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The Potential For Nigella Sativa In Treating In Risk Factors Related To The Metabolic Syndrome, Danielle L. Vaughn
The Potential For Nigella Sativa In Treating In Risk Factors Related To The Metabolic Syndrome, Danielle L. Vaughn
Research Papers
No abstract provided.
U.S Sugar Beet Price Analysis, Ethyan Kramer
U.S Sugar Beet Price Analysis, Ethyan Kramer
Research Papers
Sugar beet production was responsible for 56.6 percent of all U.S. sugar production in 2014. 82 percent of this production came from the states of Minnesota, North Dakota, Idaho, and Michigan. Sugar beets are an important crop for growers in these states so research in this area could be of great value to them. Current U.S. sugar policy protects domestic sugar prices from falling below set target rates. However, there has been very little research that describes the relationship of changing sugar beet prices above these target rates, with different economic variables. This study explores the potential relationship U.S. sugar …
For The Love Of A Sweet Country Song, Garna Christian
For The Love Of A Sweet Country Song, Garna Christian
East Texas Historical Journal
No abstract provided.
Assessing The Effectiveness Of Safety Training Provided To Corrections Personnel In Appalachia, Ali K. Al Yammahi
Assessing The Effectiveness Of Safety Training Provided To Corrections Personnel In Appalachia, Ali K. Al Yammahi
Online Theses and Dissertations
The context of the study was assessment of whether corrections officers in Appalachia are receiving adequate health and safety training who attended health and safety trainings sessions provided by the OSHA Training Institute and Education Center on the campus of Eastern Kentucky University. Participants included in the study were corrections officers who have been working in corrections for a minimum of two years. Participants were required to be working in Appalachian corrections during distribution of the questionnaire. Participants were selected by using convenience and snowball sampling procedures. The questionnaire was sent on 4 separate occasions, 10 of the expected 30 …
The Implications Of The Turnaround Process On A Rural Kentucky High School: Teacher Perspectives, Sonya Edwina Anglin
The Implications Of The Turnaround Process On A Rural Kentucky High School: Teacher Perspectives, Sonya Edwina Anglin
Online Theses and Dissertations
This dissertation is a phenomenological study of the effects of the turnaround process on a high school in rural central Kentucky. Data used for this study include interviews with teachers and archival materials such as school reports cards. Across Kentucky some forty-one schools have been identified as "priority schools" or persistently low-performing. As such, each one of them has been required to undergo changes in their daily instructional practices, procedures, and policies. The change process has affected faculty and administration and led to overall school improvement. This study provides a look at how the turnaround process has influenced school improvement …
Faculty Of Color At The Kentucky Community And Technical College System: A Survey Of Ethnic Diversity, Geographic Location, And Personal Perspectives, Linda Karen Ballard
Faculty Of Color At The Kentucky Community And Technical College System: A Survey Of Ethnic Diversity, Geographic Location, And Personal Perspectives, Linda Karen Ballard
Online Theses and Dissertations
Rural universities and colleges with traditionally homogeneous ethnic and cultural populations have to work especially hard to ensure faculty diversity. Despite efforts to increase the number of faculty of color in Kentucky's statewide system of community colleges, minority representation remains proportionally low, especially on the state's rural college campuses. The purpose of this study was to investigate how faculty of color in the Kentucky Community and Technical College System (KCTCS) perceived their work climate and resident communities in order to distinguish if these faculty members were content and therefore more inclined to remain at their jobs and offer the degree …
Graduation Rates Of Career And Technical Education (Cte) Concentrators In Kentucky: A Comparative Study, Seve L. Bennett
Graduation Rates Of Career And Technical Education (Cte) Concentrators In Kentucky: A Comparative Study, Seve L. Bennett
Online Theses and Dissertations
This research was driven by the desire to determine if graduation rates of high school students in Kentucky are significantly affected when they decide to concentrate on a Career and Technical Education (CTE) career pathway. To clarify, the research questions that prompted this study seek to find out if 12th grade CTE concentrator students in programs of study at (16) randomly chosen Area Technology Centers (ATCs) across the state had different graduation rates than those 12th grade students not engaged in CTE career pathways in (16) corresponding high schools for the 2012 – 2013 school year. The study also compared …
Anonymity, Cybercrime, And The Connection To Cryptocurrency, Jesse D. Bray
Anonymity, Cybercrime, And The Connection To Cryptocurrency, Jesse D. Bray
Online Theses and Dissertations
Cybercrime currently poses a significant threat to the infrastructure of the United States. It can exploit vulnerabilities within the Critical Infrastructure or (CI) systems that are increasingly interconnected. Although the increased interconnectedness allows for easier and more efficient communication it creates vulnerabilities that did not exist ten years ago. A lack of a standardized definition of cybercrime has made it increasingly difficult to create policy that will allow for more efficient interagency cooperation and concrete laws regarding cybercrime. Cybercrime thrives on the anonymity of the Internet with the use of specific browsers, The Onion Router for example, to access information …
