Diabetes Care Among Rural Americans

2008 ◽  
Vol 26 (1) ◽  
pp. 3-39 ◽  
Author(s):  
Sharon Williams Utz
Keyword(s):  
United States ◽  
Low Socioeconomic Status ◽  
Diabetes Care ◽  
Quantitative Methods ◽  
Minority Group ◽  
The United States ◽  
Urban Centers ◽  
Qualitative And Quantitative Methods ◽  
Program Evaluations ◽  
Complex Chronic Illness

The prevalence of diabetes in the United States is higher among those living in rural/nonmetropolitan statistical areas than in urban centers. Managing this complex chronic illness is complicated by factors such as limited access to care, low socioeconomic status, aging, and membership in a racial or ethnic minority group. A review of the literature was conducted focusing on research about rural Americans with diabetes by searching databases of CINAHL, PubMed, and MEDLINE, and selecting articles in English that were published between 2000 and 2007. Search terms included: nursing, research, rural, rural nursing, rural health services/programs, and diabetes care. Additional search strategies included journal hand searching and networking. Twenty-six research reports were found and included qualitative and quantitative methods and program evaluations. All regions of the United States were represented except the Northwest. The vast majority of research reports were of descriptive studies (n = 16), with program evaluation reports (n = 7) and studies testing an intervention (n = 3) also represented. The quality of each study is examined and summarized.

Social and Political Drivers of the Reorientation of U.S. Trade Policy: The Case of U.S. Withdrawal from the Trans-Pacific Partnership

2019 ◽  
Vol 6 (3) ◽  
pp. 199-218 ◽  
Author(s):  
Jesse Liss
Keyword(s):  
United States ◽  
Trade Policy ◽  
Multinational Corporations ◽  
Quantitative Methods ◽  
Political Power ◽  
Political Influence ◽  
The United States ◽  
Qualitative And Quantitative Methods ◽  
Stakeholder Groups ◽  
Sociological Explanation

Previous sociological studies demonstrated that U.S. multinational corporations (MNCs) had durable political power to motivate U.S. trade policy. However, why did the United States switch from a “free trade” to an “America First” trade agenda? Economists and political scientists argue that protectionist voters elected the protectionist candidate—Trump. An alternative sociological explanation is that U.S. MNCs lost political power to competing stakeholder groups. The article uses qualitative and quantitative methods to test these competing theories using the case study of the U.S. withdrawal from the Trans-Pacific Partnership (TPP). The article argues that both theories are necessary, and neither are sufficient. The United States withdrew from the TPP because increasing negative effects of trade and investment in the United States reshaped trade politics, especially on the republican side; however, power relations between stakeholder groups had to shift as well. U.S. MNCs lost political influence over trade policy to new domestic manufacturing organizations and their networks with labor and fair trade coalitions.

Lessons Learned about Evaluation in the United States and Some Possible Implications for Europe

1998 ◽  
Vol 14 (2) ◽  
pp. 97-115 ◽  
Author(s):  
Thomas D. Cook ◽  
Werner W. Wittmann
Keyword(s):  
United States ◽  
Quantitative Methods ◽  
Organizational Context ◽  
Social Scientist ◽  
The United States ◽  
Lessons Learned ◽  
Qualitative And Quantitative Methods ◽  
Political Interests ◽  
History Of ◽  
Applied Social Science

The history of program evaluation in the United States over the last 25 years is used to abstract themes that may be of importance to the development of evaluation in Europe. The themes relate to (1) the organizational context of evaluation, particularly as regards the tension between the different roles of the social scientist and the auditor; (2) the dependence of evaluation on politics, which entails that research findings be selectively used, and that evaluation questions serve some political interests more than others unless active steps are taken to make evaluations broadly accountable and their results widely disseminated; (3) the reality that most understandings of evaluation emphasize describing what programs have actually achieved, whereas some program planners want it to refer to the ex-ante task of analyzing what the results of a future program might be if it were to be implemented; (4) the mutually supportive roles that both qualitative and quantitative methods have to play in evaluation once the trap is avoided of assuming the supremacy of either one of these method types over the other; and (5) the limited value that can usually be assigned to the results of individual evaluations when compared to what careful literature reviews can accomplish. We argue that a flourishing evaluation culture requires strong methods, strong theory about the nature of evaluation and its links to use, plus continuous updates of what evaluations have discovered in different substantive areas. Today, North American evaluation is perhaps best characterized as applied social-science methods - and this may be too narrow a conception for evaluation to continue flourishing.

