Secondary Stroke Prevention Among Filipinos Compared with Other Racial Groups in Hawaii

Purpose/Background: As the fifth leading cause of death in the United States and a main cause of disability, stroke results in immense health and economic burden. Filipinos (FI) were found to have the highest mortality due to major CVD and stroke in Hawaii, and it is unclear whether the increased stroke risk among FI might be reduced by increasing the use of guideline recommended medications for secondary stroke prevention. Additionally, the attitudes and concerns of FI patients in Hawaii regarding stroke prevention have not been studied. The purpose of this study is to utilize a mixed-method approach to elucidate health disparities in FI after stroke compared with other racial groups in Hawaii, Whites, other Asians, Native Hawaiian and other Pacific Islanders (NHOPI) and other race. Materials & Methods: The Get With the Guidelines – Stroke (GWTG-Stroke) data from The Queenʼs Medical Center (QMC) will be used to identify patients hospitalized for stroke from years 2006-2016. Subjects will be excluded if diagnosed with non-ischemic stroke and with disposition other than home. Multivariable logistic regression models will examine differences in appropriate medication use at discharge related to race/ethnicity, controlling for age, sex, insurance, prior use of medications, and stroke risk factors. Additionally, semi-structured key informant interviews will be conducted among FI and other stroke patients from QMC. Transcripts from the interviews will be reviewed, coded, and interpreted for congruent themes. Results: Preliminary results from the GWTG-Stroke 2013 to 2016 data identified a total of 3574 stroke patients. After meeting inclusion criteria, a total of 1489 subjects were identified. The subjects included 398 Whites, 191 FI, 528 other Asian, 346 NHOPI, and 26 other race. At baseline, there was no difference in the average age of FI compared with Whites (66 vs 67 years old, respectively, P=0.15); however, other Asians (70 years old, P=0.002) were older, and NHOPI (60 years old, P\u3c0.001) were younger than Whites. Furthermore, FI, other Asians, and NHOPI had significantly higher rates of hypertension, diabetes mellitus, and dyslipidemia than Whites. Multivariable logistic regression results showed no statistically significant racial difference in prescribing of antithrombotics or statins at discharge. Age [OR=0.97; 95% CI (0.95, 0.995)], however, was a negative predictor of antithrombotic prescription, and being female [OR=0.68; 95% CI (0.51, 0.90)] was associated with lower rates of statin prescription on discharge (Table 1). Discussion/Conclusion: Analyses of data from a large hospital in Hawaii from 2013 to 2016 found race was not associated with prescribing differences for the guideline recommended medications for secondary stroke prevention. Further study is needed to better understand why female gender was associated with fewer statin prescriptions. The pending results of the key informant interviews may shed light on the attitudes and concerns regarding stroke prevention among FI and other racial groups in Hawaii

Facilitating Greenhouse Gas Reduction and Climate Change Adaptation within the Coastal Zone: A Policy Analysis for the California Coastal Commission

California is already experiencing impacts to its coastline due to climate change, and more severe impacts are anticipated if greenhouse gas emissions continue to rise. These climate change impacts are especially strong within the California coastal zone, which falls under the jurisdiction of the California Coastal Commission. The Commission has a history of rigorous environmental protection and is committed to protecting California’s coast through proactive planning and regulation, however they will need to initiate coastal policies with ambitious targets to facilitate effective climate change adaptation and mitigation. This study analyzed existing California climate policies and Coastal Commission policies to identify successes and gaps in the Commission’s work on climate change. Key findings include successful state funding mechanisms, energy saving state standards and ambitious state greenhouse gas reduction goals, as well as successful coastal adaptation projects and mechanisms throughout California. Findings also demonstrated a gap in the amount of funding currently available for coastal adaptation. Analysis of the Commission’s current climate adaptation policy suggests that the agency should amend their coastal act to reflect current pressing climate issues. To strengthen the Commission’s mission of protecting the California coastline, this study recommends that coastal developments obtain RELi resilience certification to ensure that coastal development can react to the shocks and stresses of climate change within the coastal zone. This analysis of policy options to strengthen the Commission’s climate policy yielded two alternative recommendations. The first recommends using a market mechanism to facilitate greenhouse gas reduction within the coastal zone, while the other recommends the implementation of a regulatory mandate. Both recommendations offer a suggested framework modeled after current California policy that works to facilitate funding for coastal adaption within the California coastal zone

The Impact of Social Class in the Hiring Process

Social class describes individuals’ possession of economic, social, and cultural capital, and their subjective social rankings relative to others (Bourdieu, 1984). As social class can be easily detected, it is quite likely that it plays a significant role in many workplace processes, such as selection. By considering the context of the hiring process, my dissertation explores the impact of social class from the perspective of hiring managers. First, I conducted a construct clarity study to clarify the multidimensional nature of the construct of social class. Second, using the factors found from my construct clarity study, I developed applicant stimulus materials (e.g., referral email, resume, video interviews) representative of three stages of the hiring process (e.g., acquiring, screening, and interviewing). Stimulus materials were presented to 78 participants in the acquiring stage, 105 participants in the screening stage, and 220 participants in the interviewing stage. Results of this dissertation find that hiring managers’ perceptions of applicant P-O fit are influenced by applicants’ social class. These effects are found during the acquiring stage and decrease in significance and prevalence as the hiring process progresses. Implications to research and practice as well as future directions for continued research on social class in the management literature are presented