A Mediacentric Examination Of The Corporate Psychopath, Pamela Martha Brooks
A Mediacentric Examination Of The Corporate Psychopath, Pamela Martha Brooks
Online Theses and Dissertations
The psychopathic personality disorder is an extraordinarily complex and multidimensional phenomenon. While its study has primarily focused on criminal and forensic populations, many researchers are broadening the scope of psychopathy research to include those in the corporate world. This, after striking similarities were revealed between the personalities of corporate leaders and clinically diagnosed psychopaths. One profession that may be attractive to psychopathic personalities is the media, specifically television and radio. This exploratory study utilized a blend of original and archival data. Calculated effect sizes were used to examine the existence of personality facets among three groups of media professionals and …
Investigating Key Components Of Classroom Engagement In Workforce Development Programming, Susan Leslie Cornelius
Investigating Key Components Of Classroom Engagement In Workforce Development Programming, Susan Leslie Cornelius
Online Theses and Dissertations
This is a qualitative study about students who attended First Line Supervision classes at a rural Kentucky Appalachian university. First Line Supervision classes are taught in six hour blocks and are designed to teach students leadership skills. These students took a series of leadership based topics to better prepare themselves for a leadership role in their current employment. In addition, they were seeking the necessary information needed to be successful in filling the educational gaps within their organizations. This study is important because participants identified: key components of classroom engagement; experiences in the classroom; types of classroom engagement currently taking …
Role Of Community Participation In Improving Quality Of Life In Clients With Dementia And Their Caregivers, Mridula Dhamija
Role Of Community Participation In Improving Quality Of Life In Clients With Dementia And Their Caregivers, Mridula Dhamija
Online Theses and Dissertations
Aim: The purpose of this study was to investigate the effects on quality of life for clients with dementia and their caregivers by participating in a community program, the Memory Café.
Method: In this qualitative, cross case study, the Marwit Meser Caregiver Grief Inventory (MM-CGI) was given to caregiver. Data collection was done by interviewing the participants; there was a main question with follow- up questions as needed. All the interviews were audiotaped and transcribed followed by primary and secondary coding. Shortlisting of categories resulted in emergence of themes which were common across cases and unique to each case.
Results: …
Carving A New Notch In The Bible Belt: Rescuing The Women Of Kentucky, Molly Dunn
Carving A New Notch In The Bible Belt: Rescuing The Women Of Kentucky, Molly Dunn
Online Theses and Dissertations
In recent years, the trafficking of women and girls for sexual exploitation has become a major focus on the local, national, and global level. This is despite research, which has identified labor trafficking to be a significantly larger issue across the globe. The purpose of this research is to identify how human trafficking has come to be defined in Kentucky by examining how prominent local actors guide the state’s anti-trafficking movement. Through interactions with non-profit organizations, law enforcement, and concerned citizens, factors and forces that may shape the public’s conception of human trafficking were examined. While the stated goal of …
Wetland Condition Matters: Amphibian Richness And Abundance Change Across Wetland Condition Gradient, Kari Dupler
Wetland Condition Matters: Amphibian Richness And Abundance Change Across Wetland Condition Gradient, Kari Dupler
Online Theses and Dissertations
In the past century, Kentucky has lost more than 80% of its wetlands, and because state-wide monitoring was historically minimal, this number is likely underestimated. The Kentucky Division of Water, with Eastern Kentucky University and a technical working group, developed a rapid wetland assessment method (i.e. KY-WRAM) to assess wetland quality and aid in establishing mitigation levels and long-term monitoring. Validation of the KY-WRAM’s ability to reflect wetland condition requires comparison to intensive biotic assessments of amphibian, plant, and bird communities. Wetland and amphibian surveys for the 2014 and 2015 seasons were conducted at 42 riverine wetlands in the Kentucky …
The Stress Of Her Disregard: Britannia’S Suez Fiasco In Consideration Of Anglo-American Diplomacy, Matthew Gerth
The Stress Of Her Disregard: Britannia’S Suez Fiasco In Consideration Of Anglo-American Diplomacy, Matthew Gerth
Online Theses and Dissertations
The Suez Crisis of 1956 was an unmitigated disaster for the United Kingdom. For the vast majority of historians, it marks the effective downfall of the British Empire. In reviewing the series of events preceding and throughout the crisis, it becomes evident that the reason for the failure of the Suez expedition rests not on actions taken in Cairo or Moscow, but in Washington. The efforts of Dwight Eisenhower and John Foster Dulles to stymie Anthony Eden from achieving his goals during the affair are the key factors to the ruination of British efforts towards removing Gamal Abdel Nasser from …