The cultural and religious animosity model: evidence from the United States

2017 ◽  
Vol 34 (2) ◽  
pp. 169-179 ◽  
Author(s):  
Morris Kalliny ◽  
Angela Hausman ◽  
Anshu Saran ◽  
Dina Ismaeil
Keyword(s):  
United States ◽  
Design Methodology ◽  
Quantitative Methods ◽  
The United States ◽  
Content Type ◽  
Qualitative And Quantitative ◽  
Qualitative And Quantitative Methods ◽  
Intention To Purchase ◽  
Model Evidence ◽  
Religious Constructs

Purpose The purpose of this paper is threefold: to extend the animosity model developed by Klein et al. (1998) by adding cultural and religious animosity constructs, to provide a tool with which to measure the cultural and religious constructs and to provide explanations, and thus an understanding, of how cultural and religious differences impact consumer intention to purchase. Design/methodology/approach Both qualitative and quantitative methods were used to test the model. Findings The cultural and religion animosity scale is created. Originality/value This fills a gap in the literature where there is not currently a scale to measure cultural or religious animosity.

scholarly journals Understanding and Promoting Racial Diversity in Healthcare Settings to Address Disparities in Pandemic Crisis Management

2021 ◽  
Vol 12 ◽  
pp. 215013272110183
Author(s):  
Azza Sarfraz ◽  
Zouina Sarfraz ◽  
Alanna Barrios ◽  
Kuchalambal Agadi ◽  
Sindhu Thevuthasan ◽  
...  
Keyword(s):  
United States ◽  
Health Disparities ◽  
Racial Discrimination ◽  
Clinical Training ◽  
Minority Groups ◽  
Mental Health Problems ◽  
Minority Group ◽  
Healthcare Delivery ◽  
The United States ◽  
Majority Group

Background: Health disparities have become apparent since the beginning of the COVID-19 pandemic. When observing racial discrimination in healthcare, self-reported incidences, and perceptions among minority groups in the United States suggest that, the most socioeconomically underrepresented groups will suffer disproportionately in COVID-19 due to synergistic mechanisms. This study reports racially-stratified data regarding the experiences and impacts of different groups availing the healthcare system to identify disparities in outcomes of minority and majority groups in the United States. Methods: Studies were identified utilizing PubMed, Embase, CINAHL Plus, and PsycINFO search engines without date and language restrictions. The following keywords were used: Healthcare, raci*, ethnic*, discriminant, hosti*, harass*, insur*, education, income, psychiat*, COVID-19, incidence, mortality, mechanical ventilation. Statistical analysis was conducted in Review Manager (RevMan V.5.4). Unadjusted Odds Ratios, P-values, and 95% confidence intervals were presented. Results: Discrimination in the United States is evident among racial groups regarding medical care portraying mental risk behaviors as having serious outcomes in the health of minority groups. The perceived health inequity had a low association to the majority group as compared to the minority group (OR = 0.41; 95% CI = 0.22 to 0.78; P = .007), and the association of mental health problems to the Caucasian-American majority group was low (OR = 0.51; 95% CI = 0.45 to 0.58; P < .001). Conclusion: As the pandemic continues into its next stage, efforts should be taken to address the gaps in clinical training and education, and medical practice to avoid the recurring patterns of racial health disparities that become especially prominent in community health emergencies. A standardized tool to assess racial discrimination and inequity will potentially improve pandemic healthcare delivery.

scholarly journals Asian American Older Adults and Social Isolation: A Systematic Literature Review

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 328-328
Author(s):  
Simona Kwon ◽  
Deborah Min ◽  
Stella Chong
Keyword(s):  
United States ◽  
Older Adults ◽  
Literature Review ◽  
Social Isolation ◽  
Asian Americans ◽  
Systematic Literature Review ◽  
Asian American ◽  
Minority Group ◽  
The United States ◽  
Eligibility Criteria

Abstract Asian Americans are the fastest growing racial and ethnic minority group in the United States, whose population is aging considerably. Previous studies indicate that social isolation and loneliness disproportionately affects older adults and predicts greater physical, mental, and cognitive decline. A systematic literature review using PRISMA guidelines was conducted to address this emerging need to understand the scope of research focused on social isolation and loneliness among the disparity population of older Asian Americans. Four interdisciplinary databases were searched: PubMed, CINAHL, PsycINFO, and AgeLine; search terms included variations on social isolation, loneliness, Asian Americans, and older adults. Articles were reviewed based on six eligibility criteria: (1) research topic relevance, (2) study participants aged &gt;60 years, (3) Asian immigrants as main participants, (4) conducted in the United States, (5) published between 1995-2019, and (6) printed in the English language. The search yielded 799 articles across the four databases and 61 duplicate articles were removed. Abstracts were screened for the 738 remaining studies, 107 of which underwent full-text review. A total of 56 articles met the eligibility criteria. Synthesis of our review indicates that existing research focuses heavily on Chinese and Korean American immigrant communities, despite the heterogeneity of the diverse Asian American population. Studies were largely observational and employed community-based sampling. Critical literature gaps exist surrounding social isolation and loneliness in Asian American older adults, including the lack of studies on South Asian populations. Future studies should prioritize health promotion intervention research and focus on diverse understudied Asian subgroups.

