that America's ethnically diverse perimenopausal women have ready access to culturally appropriate care. This would optimize their health outcomes, and enhance their quality of life and productive capacities at this critical juncture of their lives. ^

A computer based approach to improve the dietary and physical activity patterns of a diverse group of adolescents

Diet and physical activity patterns have been implicated as major factors in the increasing prevalence of childhood and adolescent obesity. It is estimated that between 16 and 33 percent of children and adolescents in the United States are overweight (CDC, 2000). Moreover, the CDC estimates that less than 50% of adolescents are physically active on a regular basis (CDC, 2003). Interventions must be focused to modify these behaviors. Facilitating the understanding of proper nutrition and need for physical activity among adolescents is the first step in preventing overweight and obesity and delaying the development of chronic diseases later in life (Dwyer, 2000). The purpose of this study was to compare the outcomes of students receiving one of two forms of education (both emphasizing diet and physical activity), to determine whether a computer based intervention (CBI) program using an interactive, animated CD-ROM would elicit a greater behavior change in comparison to a traditional didactic intervention (TDI) program. A convenience sample of 254 high school students aged 14-19 participated in the 6-month program. A pre-test post-test design was used, with follow-up measures taken at three months post-intervention. ^ No change was noted in total fat, saturated fat, fruit/vegetables, or fiber intake for any of the groups. There was also no change in perceived self-efficacy or perceived social support. Results did, however, indicate an increase in nutrition knowledge for both intervention groups (p<0.001). In addition, the CBI group demonstrated more positive and sustained behavior changes throughout the course of the study. These changes included a decrease in BMI (ppre/post<0.001, ppost/follow-up<0.001), number of meals skipped (ppre/post<0.001), and soda consumption (ppre/post=0.003, ppost/follow-up=0.03) and an increase in nutrition knowledge (ppre/post<0.001, ppre/follow-up <0.001), physical activity (ppre/post<0.05, p pre/follow-up<0.01), frequency of label reading (ppre/follow-up <0.0l) and in dairy consumption (ppre/post=0.03). The TDI group did show positive gains in some areas post intervention, however a return to baseline behavior was shown at follow-up. Findings of this study suggest that compared to traditional didactic teaching, computer-based nutrition and health education has greater potential to elicit change in knowledge and behavior as well as promote maintenance of the behavior change over time. ^

Improving civil jury decision-making: Evidentiary and procedural issues

The civil jury has been under attack in recent years for being unreliable and incompetent. Considering the myriad causes for poor civil juror decision-making, the current investigation explores both procedural and evidentiary issues that impact juror's decisions. Specifically, the first phase of this dissertation examines how jurors (mis)use evidence pertaining to the litigants when determining liability and awarding damages. After investigating how jurors utilize evidence, the focus shifts to exploring the utility of procedural reforms designed to improve decision-making (specifically revising the instructions on the laws in the case and bifurcating the damage phases of the trial). Using the results from the first two phases of the research, the final study involves manipulating pieces of evidence related to the litigants while exploring the effects that revising the judicial instructions have on the utilization of evidence in particular and on decision-making in general. ^ This dissertation was run on-line, allowing participants to access the study materials at their convenience. After giving consent, participants read the scenario of a fictitious product liability case with the litigant manipulations incorporated into the summary. Participants answered several attitudinal, case-specific, and comprehension questions, and were instructed to find in favor of one side and award any damages they felt warranted. Exploratory factor analyses, Probit and linear regressions, and path analyses were used to analyze the data (M-plus and SPSS were the software packages used to conduct the analyses). Results indicated that misuse of evidence was fairly frequent, though the mock jurors also utilized evidence appropriately. Although the results did not support bifurcation as a viable procedural reform, revising the judicial instructions did significantly increase comprehension rates. Trends in the data suggested that better decision-making occurred when the revised instructions were used, thus providing empirical support for this procedural reform as a means of improving civil jury decision-making. Implications for actual trials and attorneys are discussed. ^

