Johnson & Wales University

Diabetes is a complex and challenging disease that requires daily self-management decisions made by the person with diabetes. Diabetes self-management education and support (DSMES) addresses the comprehensive blend of clinical, educational, psychosocial, and behavioral aspects of care needed for daily self-management and provides the foundation to help all people with diabetes navigate their daily self-care with confidence and improved outcomes (1,2). The prevalence of diagnosed diabetes is projected to increase in the U.S. from 22.3 million (9.1% of the total population) in 2014, to 39.7 million (13%) in 2030, and to 60.6 million (17%) in 2060 (3). Approximately 90–95% of those with diabetes have type 2 diabetes (4). Diabetes is an expensive disease, and the medical costs of health care alone for a person with diabetes are 2.3 times more than for a person without diabetes (5). Confounding the diabetes epidemic and high costs, therapeutic targets are not being met (6). There is a lack of improvement in reaching clinical target goals since 2005 despite advancements in medication and technology treatment modalities. Indeed, between 2010 and 2016 improved outcomes stalled or reversed (6). The goals of this Consensus Report are to improve clinical care and education services, to improve the health of individuals and populations, and to reduce diabetes-associated per capita health care costs (1,7). This article is specifically directed toward health care providers (physicians, nurse practitioners, physician assistants [PAs]), referred to herein as providers, as it outlines the benefits of DSMES, defines four critical times to provide and modify DSMES (see Fig. 1), proposes how to locate DSMES-related resources, and discusses potential solutions to access and utilization barriers. This report provides guidance to others as well: health systems and organizations can use this report to anticipate and address the needs of persons with …

Investigations of the causal relationship between organizational commitment and job satisfaction have yielded contradictory findings. Little empirical research has looked at this complex relationship in the context of work effort. The purpose of this study was to determine how these variables interact in the service environment. Using a sample of 425 employees in two service organizations, the author tested two structural equation models. The hypothesized model with organizational commitment as a moderator between job satisfaction and service effort fit better than a model with job satisfaction as moderator did. Conceptual implications are discussed, and suggestions for future research are made.

The body of evidence from the past three decades demonstrates that oxidative stress can be involved in several diseases. This study aims to summarise the current state of knowledge on the association between oxidative stress and the pathogenesis of some characteristic to the biological systems diseases and aging process. This review also presents the effect of physical activity on redox homeostasis. There is strong evidence from studies for participation of reactive oxygen and nitrogen species in pathogenesis of acute and chronic diseases based on animal models and human studies. Elevated levels of pro-oxidants and various markers of the oxidative stress and cells and tissues damage linked with pathogenesis of cancer, atherosclerosis, neurodegenerative diseases hypertension, diabetes mellitus, cardiovascular disease, atherosclerosis, reproductive system diseases, and aging were reported. Evidence confirmed that inflammation contributes widely to multiple chronic diseases and is closely linked with oxidative stress. Regular moderate physical activity regulates oxidative stress enhancing cellular antioxidant defence mechanisms, whereas acute exercise not preceded by training can alter cellular redox homeostasis towards higher level of oxidative stress. Future studies are needed to clarify the multifaceted effects of reactive oxygen/nitrogen species on cells and tissues and to continue study on the biochemical roles of antioxidants and physical activity in prevention of oxidative stress-related tissue injury.

The maintenance of well-being, healthcare, and social connection is crucial for older adults (OA) and has become a topic of debate as much of the world faces lockdown during the coronavirus disease 2019 (COVID-19) pandemic. OAs have been advised to isolate themselves because they are at higher risk for developing serious complications from severe acute respiratory syndrome coronavirus. Additionally, nursing homes and assisted-living facilities across the country have closed their doors to visitors to protect their residents. Mobile technology such as applications (apps) could provide a valuable tool to help families stay connected, and to help OAs maintain mobility and link them to resources that encourage physical and mental well-being. Apps could address cognitive, visual, and hearing impairments. Our objective was to narratively summarize 15 apps that address physical and cognitive limitations and have the potential to improve OAs' quality of life, especially during social distancing or self-quarantine.