Site Selection Bias in Program Evaluation *

2015 ◽  
Vol 130 (3) ◽  
pp. 1117-1165 ◽  
Author(s):  
Hunt Allcott
Keyword(s):  
United States ◽  
Selection Bias ◽  
Site Selection ◽  
The United States ◽  
Randomized Control Trials ◽  
Program Evaluations ◽  
Out Of Sample ◽  
Target Treatment ◽  
Randomized Control ◽  
Selection For

Abstract “Site selection bias” can occur when the probability that a program is adopted or evaluated is correlated with its impacts. I test for site selection bias in the context of the Opower energy conservation programs, using 111 randomized control trials involving 8.6 million households across the United States. Predictions based on rich microdata from the first 10 replications substantially overstate efficacy in the next 101 sites. Several mechanisms caused this positive selection. For example, utilities in more environmentalist areas are more likely to adopt the program, and their customers are more responsive to the treatment. Also, because utilities initially target treatment at higher-usage consumer subpopulations, efficacy drops as the program is later expanded. The results illustrate how program evaluations can still give systematically biased out-of-sample predictions, even after many replications.

scholarly journals Clinical decision support alert malfunctions: analysis and empirically derived taxonomy

2017 ◽  
Vol 25 (5) ◽  
pp. 496-506 ◽  
Author(s):  
Adam Wright ◽  
Angela Ai ◽  
Joan Ash ◽  
Jane F Wiesen ◽  
Thu-Trang T Hickman ◽  
...  
Keyword(s):  
Decision Support ◽  
Electronic Health Record ◽  
Medical Informatics ◽  
Clinical Decision Support ◽  
Quantitative Methods ◽  
Clinical Decision ◽  
The United States ◽  
Health Record ◽  
Qualitative And Quantitative Methods ◽  
Electronic Health

Abstract Objective To develop an empirically derived taxonomy of clinical decision support (CDS) alert malfunctions. Materials and Methods We identified CDS alert malfunctions using a mix of qualitative and quantitative methods: (1) site visits with interviews of chief medical informatics officers, CDS developers, clinical leaders, and CDS end users; (2) surveys of chief medical informatics officers; (3) analysis of CDS firing rates; and (4) analysis of CDS overrides. We used a multi-round, manual, iterative card sort to develop a multi-axial, empirically derived taxonomy of CDS malfunctions. Results We analyzed 68 CDS alert malfunction cases from 14 sites across the United States with diverse electronic health record systems. Four primary axes emerged: the cause of the malfunction, its mode of discovery, when it began, and how it affected rule firing. Build errors, conceptualization errors, and the introduction of new concepts or terms were the most frequent causes. User reports were the predominant mode of discovery. Many malfunctions within our database caused rules to fire for patients for whom they should not have (false positives), but the reverse (false negatives) was also common. Discussion Across organizations and electronic health record systems, similar malfunction patterns recurred. Challenges included updates to code sets and values, software issues at the time of system upgrades, difficulties with migration of CDS content between computing environments, and the challenge of correctly conceptualizing and building CDS. Conclusion CDS alert malfunctions are frequent. The empirically derived taxonomy formalizes the common recurring issues that cause these malfunctions, helping CDS developers anticipate and prevent CDS malfunctions before they occur or detect and resolve them expediently.

scholarly journals Successful Schools, Stagnant Education

2015 ◽  
Vol 32 (4) ◽  
pp. 144-152
Author(s):  
Saulat Pervez
Keyword(s):  
United States ◽  
Private Education ◽  
The United States ◽  
Successful Schools ◽  
Muslim World ◽  
Urban Centers ◽  
Relevant Concept ◽  
The World

With so much focus on illiteracy, we sometimes forget the dire stateof affairs in our urban centers with regard to education. Educationin the Muslim world has increasingly regressed into an exercise ofrote learning, a mass of discrete knowledge, and a frenzied race towardwhat we deem “useful” skills. By showing the ground realityin private education in Karachi, Pakistan, this article strives to highlightthe cyclical and future-oriented trends in schools that are inimicalto the very spirit of education. In doing so, it emphasizes theneed to adopt thinking as the primary skill taught to students inschools, with everything else encompassed within its fold. WhileKarachi is a case study here, the importance of creating thinkingcultures within schools is a crucial and very relevant concept toschools everywhere in the world, including the United States.

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