Development of a medium-capacity guideway transit planning guide

Rapid population increase and booming economic growth have caused a significant escalation in car ownership in many cities, leading to additional or, multiple traffic problems on congested roadways. The increase of automobiles is generating a significant amount of congestion and pollution in many cities. It has become necessary to find a solution to the ever worsening traffic problems in our cities. Building more roadways is nearly impossible due to the limitations of right-of-way in cities. Studies have shown that guideway transit could provide effective transportation and could stimulate land development. The Medium-Capacity Guideway Transit (MCGT) is one of the alternatives to solve this problem. The objective of this research was to better understand the characteristics of MCGT systems, to investigate the existing MCGT systems around the world and determine the main factors behind the planning of successful systems, and to develop a MCGT planning guide. The factors utilized in this study were determined and were analyzed using Excel. A MCGT Planning Guide was developed using Microsoft Visual Basic. ^ A MCGT was defined as a transit system whose capacity can carry up to 20,000 passengers per hour per direction (pphpd). The results shown that Light Rail Transit (LRT) is favored when peak hour demand is less than 13,000 pphpd. Automated People Mover (APM) is favored when the peak hour demand is more than 18,000 pphpd. APM systems could save up to three times the waiting time cost compared to that of the LRT. If comfort and convenience are important, then using an APM does make sense. However, if cost is the critical factor, then LRT will make more sense because it is reasonable service at a reasonable price. If travel time and safety (accident/crush) costs were included in calculating life-cycle “total” costs, the capital cost advantage of LRT disappeared and APM could become very competitive. The results also included a range of cost-performance criteria for MCGT systems that help planners, engineers, and decision-makers to select the most feasible system for their respective areas. ^

An analysis of student and instructor perceptions of students' writing skills at the university level

This study examined university students' writing skills as perceived by university students and their English instructors. The goal of the study was to provide English instructors with objective, quantified information about writing perceptions from both the students' and instructors' viewpoints. ^ A survey instrument was developed based on a survey instrument created by Newkirk, Cameron, and Selfe (1977) to identify instructors' perceived knowledge of student writing skills. The present study used a descriptive statistical design. It examined five writing skill areas: attitude, content, grammar and mechanics, literary considerations, and the writing process through a questionnaire completed by a convenience sample of summer and fall admitted freshmen who were enrolled in Essay Writing and Freshman Composition courses and English Department instructors at a large South Florida public university. ^ The study consisted of five phases. The first phase was modifying of the Newkirk, Cameron, and Selfe (1977) questionnaire. Two versions of the revised survey were developed - one for instructors and one for students. The second phase was pilot testing the questionnaire for evaluation of administration and scoring. The third phase was administering the questionnaire to 1,280 students and 48 instructors. The fourth phase was analyzing the data. The study found a significant difference in the perceptions of students and instructors in all areas of writing skills examined by the survey. Responses to 29 of 30 questions showed that students felt they had better attitudes toward writing and better writing skills than instructors thought. ^ The final phase was developing recommendations for practice. Based on findings and theory and empirical evidence drawn from the fields of adult education and composition research, learner-centered, self-directed curriculum guidelines are offered. ^ By objectively quantifying student and instructor perceptions of students' writing skills, this study contributes to a growing body of literature that: (a) encourages instructors to acknowledge the perception disparities between instructors and students; (b) gives instructors a better understanding of how to communicate with students; and (c) recommends the development of new curriculum, placement tests, and courses that meet the needs of students and enables English instructors to provide meaningful instruction. ^

Examining a proposed job retention model for adult workers with mental retardation in supported employment

This quantitative study investigated the predictive relationships and interaction between factors such as work-related social behaviors (WRSB), self-determination (SD), person-job congruency (PJC), job performance (JP), job satisfaction (JS), and job retention (JR). A convenience sample of 100 working adults with MR were selected from supported employment agencies. Data were collected using a survey test battery of standardized instruments. The hypotheses were analyzed using three multiple regression analyses to identify significant relationships. Beta weights and hierarchical regression analysis determined the percentage of the predictor variables contribution to the total variance of the criterion variables, JR, JP, and JS. ^ The findings highlight the importance of self-determination skills in predicting job retention, satisfaction, and performance for employees with MR. Consistent with the literature and hypothesized model, there was a predictive relationship between SD, JS and JR. Furthermore, SD and PJC were predictors of JP. SD and JR were predictors of JS. Interestingly, the results indicated no significant relationship between JR and JP, or between JP and JS, or between PJC and JS. This suggests that there is a limited fit between the hypothesized model and the study's findings. However, the theoretical contribution made by this study is that self-determination is a particularly relevant predictor of important work outcomes including JR, JP, and JS. This finding is consistent with Deci's (1992) Self-Determination Theory and Wehmeyer's (1996) argument that SD skills in individuals with disabilities have important consequences for the success in transitioning from school to adult and work life. This study provides job retention strategies that offer rehabilitation and HR professionals a useful structure for understanding and implementing job retention interventions for people with MR. ^ The study concluded that workers with mental retardation who had more self-determination skills were employed longer, more satisfied, and better performers on the job. Also, individuals whose jobs were matched to their interests and abilities (person-job congruency) were better at self-determination skills. ^

