Ecological Influences on Dietary Behavior: The Interaction Between Person and Neighborhood Environment in a Low-SES, Hispanic Community

Despite existing knowledge about lifestyle choices and their relationships to obesity and diabetes, the prevalence of Type 2 Diabetes Mellitus (T2DM) is increasing, and the number of Americans at risk is greater than 70% (CDC, 2019). Obesity is a complex, multifactorial, and largely preventable disease, affecting, along with overweight, over a third of the world\u27s population today. A significant factor in lifestyle management is the ecology of food choice. Literature suggests that environment and exposure can predict food-related health risk behaviors and health outcomes. The objective of this dissertation was to conceptualize and carry out a series of pilot studies relative to the refinement of nutrition ecological issues, methodologies, and measures. After a review of methodological difficulties, gaps, and unresolved issues, I propose methodological solutions, present the methodologies and results of pilot studies about the feasibility of these solutions. Study one involved database and windshield survey of more than 200 retail food locations in Jurupa Valley, CA. After redefining criteria for good quality food providers, this area was found to have an abundance of fast food and convenience stores and limited access to stores of the best nutritional quality. Study two included adaptations and implementation of a direct measure of the nutrition environment in Pomona, CA. The target area was a high-risk corridor with a concentration of both community activity and retail locations. Using database analysis and visual assessment, a list of stores was compiled, and of the 91 stores in the target area, 60 were surveyed for overall scores, which was a sum score of quality, accessibility, availability of fresh fruits and vegetables, and price. The results indicated that Grocery, Independent Market, and Ethnic Food outlets could be considered together as high-quality or at least higher quality in that they provided overall, price, access, and quality scores in the modified NEMS survey that were not statistically different from one another in quality of offerings (Kruskal-Wallis H X2(2) .386-6.726, p=. 035 to .832 (only significant value was for availability of fresh fruits and vegetables). Furthermore, all sub-types of convenience stores, including independent locations, those associated with a gas station, and liquor stores can be considered together, Kruskal-Wallis test X2(1.788-5.535) p= .63 to .409 (near-significant values for Price and Quality). Study three presents a methodology for accurately assessing the retail food environment using walking surveys on a GIS enabled mapping application. Results revealed significant inconsistencies between database (GIS) data and survey data acquired from current observations of the actual locations in the community; there was a 31% error in database findings. Additional comparisons were made between GIS results and participant data, which indicated possible patterns of positive or negative health and intake outcomes with neighborhood retail food availability. Results from this series of developmental studies indicated a need for primary data sources whenever possible for compiling information about retail food locations. As well, the methodology for collecting business-types from databases and for completing a safe and thorough environmental scan for retail food locations was presented in this dissertation. Additional findings indicated that a refined methodology to score store quality identified considerable variation between store types. These results may have implications for city planning, diabetes prevention, and lifestyle management programs

Coaching parents of children with ADHD: A Western Australian study

Parents of children with Attention Deficit/Hyperactivity Disorder (ADHD) often experience emotional and behavioural difficulties that contribute to stress and conflict in their family relationships. ADHD Parent Coaching is a promising intervention for these families; however, little is known about its effectiveness. This study explored the effects parent coaching had on parents of children with ADHD using descriptive case study methodology. A secondary purpose was to measure any reduction in stress and homework problems. A workshop offering solutions to homework-related issues was conducted over two consecutive weeks. Parents who attended (N=10) were offered parent coaching, and five parents were subsequently coached over a period of six to eleven weeks. Parents’ experiences of engaging with coaching were explored using thematic analysis of an interview conducted following the intervention (N=4). They also completed a Parent Stress Index (PSI) and Homework Problem Checklist (HPC) pre and post after intervention. Themes relating to mindfulness in parenting, changed parental cognitions, awareness of parenting styles, improved parent-child relationships, impacts on the wider family, and improved self-efficacy emerged from the interviews. The PSI results indicated significantly lower total parent stress scores following intervention while HPC scores were significantly improved. The results showed that parent coaching may produce positive outcomes, including reduced parental stress, increased self-efficacy and parent mindfulness