BACKGROUND: Behavioral economic alcohol purchase tasks (APTs) are self-report measures of alcohol demand that assess estimated consumption at escalating levels of price. However, the relationship between estimated performance for hypothetical outcomes and choices for actual outcomes has not been determined. The present study examined both the correspondence between choices for hypothetical and actual outcomes, and the correspondence between estimated alcohol consumption and actual drinking behavior. A collateral goal of the study was to examine the effects of alcohol cues on APT performance. METHODS: Forty-one heavy-drinking adults (56% men) participated in a human laboratory protocol comprising APTs for hypothetical and actual alcohol and money, an alcohol cue reactivity paradigm, an alcohol self-administration period, and a recovery period. RESULTS: Pearson correlations revealed very high correspondence between APT performance for hypothetical and actual alcohol (ps < 0.001). Estimated consumption on the APT was similarly strongly associated with actual consumption during the self-administration period (r = 0.87, p < 0.001). Exposure to alcohol cues significantly increased subjective craving and arousal and had a trend-level effect on intensity of demand, in spite of notable ceiling effects. Associations among motivational indices were highly variable, suggesting multidimensionality. CONCLUSIONS: These results suggest there may be close correspondence both between value preferences for hypothetical alcohol and actual alcohol, and between estimated consumption and actual consumption. Methodological considerations and priorities for future studies are discussed.

Microgreens are young, tender greens that are used to enhance the color, texture, or flavor of salads and main dishes. They can be grown in small scales and indoors, making them widely adopted by controlled environment agriculture, an indoor farming practice is particularly important for feeding increasing urban populations. Besides, microgreens are attracting more consumers’ attention due to their high nutritional value and unique sensory characteristics. This review focuses on the nutrition quality, sensory evaluation, pre- and post-harvest interventions, and health benefits of microgreens. Microgreens are rich in vitamins (e.g., vitamin C), minerals (e.g., copper and zinc), and phytochemicals, including carotenoids and phenolic compounds, which act as antioxidants in human body. Pre-harvest interventions, such as illumination, salinity stress, nutrient fortification, and natural substrates, influence the photosynthetic and metabolic activities of microgreens and were shown to improve their nutritional quality, while the effects varied among species. After harvesting, packaging method and storage temperature can influence the nutrient retention in microgreens. Both in vitro and in vivo studies have shown that microgreens have anti-inflammatory, anti-cancer, anti-bacterial, and anti-hyperglycemia properties, making it a new functional food beneficial to human health. The sensory attributes and overall acceptability and liking of microgreens are primarily influenced by their phytochemical content. Microgreens are only getting popular during the last decades and research on microgreens is still at its early stage. More studies are warranted to optimize the pre- and post-harvest practices for nutrient enhancement and retention and to explore the potential health benefits of different microgreens for the prevention and treatment of chronic diseases.

Extensive research has found strongly increased generation of reactive oxygen species, free radicals, and reactive nitrogen species during acute physical exercise that can lead to oxidative stress (OS) and impair muscle function. Polyphenols (PCs), the most abundant antioxidants in the human diet, are of increasing interest to athletes as antioxidants. Current literature suggests that antioxidants supplementation can effectively modulate these processes. This overview summarizes the actual knowledge of chemical and biomechanical properties of PCs and their impact as supplements on acute exercise-induced OS, inflammation control, and exercise performance. Evidence maintains that PC supplements have high potency to positively impact redox homeostasis and improve skeletal muscle's physiological and physical functions. However, many studies have failed to present improvement in physical performance. Eleven of 15 representative experimental studies reported a reduction of severe exercise-induced OS and inflammation markers or enhancement of total antioxidant capacity; four of eight studies found improvement in exercise performance outcomes. Further studies should be continued to address a safe, optimal PC dosage, supplementation timing during a severe training program in different sports disciplines, and effects on performance response and adaptations of skeletal muscle to exercise.