The effect of ethnic-identity salience and negative performance feedback on African Americans\u27 explicit and implicit self-evaluations

The processes that underlie African Americans explicit versus implicit self-evaluations are examined by using the Associative Propositional Evaluative model (APE)

Effects of Amino Acid Supplementation of Reduced Crude Protein (RCP) Diets on the Performance and Carcass Quality of Growing-Finishing Swine

Barrows and gilts (215/gender) were used to test the effects of synthetic AA supplementation of reduced CP diets on the growth performance and quality characteristics of the LM and the fatty acid composition of the LM and s.c. jowl fat from growing-finishing swine. Pigs were blocked by BW within gender, and allocated randomly to pens (6 pigs/pen) which were then assigned randomly within each block and gender to either corn-SBM diets 1) that were devoid of synthetic lysine (Ctrl); 2) with reduced CP diets where lysine was added to all diets (RCP1); 3) with reduced CP where lysine, threonine, and tryptophan were added to all diets (RCP2); 4) with where lysine, threonine, and tryptophan were added to all diets (RCP3); or 5) with reduced CP diets where lysine, threonine, tryptophan, and isoleucine was added to all diets (RCP4). During finisher phase 3, 10 mg/kg of ractopamine was included in all diets. A subsample of whole pork loins was processed into chops for data collection. Another subsample from the whole pork loin and the s.c. fat from each jowl was freeze dried for fatty acid determination. Gilts had a greater (P = 0.02) (lightness) L* value and drip loss than barrows, but the ultimate pH, marbling, and intramuscular fat (IMF) of the LM were greater (P \u3c 0.04) for barrows than gilts. Color measurements were not affected (P \u3e 0.06) by the RCP diets, with the exception of redness (a*) which increased (P = 0.01) with decreasing CP levels. There were greater (P \u3c 0.001) proportions of SFA in the LM of barrows than the LM from gilts. However, gilts had an increase in PUFA content with decreasing levels of CP in the diet and barrows had a decrease in PUFA content of the LM (P = 0.056). Barrows had greater (P = 0.008) SFA and less (P \u3c 0.001) PUFA content in the jowl fat than gilts. The results point toward the reduced CP diets improving fresh pork quality, especially IMF. Also, pork lean and jowl fat were altered in their fatty acid composition by the reducing dietary CP

Life Science - STRUCTURE AND FUNCTION: Internal and External

Plants and animals evolve to survive and reproduce in their environments. Both their internal and external structures will be well suited to support survival, growth, behavior and reproduction. All animals have a mouth. Its function is to take in food, without which it could not survive to reproduce. The type of mouth, however, will vary between animals, depending on what they have evolved to eat. Internal organs of the digestive system will likewise vary depending on an animal’s diet. All parts of the system for eating and digesting food must work together. Plants also have internal systems for processing food and water. Although most of the “food” used by plants is produced in the leaves from air and light, many essential nutrients, like nitrogen, are brought in with water through the roots. A system of tubes, called the xylem, carry water from the roots up through the other structures of the plant, and finally to the leaves. A second system of tubes, called the phloem, carry sugars produced in the leaves down to all the other parts of the plant

Sales, The Process, Techniques, and It’s Application

Abstract In this paper, you will read about the entire sales process from open to close. The 7 main steps involved in selling will be explored. These steps are Prospecting, Qualification, Demonstration, Evaluation, Negotiation, Closing, and Nurturing (Freshworks, n.d.). There are many variations to each label of these steps but the main idea behind them remains; to fully understand the sales process, you must understand the concepts and objectives behind each step. After describing the sales steps, you will also read about different techniques used in each process described. The number of techniques available in each sales step is almost endless. Every salesperson has their own idea and personal experience with many techniques. There will be an abundance of these techniques explored and evaluated depending on the type of sale attempting to be achieved. Lastly, throughout the paper examples will be used to provide clarity for each sales step and technique. These examples will often involve general life experience to explain the idea that our entire life is a sale. This idea references the connection between daily life and the importance of communication, body language, and persuasion. These are keys features in the Sales Process. Keywords: Sales, Presentation, The Clos

Prospect Theory and Information Security Investment Decisions

Most articles that discuss the economics of security focus on the use of rational choice decision models for evaluating investment alternatives. However, security investment decisions involve risk and several researchers have noted that risk related decisions often violate the fundamental principles of rational choice decision models. Accordingly, we assert that problems exist with using these models to explain security investment decisions. Further, we believe that the development of prescriptive models to guide investment decisions requires a deeper understanding of the cognitive processes involved. To test these ideas, we introduce a study that uses prospect theory to analyze security practitioners’ investment decisions. The article includes a discussion of our methodology to electronically assess security practitioners’ preference patterns. Additionally, we discuss data collection efforts which are currently in-process and future plans to analyze the collected data. Interim analytical results of data received prior to AMCIS 2012 will be presented to conference attendees