Outcomes after treatment of distal radius fractures with a volar locking plate or an external fixator

Samandrag på norsk Bakgrunn Bruk av volare låseplater (VLP) i behandling av ustabile ekstra-artikulære distale radiusfrakturar (DRF) har auka dei siste tiåra samstundes som bruk av ekstern fiksasjon (EF) er mindre vanleg. Denne endringa i kirurgisk tilnærming er berre til ei viss grad basert på forsking. Mål med Artikkel I var å avgjere om EF eller VLP gjer det beste resultatet i behandling av dislokerte distale ekstra-artikulære radiusfrakturar. Samanhengen mellom grad av radiografisk feilstilling og funksjonelt resultat for pasienten er usikker og kontroversiell. Mål med Artikkel II var å teste hypotesen at presis reponering av distale radiusfrakturar er korrelert med betre pasient rapporterte resultat (PROM). Komplekst regionalt smertesyndrom (CRPS) er ein alvorleg kronisk smertetilstand som kan føre til uttalte plager med smerte og redusert funksjon. Den vanlegaste utløysande årsaken til CRPS er brot i distale radius (DRF). I artikkel III såg ein på om det var auke risiko for å utvikle CRPS etter kirurgisk behandling for DRF med anten VLP eller EF. Metode Artikkel I og II er basert på 156 pasientar i alderen 18-70 år inkludert i ein randomisert klinisk studie. Pasientane hadde dislokerte, ekstra-artikulære DRF, AO type A3, som vart behandla på Haukeland Universitetssjukehus eller Voss sjukehus i perioden 2013-2017. Pasientane vart behandla med VLP eller EF og vart undersøkt 6 veker, 3 månader og 1 år etter operasjonen. Primært utfallsmål var Patient-Rated Wrist and Hand Evaluation-score (PRWHE). Sekundære utfall var Disabilities of the Arm, Shoulder and Hand-scores (QuickDASH), smerte (VAS), røyrsleutslag (ROM), gripestyrke, fingerstivheit og radiologiske målingar. Komplikasjonar og reoperasjonar vart også registrert. I Artikkel II vart korrelasjonen mellom radiografisk funn og funksjonelt resultat undersøkt ved bruk av Pearson korrelasjosanalyse. I Artikkel III vart data frå dei same 156 pasientane kopla saman med data frå ein annan RCT på distale radiusfrakturar utført ved Akershus Universitetsykehus. Det primære utfallsmålet for denne studien var CRPS diagnose basert på Budapest kriteria. Vi utførte ein logistisk regresjonsanalyse for å identifisere uavhengige risikofaktorar for å utvikle CRPS. Resultat 142 pasientar (91%) fullførte 1-års oppfølging. Gjennomsnittsalder var 56 år. Etter 6 veker var median PRWHE signifikant høgare for pasientar operert med EF samanlikna med VLP, men etter 3 mnd og 1 år var skilnaden ikkje lengre signifikant. Median QuickDASH var signifikant høgare for EF etter 6 veker og framleis ved 3 mnd. Smerte ved aktivitet, ekstensjon i handleddet og ulnar- og radial deviasjon var i favør av VLP etter 1 år, medan tal på alvorlege komplikasjonar var lik i dei to gruppene. I Artikkel II fann me ingen korrelasjon mellom radiografiske målingar og PRWHE etter 1 år i heile gruppa uavhengig av kva implantat som vart nytta. Artikkel III inkluderte 322 pasientar frå dei to RCTane. CRPS vart diagnostisert hjå 6 pasientar behandla med VLP (4%) og 16 pasientar behandla med EF (11%) (p=0,032), i alt 22 tilfelle av CRPS (7%). Risikoen for å utvikle CRPS var høgare (95% CI 1,1-7,2) for pasientar behandla med EF samanlikna med VLP. Konklusjon Artikkel I Pasientar operert med VLP kom seg raskare samanlikna med pasientar operert med EF. Eit år etter operasjonen fann me ingen skilnad i funksjonelt resultat. Artikkel II Me fann ingen korrelasjon mellom funksjonelt resultat (PRWHE) og radiologiske funn etter 1 år hjå pasientar med distale radiusfrakturar, AO type A3, operert med VLP eller EF. Andre faktorar var viktigare enn radiologiske målingar i denne pasientgruppa. Artikkel III Pasientar med distale radiusfrakturar operert med EF hadde høgare risiko for å utvikle CRPS samanlikna med dei som blei operert med VLP.Abstract Background/aims The use of volar locking plates (VLPs) for unstable extra-articular distal radius fracture (DRF) has increased in recent decades while external fixation is