BACKGROUND: Prevalence rates of women in community samples who screened positive for meeting the DSM-IV criteria for posttraumatic stress disorder after childbirth range from 1.7 to 9 percent. A positive screen indicates a high likelihood of this postpartum anxiety disorder. The objective of this analysis was to examine the results that focus on the posttraumatic stress disorder data obtained from a two-stage United States national survey conducted by Childbirth Connection: Listening to Mothers II (LTM II) and Listening to Mothers II Postpartum Survey (LTM II/PP). METHODS: In the LTM II study, 1,373 women completed the survey online, and 200 mothers were interviewed by telephone. The same mothers were recontacted and asked to complete a second questionnaire 6 months later and of those, 859 women completed the online survey and 44 a telephone interview. Data obtained from three instruments are reported in this article: Posttraumatic Stress Disorder Symptom Scale-Self Report (PSS-SR), Postpartum Depression Screening Scale (PDSS), and the Patient Health Questionnaire-2 (PHQ-2). RESULTS: Nine percent of the sample screened positive for meeting the diagnostic criteria of posttraumatic stress disorder after childbirth as determined by responses on the PSS-SR. A total of 18 percent of women scored above the cutoff score on the PSS-SR, which indicated that they were experiencing elevated levels of posttraumatic stress symptoms. The following variables were significantly related to elevated posttraumatic stress symptoms levels: low partner support, elevated postpartum depressive symptoms, more physical problems since birth, and less health-promoting behaviors. In addition, eight variables significantly differentiated women who had elevated posttraumatic stress symptom levels from those who did not: no private health insurance, unplanned pregnancy, pressure to have an induction and epidural analgesia, planned cesarean birth, not breastfeeding as long as wanted, not exclusively breastfeeding at 1 month, and consulting with a clinician about mental well-being since birth. A stepwise multiple regression revealed that two predictor variables significantly explained 55 percent of the variance in posttraumatic stress symptom scores: depressive symptom scores on the PHQ-2 and total number of physical symptoms women were experiencing at the time they completed the LTM II/PP survey. CONCLUSION: In this two-stage national survey the high percentage of mothers who screened positive for meeting all the DSM-IV criteria for a posttraumatic stress disorder diagnosis is a sobering statistic.

Inhibitory constants (Ki) between 5 and 35 nM were derived (under different conditions of pH and ionic strength) for the interaction of HIV-1 proteinase with acetyl-pepstatin and H-261, two characteristic inhibitors of aspartic proteinases. Thus this enzyme, essential for replication of the AIDS virus, may be classified unequivocally as belonging to this proteinase family.

While employee turnover has long been recognized as a critical factor to be effectively managed by the hospitality industry, there has been little effort aimed at developing a systematic model to address and predict employee intentions to stay. This research investigated the effects of individual and organizational factors on job satisfaction and intent to stay of hotel and restaurant employees. Analysis of 221 responses obtained from a survey reveals that “job characteristics”, “participative decision-making”, and “pressure/stress”, can be good predictors of “job satisfaction”, while “supervisory leadership” and “intrinsic motivation” may not be a good predictors of “job satisfaction”. Somewhat unpredictably, both “intrinsic motivation” and “supervisory leadership” emerge as sound predictors of employee “intent to stay”. Based on the findings, several managerial implications are discussed.

ABSTRACT By considering differences in culture and economic conditions in two different countries, India and the United States, this study investigates the psychological factors (consumers' attitudes, behavioral intentions, and involvement) in relation to Green practices (GP) in the restaurant industry as measured by three concerns (health, social, and environmental). Next, the study examines how these factors affect consumers' willingness to pay for GP. Results from principal component analyses and multinomial logistic regressions with data from India (n = 196) and the United States (n = 200) (collected from customers at two comparable commercial restaurants in each country) show that there is a clear difference in consumers' attitudes, behavioral intentions, and involvement in GP and the relationship of these factors to the consumers' willingness to pay. The findings of this study showed that consumers in the United States have a higher degree of involvement in environmentally and socially responsible practices in restaurants, which have the most significant effect on consumers' willingness to pay up to 10% or higher on menu prices for GP. In contrast, consumers in India have a higher degree of involvement in health and visibility than consumers in the United States, which is the major driver of their willingness to pay more than 10% or higher on menu prices for GP.

on This Planet? 623 Chapter 9.