The impact of a family home-learning program on levels of parental/caregiver efficacy

This study sought to determine if participation in a home education learning program would impact the perceived levels of parental self-efficacy of parents/caregivers who participate in the completion of home-learning assignments and increase their levels of home-learning involvement practices. Also, the study examined the relationship between the parental involvement practice of completing interactive home-learning assignments and the reading comprehension achievement of first grade students. A total of 146 students and their parents/caregivers representing a convenience sample of eight first grade classes participated in the study. Four classes (n=74) were selected as the experimental group and four classes (n=72) served as the control group. There were 72 girls in the sample and 74 boys and the median age was 6 years 6 months. The study employed a quasi-experimental research design utilizing eight existing first grade classes. It examined the effects of a home-learning support intervention program on the perceived efficacy levels of the participating parents/caregivers, as measured by the Parent Perceptions of Parent Efficacy Scale (Hoover-Dempsey, Bassler, & Brissie, 1992) administered on a pre/post basis. The amount and type of parent involvement in the completion of home assignments was determined by means of a locally developed instrument, the H.E.L.P. Parent Involvement Home-learning Scale, administered on a pre/post basis. Student achievement in reading comprehension was measured via the reading subtest of the Brigance, CIB-S pre and post. The elementary students and their parents/caregivers participated in an interactive home-learning intervention program for 12 weeks that required parent/caregiver assistance. Results revealed the experimental group of parents/caregivers had a significant increase in their levels of perceived self-efficacy, p<.001, from the pre to post, and also had significantly increased levels of parental involvement in seven home-learning activities, p<.001, than the control group parents/caregivers. The experimental group students demonstrated significantly higher reading levels than the control group students, p<.001. This study provided evidence that interactive home-learning activities improved the levels of parental self-efficacy and parental involvement in home-learning activities, and improved the reading comprehension of the experimental group in comparison to the control.

How employees with different national identities experience a geocentric organizational culture of a global corporation: A phenomenological study

A global corporation values both profitability and social acceptance; its units mutually negotiate governance and represent a highly interdependent network where centers of excellence and high-potential employees are identified regardless of geographic locations. These companies try to build geocentric, or “world oriented” (Marquardt, 1999, p. 20), organizational cultures. Such culture “transcends cultural differences and establishes ‘beacons’ – values and attitudes – that are comprehensive and compelling” (Kets de Vries & Florent-Treacy, 2002, p. 299) for all employees, regardless of their national origins. Creating a geocentric organizational culture involves transforming each employee’s mindset, beliefs, and behaviors so that he/she can become “a world citizen in spite of having a national identity” (Marquardt, 1999, p. 47). The purpose of this phenomenological study was to explore how employees with different national identities experience a geocentric organizational culture of a global corporation. Phenomenological research aims to understand “how people experience some phenomenon—how they perceive it, describe it, feel about it, judge it, remember it, make sense of it, and talk about it with others” (Patton, 2002, p. 104). Twelve participants were selected using criteria, convenience, and snow-ball sampling strategies. A semi-structured interview guide was used to collect data. Data were analyzed inductively, using Moustakas’s (1994) Modification of the Stevick-Colaizzi-Keen Method of Analysis of Phenomenological Data. The participants in this study experienced a geocentric organizational culture of a global corporation as on in which they felt connected, valued, and growing personally and professionally. The participants felt connected to the companies via business goals and social responsibility. The participants felt valued by the company because their creativity was welcomed and they could contribute to the corporation certain unique knowledge of the culture and language of their native countries. The participants felt growing personally and professionally due to the professional development opportunities, cross-cultural awareness, and perspective consciousness. Based on the findings from this study, a model of a geocentric organizational culture of a global corporation: An employee perspective is proposed. Implications for research and practice conclude this study.