correspondingly less frequently used. This change of surgical approach has only to some extent been evidence based. The aim of Paper I was to determine whether an EF or VLP provides superior outcomes for treatment of displaced extra-articular DRF. The correlation between the degree of radiographic deformity and functional outcome of the fracture is controversial. The aim of Paper II was to test the hypothesis that precise restoration of distal radius fractures is correlated to better patient-reported outcome measures (PROMs). Complex regional pain syndrome (CRPS) is a severe chronic pain condition that can lead to a vicious circle of pain and disability. The most common cause of CRPS is a fracture of the distal radius (DRF). The aim of Paper III was to compare the risk of developing CRPS following surgical treatment of DRFs with a VLP or EF. Methods For Papers I and II the study included 156 patients, aged 18 to 70 years, in a multicentre, randomized controlled trial. Patients with displaced, extra-articular DRF, AO type A3, who attended Haukeland University Hospital or Voss Hospital, Norway between 2013 and 2017 were included. The patients were treated with a VLP or EF and examined at six weeks, three months and one year postoperatively. The primary outcome measure was the Patient-Rated Wrist and Hand Evaluation score (PRWHE). Secondary outcomes were Disabilities of the Arm, Shoulder and Hand scores (QuickDASH), pain (VAS), range of motion (ROM), grip strength, finger stiffness and radiological measurements. Complications and reoperations were also recorded. In Paper II the correlation between radiographic results and functional outcome was assessed using a Pearson correlation analysis. In Paper III the data from the same 156 patients were combined with data from another RCT on distal radius fractures conducted at Akershus University Hospital, Lørenskog, Norway. The primary outcome of this study was the diagnosis of CRPS according to the Budapest criteria. We conducted a logistic regression analysis to identify independent risk factors for the occurrence of CRPS, including age, gender, type of implant and fracture, energy of trauma, an additional fracture of the ulnar styloid, time to surgery and operation time. Results One hundred and forty-two patients (91%) completed one-year follow-up. Mean age was 56 years. At six weeks, the median PRWHE was significantly higher (worse) for EF than for VLP but at three months and one year, the difference was not significant. Median QuickDASH score was significantly higher for EF after six weeks and a significant difference persisted at three months. Pain during activity, wrist extension and ulnar and radial deviation were better with VLP after one year while the number of major complications was similar in the two groups. In Paper II we found no correlation between radiographic parameters and the PRWHE at one-year follow-up within the whole group, regardless of which treatment was chosen. Paper III included 322 patients from the two RCTs. A CRPS was diagnosed in six patients treated with VLPs (4%) and 16 patients receiving EFs (11%) (p=0.032). The risk of developing CRPS was higher for patients treated with EF compared to VLP (OR 2.78, 95% Confidence Interval 1.06-7.29). None of the other independent risk factors had a significant influence on the risk for CRPS (all p>0.05). Conclusions Paper I Patients treated with a VLP had earlier recovery of function than those treated with an EF. One year postoperatively, we found no significant functional difference. Paper II We found no correlation between functional outcome (PRWHE) and radiographic findings after one year in patients with AO type A3 distal radius fractures operated with a VLP or EF. Patient specific factors were more important than radiographic measurements in this study group. Paper III We observed, when merging data from the two RCTs that patients treated with an EF had a higher risk of developing CRPS compared to those treated with a VLP. We found no other independent variable predicting CRPS.Doktorgradsavhandlin