OBJECTIVE: Alcohol marketing has proliferated on digital media, such as websites, social media, and apps. A systematic review was conducted to examine studies of associations between exposure to digital alcohol marketing and alcohol consumption. METHOD: Eight electronic databases were searched for "alcohol" and "marketing" through 14 February 2017. Studies were included if exposure to digital alcohol marketing and alcohol consumption, or related attitudes and intentions, were assessed. Studies were excluded if they only measured exposure to alcohol depictions posted online by family and friends. Study quality was also assessed. RESULTS: In all, 25 studies were included, including 2 randomized controlled trials, 15 cross-sectional studies, and 8 prospective cohort studies. There was a consistent finding across studies that participation and engagement with digital alcohol marketing--such as clicking on an alcohol ad, visiting an alcohol-branded website, liking or sharing an ad on social media, or downloading alcohol-branded content--was positively associated with alcohol use. The effects of simple exposure to digital alcohol advertising were inconclusive. Proper blinding of subjects, measuring exposures before the outcomes, and measuring the exposures multiple times would improve study quality. CONCLUSIONS: Although more research is needed, existing studies suggest that engagement with digital alcohol marketing is positively associated with increased alcohol consumption and increased binge or hazardous drinking behavior. Governments should consider implementing digital alcohol marketing regulations under the precautionary principle as the alcohol industry's self-regulated marketing codes are likely ineffective at protecting populations vulnerable to alcohol-related harm.

This study utilizes data collected from Greece and the United States to examine consumer attitudes and behavior intentions toward the environmentally responsible practices (ERP) of hotels. Specifically examined is the impact of ERP on consumers' willingness to pay (WTP) for such hotel practices. The results indicate that consumers in both countries were more likely to patronize and demonstrate a strong WTP for hotels that provide ERP. Furthermore, the results reveal that consumers in Greece have higher environmental concerns and WTP than those in the United States, confirming that differences in culture and social structure determine a consumer's Green orientation and WTP.

An attacker wishing to disrupt a wireless network has a wide arsenal available to them. Many of these tools rely on using a faked MAC address, masquerading as an authorized wireless access point or as an authorized client. Using these tools, an attacker can launch denial of service attacks, bypass access control mechanisms, or falsely advertise services to wireless clients. This presents unique opportunities for attacks against wireless networks that are difficult to detect, since the attacker can present himself as an authorized client by using an altered MAC address. As nearly all wireless NICs permit changing their MAC address to an arbitrary value – through vendor-supplied drivers, open-source drivers or various application programming frameworks – it is trivial for an attacker to wreak havoc on a target wireless LAN. This paper describes some of the techniques attackers utilize to disrupt wireless networks through MAC address spoofing, demonstrated with captured traffic that was generated by the AirJack, FakeAP and Wellenreiter tools. Through the analysis of these traces, the author identifies techniques that can be employed to detect applications that are using spoofed MAC addresses. With this information, wireless equipment manufacturers could implement anomalybased intrusion detection systems capable of identifying MAC address spoofing to alert administrators of attacks against their networks.

Early growth response factor-1 (Egr-1) controls the expression of a growing number of genes involved in the pathogenesis of atherosclerosis and postangioplasty restenosis. Egr-1 is activated by diverse proatherogenic stimuli. As such, this transcription factor represents a key molecular target in efforts to control vascular lesion formation in humans. In this study, we have generated DNAzymes targeting specific sequences in human EGR-1 mRNA. These molecules cleave in vitro transcribed EGR-1 mRNA efficiently at preselected sites, inhibit EGR-1 protein expression in human aortic smooth muscle cells, block serum-inducible cell proliferation, and abrogate cellular regrowth after mechanical injury in vitro. These DNAzymes also selectively inhibit EGR-1 expression and proliferation of porcine arterial smooth muscle cells and reduce intimal thickening after stenting pig coronary arteries in vivo. These findings demonstrate that endoluminally delivered DNAzymes targeting EGR-1 may serve as inhibitors of in-stent restenosis.

