Playing in the Giant\u27s Field: Strategies for Effectively Competing in the Global Marketplace

This article inversitgates how a smaller, less resource-rich competitor can successfully out-maneuver a stronger opponent

Fossils Aren\u27t Found in Appalachia

Pages 9-1

The Effectiveness of Registered Dietitians in Diabetes Case Management

OBJECTIVE: The objective of this paper is to investigate the effectiveness of diabetes education provided by registered dietitians (RD) in a diabetes case management (DCMs) model, compared to diabetes education provided by RDs in the usual care model (UCM) at an outpatient endocrinology clinic in Omaha, Nebraska. This study hypothesizes that education by RD DCMs will be equal or more efficacious in regards to primary outcomes of A1C and BMI and secondarily, lipid results and adherence (total encounters) when compared to outcomes of UC. METHODS: This is a cross sectional retrospective review of patients with diabetes (n=946), receiving traditional RD education (n=445) and DCM (n=501). Groups had like distribution of A1C and lipids at baseline. The DCM group had a higher BMI, higher percentage of male subjects and older population compared to the UCM at baseline. BMI, Lipids, A1C and total encounters were compared from initial visit to 12 months. SPSS software provided descriptive statistics of the sample groups and independent samples t-test for differences of means between groups. P-value of \u3c 0.5 was considered statistically significant. RESULTS: Primary outcomes were endpoint A1C and BMI and mean change in A1C and BMI at 1 year. Endpoint A1C was lower in the DCM (8.0 vs. 8.4, p= 0.02). Mean A1C change was -0.4 in DCM, compared with - 0.2 in UCM (p=0.06). Endpoint BMI was higher in the DCM (32.7 vs 31.5, p=0.04), however BMI declined slightly (- 0.04) in DCM and increased slightly (+ 0.2) in the UCM (p=0.07). Secondary findings included greater mean change in LDL in DCM (+1.78 vs - 4.16, p=0.002) and higher number of overall encounters with RD (10.01 vs 7.39) and Endocrinogist (11.11 vs 8.22) (p=0.001) in DCM group. No significant differences were found in HDL or Triglycerides. CONCLUSION: The DCM group had improvements in endpoint and change in A1C and change in LDL. Of note, the DCM group results for mean change in BMI showed a trend toward significance. DCM subjects attended more visits with the RD and Endcrinologist, suggesting more engagement in the DCM than the UCM. Further research should analyze interventions within the DCM model, compared to the UCM. Additional study is needed regarding cardiovascular risk benefit over time and cost-benefits of the model

The attitudes of ten pediatric staff nurses toward rooming-in-mothers

Thesis (M.S.)--Boston Universit

Anesthetic Implications of Robotic Gynecologic Surgery

Surgery using robotic techniques is becoming more and more common. One of the specialties at the fore-front of robotic surgery has been gynecology, much like it was at the fore-front a generation ago in bringing laparoscopy into the operating room. New considerations have been noted and new techniques have been learned on both sides of the drape in order to ensure a successful outcome for the patient undergoing robotic gynecologic surgery. The purpose of this article is to bring, to light the concerns facing the anesthesiologist in regards to robotic procedures. We discuss the problems facing anesthesiologists, when a patient is experiencing both intraabdominal insufflation and steep Trendelenburg position, and also the intraoperative management of such a patient

A Study of Change in Student’s Critical Thinking in the Social Studies as Related to a Modification of the Curriculum

It was the purpose of this study to discover the extent to which the social studies curriculum of the Highline Public Schools for Sixth Grade creates constructive critical thinking on the part of the students in relation to preconceived attitudes and concepts directed toward people in other lands. More specifically the problem was to determine how modifications in the social studies course content affect critical thinking and attitudes of students

Where does all the money go? an investigation of donation filtration

This paper is divided into three sections. The first section profiles three charities. The second section discusses the lack of established quantitative and qualitative measures to judge a charity’s performance; i.e., the degree to which a charity is successful at accomplishing its stated aims. It then goes on to suggest certain measures a charity can be evaluated against to evaluate the degree of its success. The paper uses these guidelines to measure the comparative success of each of the profiled charities. The third section finishes with recommendations for making charitable behaviours a widespread phenomenon that will further contribute to the success of each organization

Post-materialism's "silent revolution" in consumer research: still silent after all these years

The Protestant work ethic, with its emphasis on ever-increasing levels of production, contributed to the rise of the consumption culture and the legitimization of the market society. It appears that the very premise of the market society--specialization and the production of consumption--also paves the way for a post-materialist revolution