The relation between extracurricular activities with academic and social competencies in school age children: a meta-analysis

There has been a growing discussion in the fields of education and psychology about the relationship between social skill proficiency and academic excellence. However, the presence of extracurricular involvement as promoting both academic and social development has not been thoroughly explored. The most recent literature syntheses and meta-analyses on extracurricular activity participation were conducted in the 1980??s. An updated review and quantitative look at the participation literature is due. The purpose of this study is to integrate participation studies from the 1990s and give summative information as to the impact of extracurricular activity participation on various educational and psycho-social characteristics. Of the 164 identified studies, 41 were included in these meta-analyses. The current analyses produced 6 different activity categories: general extracurricular activity, sports, work and vocational activities, performing arts, pro-social activities, and community-based activities. The current meta-analyses suggest student outcomes were significantly related to general extracurricular activity and pro-social activity participation. General activities and pro-social activities had the most impact on academic achievement, while performing arts and pro-social activities?? participants reported the largest effect on identity and self esteem related outcomes. Sports and related activities (i.e. Cheerleading) were not as strongly linked to academic achievement indicators as anticipated and student workers had more negative outcomes than any other activity participants. In conclusion, the best outcomes for children and adolescents are brought about through well-built, developmentally appropriate structured activities. Moreover, the academic and social profits of extracurricular activities that have been examined in this study can be used to inform program planning and implementation

Merits Stripping

As the debate rages about the power and wisdom of Congress to “strip” federal courts of jurisdiction to adjudicate particular controversial federal issues, the discussion either ignores another means of constricting the power and influence of the courts. That is the distinct act of “merits stripping.” Merits stripping eliminates, limits, or diminishes enforceable substantive rights and the merits of claims brought to enforce those rights. Merits strips diminish the amount of real-world actors and conduct subject to legal duties and protected by legal rights. Merits striping limits who can sue whom over what conduct. Merits strips can target statutory or constitutional rights and can be affected by the legislative, executive, or judicial departments, acting individually or in concert. A “strip” occurs whenever the scope of legal rights (and the legal duties those rights impose on others) falls below some baseline of preexisting law or normative preference. Unfortunately, courts and commentators often conflate merits stripping with true jurisdiction stripping. But they are necessarily distinct concepts and such conflation confounds our ability to understand both. Three differences loom. First, while jurisdiction strips shift litigation out of federal court and into another forum (presumably state courts), merits strips eliminate enforceable rights altogether, in any forum. Second, the manner of litigating and resolving legal and factual issues will be different, depending on whether the “stripping enactment” being applied in court targets merits or jurisdiction; this distinction between merits stripping and jurisdiction stripping is a sub-category of the broader differences between judicial jurisdiction and substantive merits. Third, and most importantly, the structural and constitutional controversy surrounding the power to jurisdiction strip does not apply to merits stripping. Congress clearly has the power to redefine statutory rights, including narrowing those rights; courts clearly have the power to define constitutional rights, including narrowing those rights. One might disagree with the resulting scope of federal rights. But one cannot question the basic power to define those rights. This article defines and examines multiple examples of merits stripping of federal statutory and constitutional rights. It then considers the differences between merits stripping and jurisdiction stripping and how those differences play out in court. Ultimately, distinguishing these concepts is essential to understanding the operation of federal law in the federal courts

Western Australian Graduate Diploma of Education (Primary) Students\u27 Perceptions of Sustainability