This study reviews empirical evidence from four research methods related to the impact of money on short‐term nominal rates. The studies consistently fail to find evidence supporting the much hypothesized short‐term, negative relationship between money and nominal rates since at least April 1975. Reasons for the absence of a negative relationship include the tendency of financial markets to anticipate corrective action by the Fed whenever Ml deviates from targeted growth ranges and a rapid adjustment of inflationary expectations to changes in money growth.

Organizational vision is a generally accepted necessity for organizational success in the 1990s. Specifically, stakeholder attitude toward the vision is believed to improve performance and enhance efforts toward increased quality. To date, little empirical research has proven that attitude toward the organizational vision yields any measurable organizational outcomes. The purpose of this exploratory study was to determine if stakeholder satisfaction with organizational vision was associated with overall job satisfaction and perceived effort. A sample of 709 cruise line managers responded to the 31‐item questionnaire and a service effort scale developed for this study. Both exploratory and confirmatory factor analyses were conducted to define the constructs and establish the measurement properties of the structural equation model tested. Results indicated that satisfaction with vision accounted for 33 per cent and 21 per cent of the variance in job satisfaction and service efforts respectively. Conceptual and theoretical implications of the results are discussed.

Purpose – Delighting customers by pleasant surprises is a common strategy, yet the potential downside of such a strategy (i.e. raising customer expectations) has received scant attention. The purpose of this study is to examine the role of explanations as a solution to control customers ' expectations following a surprise-delight event. Design/methodology/approach – Hypotheses were tested with a 2 (surprise)×2 (explanation) between-subjects experimental design in two different service contexts (utilitarian and hedonic). University staff and faculty members served as the participant pool. Findings – The results indicate that providing an explanation helps to avoid raising customer expectations to unsustainable levels and enhances customer delight. Research limitations/implications – Using hypothetical scenarios, single test for each context, and having the participants with high educational and income levels are identified as limitations in this study. Practical implications – This study demonstrates that providing appropriate explanations can reduce escalating expectations for future consumption episodes and thus help service firms to effectively delight their customers. Originality/value – This is the first empirical study to test the use of explanation as a possible solution for problems associated with surprise strategies, therefore extending the relevant literature.

Diabetes is a complex and challenging disease that requires daily self-management decisions made by the person with diabetes. Diabetes self-management education and support (DSMES) addresses the comprehensive blend of clinical, educational, psychosocial, and behavioral aspects of care needed for daily self-management and provides the foundation to help all people with diabetes navigate their daily self-care with confidence and improved outcomes (1,2). The prevalence of diagnosed diabetes is projected to increase in the U.S. from 22.3 million (9.1% of the total population) in 2014, to 39.7 million (13%) in 2030, and to 60.6 million (17%) in 2060 (3). Approximately 90–95% of those with diabetes have type 2 diabetes (4). Diabetes is an expensive disease, and the medical costs of health care alone for a person with diabetes are 2.3 times more than for a person without diabetes (5). Confounding the diabetes epidemic and high costs, therapeutic targets are not being met (6). There is a lack of improvement in reaching clinical target goals since 2005 despite advancements in medication and technology treatment modalities. Indeed, between 2010 and 2016 improved outcomes stalled or reversed (6). The goals of this Consensus Report are to improve clinical care and education services, to improve the health of individuals and populations, and to reduce diabetes-associated per capita health care costs (1,7). This article is specifically directed toward health care providers (physicians, nurse practitioners, physician assistants [PAs]), referred to herein as providers, as it outlines the benefits of DSMES, defines four critical times to provide and modify DSMES (see Fig. 1), proposes how to locate DSMES-related resources, and discusses potential solutions to access and utilization barriers. This report provides guidance to others as well: health systems and organizations can use this report to anticipate and address the needs of persons with …