In late 2011, the researcher investigated a cohort of Western Australian (WA) Graduate Diploma of Education Primary (GDE-P) students’ perceptions of Sustainability across a broad range of biophysical/natural, social and cultural, economic and political spheres. The study occurred during the seventh year of UNESCO’s Decade of Education for Sustainability Development, and when Sustainability Education became one of three cross-curriculum priorities of the new Australian Curriculum. Importantly, the students’ perceptions were interpreted during the context of the Post Global Financial Crisis and after Julia Gillard replaced Kevin Rudd as the Labor Prime Minister. The intense political context was often supported by controversial media debates covering a range of themes linked to Sustainability: Climate Change, the introduction of a carbon tax, global economics, population and the refugee crisis associated with the Christmas Island detention policy. The researcher sought to use an explanatory mixed methods approach for the investigation. However, measuring GDE-P students’ perceptions of Sustainability through a quantitative instrument proved to be unreliable and the researcher focused on interpretivist-constructivist qualitative methods. Subsequently, rich feedback from 18 students was obtained using semi-structured interviews that linked to both UNESCO’s definition of Sustainability and associate themes within the Australian political debate. The research findings underscore the multitude of factors that frame perceptions of the term Sustainability and the subjectivity that even well educated people encounter when dealing with this global priority. In addition, the research emphasises the need for its inclusion in pre-service teacher training, supported by ongoing professional learning for both pre-service and established primary teachers. It is vital teachers are aware of the complex themes within Sustainability as a key multimodal literacy and cross-curriculum priority in the emerging Australian Curriculum

Two perspectives on gifted students: Time One of a longitudinal study of academically gifted Iowa students, and program evaluation of CY-TAG, a summer residential program for highly gifted seventh and eighth grade students

This research consisted of two studies. First, benchmark data were collected and summarized for Time One of a time-series/longitudinal study of highly gifted Iowa students. Subjects were 417 seventh and eighth graders who were named Duke Talent Identification Program finalists;Most students were living with their natural parents who were characterized by high levels of education and employment in professional and technical occupations. Most respondents anticipated career choices in the professional and technical categories. Nearly all subjects reported plans to attend college, with public universities being named most often. Students were evenly divided on preferences for in- or out-of-state schools;Participants expressed positive attitudes related to school, self-perceived ability, self-esteem, and giftedness. In terms of values, they attached greatest significance to becoming recognized authorities in a particular field and helping others in difficulty. Students suggested that educators could be supportive of gifted students by providing academic challenge, by offering encouragement, and by facilitating improved understanding of giftedness;Program evaluation of the first session of CY-TAG (Challenges for Youth - Talented and Gifted) comprised the second part of the research project. During its first session, this three-week summer residential program offered fast-pace courses to 72 students who were Duke TIP finalists. Program evaluation involved four constituent groups: students, their parents, their school principals, and CY-TAG faculty/staff;Strengths of the program included students\u27 academic accomplishments, ability-peer interaction, and improved self-esteem. Recommendations focused on improving communication between staff and the constituent groups. Statistical tests revealed significant differences in terms of (a) satisfaction with various program aspects based on course enrollment, and (b) males who felt they received less attention from staff than did females. Results point to the need for greater staff awareness of the emotional and social needs and characteristics of gifted adolescents;Related research indicated that, in terms of learning style, CY-TAG participants differed significantly form a large pool of high school graduates. This finding supports the need for differentiated curriculum in gifted education

Choosing a career : a study of motivational factors and demographics that influence P-12 pre-service teachers.

The purpose of this study was to analyze motivational and demographic factors that influence pre-service teachers’ decision to become teachers. The theoretical framework used in this study is the Factors Influencing Teaching Choice (Richardson & Watt, 2006), which is rooted in Expectancy Choice (Wigfield & Eccles, 2000) and Social Cognitive theories (Bandura, 1997). The results indicated that the motivational factors did not significantly influence respondents choices. The demographic factors, gender, ethnicity, type of program, and type of certification, were not significantly associated with motivational factors that influence pre-service teachers to choose teaching as a career. Findings suggest in terms of policy, changes to teacher preparation programs should be leveraged to prepare a diverse pool of social persuaders who will shape the future of the teaching profession. In terms of research, future and longitudinal studies which employ mixed methods are needed in order to explore further the motivational factors and the ongoing nature of these in pre-service teacher preparation and induction to the profession. In terms of practice, the teaching profession needs practitioners and teacher preparation programs to address and further develop increased social equity awareness among pre-service and new teachers. Teacher preparation programs and school districts are advised to design, provide, and upkeep appropriate support systems to help pre-service teachers and teachers new to the profession to successfully navigate and cope with the challenges of the 21st century, in their classrooms and for their P-12 students as world citizens

The Influence of Subject Sophistication on the Ability to Feign Mild Head Injury Symptoms.

The present study examined the effects that personal experience with head injury, task specific instruction and brain injury knowledge have on the ability to feign postconcussion symptoms and neuropsychological performance patterns seen in mild head injured patients. A sample of non-head injured and head injured college students served as the experimental subjects. These subjects were randomly assigned to conditions in which they were told to either do their best, feign deficits consistent with mild head injury without task specific instruction, or feign deficits while given task specific instruction. Subjects were also classified into one of two head injury knowledge groups based upon above average or below-to-average performance on a head injury misconception survey. Postconcussive symptom complaints were affected by head injury knowledge, instruction, and gender. Coached male malingerers with above average head injury knowledge endorsed relatively higher rates of postconcussive symptoms than any of the other groups. However, other malingering groups accurately simulated levels of postconcussive symptoms seen in the mild head injured patients. Performance on malingering tests was affected by instruction to simulate head injury, however coaching was not shown to produce a more realistic pattern of performance on the malingering tests relative to the head injured patients. The results of this study indicate that analog malingerers can accurately replicate self-reported postconcussive symptoms reported in mild head injured patients. However, malingering subjects are unable to simulate mild head injured patient\u27s performance on clinical malingering tests. These results suggest that self-report measures of postconcussive symptoms and clinical tests are differentially vulnerable to instructions to malinger. In summary, personal experience, accuracy of head injury beliefs, and test specific coaching did not contribute to a more realistic mild head injury profile

Examining commitment and heterogeneity within the membership base of agricultural co-operatives : an empirical study of a large New Zealand dairy co-operative : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Agribusiness at Massey University, New Zealand

A strong relationship between member and co-operative is vital for agricultural co-operatives. Yet most of the research on agricultural co-operatives is centered on non-relational aspects such as efficiency. Although these conventional economic centric approaches are useful in understanding co-operatives and evaluating its performance, they are not comprehensive enough. Studies on the member - co-operative relationship which require an examination of co-operatives from a socio-psychological perspective are lacking. This research gap is addressed in this thesis via first identifying three important socio-psychological phenomena in agricultural co-operatives – 1. Commitment, 2. Heterogeneity and 3. Social Capital, and presenting a conceptual framework that links the three. Thereafter, the commitment and heterogeneity sub-components of the framework were further unravelled and empirically examined by randomly surveying 2,000 members of Fonterra Co-operative Group, of which 568 responded. The organisational commitment dimension of commitment is decoupled into three components – affective (emotive), normative (ideological) and continuance (utilitarian), and the commitment to collective action dimension into two components – patronage and governance. Fonterra had moderately high levels of affective, moderate levels of normative and slightly low levels of continuance commitment. The level of commitment to collective action was moderately high as the levels of commitment to both patronage and governance were moderately high. Importantly, there was a positive association between commitment to collective action and affective and normative commitment but not continuance commitment. This suggests that it is the emotive followed by ideological aspects of membership that influence a member’s commitment to collective action, and not the utilitarian or financial benefit aspects. Heterogeneity was measured and analysed using 35 heterogeneity sources that were categorized under three dimensions – farmer-member, farm-business and member-interest. Fonterra had high levels of heterogeneity with most of the sources in all three dimensions showing high heterogeneity. Of the three dimensions, member-interest, followed by farm-business showed the greatest heterogeneity and sources within them were most likely to result in differences in affective commitment, normative commitment, continuance commitment, commitment to collective action as well as commitment to governance and patronage. In contrast, most of the sources within the farmer-member dimension were not associated with either organisational commitment or commitment to collective action