Graduating Associate Degree Nursing Students: Keeping Students On Track, Marisa Ellen Greer
Graduating Associate Degree Nursing Students: Keeping Students On Track, Marisa Ellen Greer
Online Theses and Dissertations
The national job outlook for registered nurses, according to a News Release for Employment Projections 2012-2022 from the Bureau of Labor Statistics (2013), will continue to increase in job growth from 2012 to 2022 by 19.4%. This increase will result in an additional 526,800 registered nursing positions that will be available nationwide by 2022. This qualitative dissertation investigated associate degree nursing students and the strategies they employed to be successful and graduate from their respective nursing program. According to a report entitled The Registered Nurse Population by the US Department of Health and Human Services (2008), associate degree nursing programs …
Relationships Between Some Endogenous Signal Compounds And The Antioxidantsystem In Response To Chilling Stress In Maize (Zea Mays L.) Seedlings, Nevzat Esi̇m, Ökkeş Atici
Relationships Between Some Endogenous Signal Compounds And The Antioxidantsystem In Response To Chilling Stress In Maize (Zea Mays L.) Seedlings, Nevzat Esi̇m, Ökkeş Atici
Turkish Journal of Botany
This study investigated the correlation between endogenous levels of some signal compounds [nitric oxide (NO), salicylic acid (SA), abscisic acid (ABA)] and the antioxidant system in response to chilling stress in maize (Zea mays L.). Seedlings grown for 12 or 19 days under normal conditions (24/20 °C) were exposed to chilling stress (10/7 °C) for 2 days. The levels of NO, SA, ABA, hydrogen peroxide (H2O2), superoxide anion (O2.-), and malondialdehyde (MDA) were determined in leaves of seedlings harvested on day 14 and day 21. In the same seedlings, the activities of superoxide dismutase (SOD), peroxidase (POX), catalase (CAT), and …
The Current Status Of Ethnopharmacobotanical Knowledge In Çamlıdere (Ankara, Turkey), Tuğba Günbatan, İlhan Gürbüz, Ayşe Mi̇ne Gençler Özkan
The Current Status Of Ethnopharmacobotanical Knowledge In Çamlıdere (Ankara, Turkey), Tuğba Günbatan, İlhan Gürbüz, Ayşe Mi̇ne Gençler Özkan
Turkish Journal of Botany
The main objective of this study is to identify and record the folk medicines used in Çamlıdere (Ankara) as well as to contribute to the preservation of this precious lore. For this purpose field trips were organized to Çamlıdere. A total of 79 taxa belonging to 66 genera and 33 families were recorded for the treatment of various disorders. The most represented families were Asteraceae, Lamiaceae, and Rosaceae, respectively. Respiratory tract diseases were the principal reasons for using folk medicines. Eight new folk medicines were included in the Turkish ethnobotanical repository with this study. Different ethnobotanical usages such as fuel …
Haematococcus: A Successful Air-Dispersed Colonist In Ephemeral Waters Is Rarely Found In Phytoplankton Communities, Savvas Genitsaris, Natasa Stefanidou, Matina Katsiapi, Elisabeth Vardaka, Konstantinos Ar. Kormas, Ulrich Sommer, Maria Moustaka-Gouni
Haematococcus: A Successful Air-Dispersed Colonist In Ephemeral Waters Is Rarely Found In Phytoplankton Communities, Savvas Genitsaris, Natasa Stefanidou, Matina Katsiapi, Elisabeth Vardaka, Konstantinos Ar. Kormas, Ulrich Sommer, Maria Moustaka-Gouni
Turkish Journal of Botany
In a literature search, the presence of Haematococcus in phytoplankton communities and its biogeography were investigated. Haematococcus, although showing a wide biogeographical distribution, has been rarely found in phytoplankton communities. Simultaneously, the colonization potential of air-dispersed Haematococcus in ephemeral waters and its interactions with coexisting phytoplankton taxa were examined by microscopy and molecular methods. Haematococcus was a successful colonist, appearing among the first taxa in the experimental containers. According to principal component analysis, Haematococcus growth rate was negatively correlated with the abundance and species richness of the other autotrophs. Furthermore, a negative correlation between Haematococcus and Chlamydomonas and a positive …
Simvastatin's Effects On Survival And Outcome In Traumatic Braininjury Patients: A Comparative Study, Taraneh Naghibi, Sara Madani, Saideh Mazloomzadeh, Faramarz Dobakhti
Simvastatin's Effects On Survival And Outcome In Traumatic Braininjury Patients: A Comparative Study, Taraneh Naghibi, Sara Madani, Saideh Mazloomzadeh, Faramarz Dobakhti
Turkish Journal of Medical Sciences
Background/aim: Mortality and morbidity still remain high in patients with traumatic brain injuries. Understanding the role of new treatments in these patients is critical. The aim of this study was to determine the effect of simvastatin on survival and outcome in traumatic brain injury patients. Materials and methods: Forty-four patients were assigned to receive either simvastatin or a placebo. The serum interleukin-6 and C-reactive protein levels were measured at the first 24 h and 48 h after trauma. All data, including the Glasgow Coma Scale score, survival at discharge, length of intensive care unit stay, and duration of mechanical ventilation, …
Mucormycosis: A 10-Year Experience At A Tertiary Care Center In Turkey, Süheyla Kömür, Ayşe Seza İnal, Behi̇ce Kurtaran, Aslihan Ulu, Aysun Uğuz, Hasan Sali̇h Zeki̇ Aksu, Yeşi̇m Taşova
Mucormycosis: A 10-Year Experience At A Tertiary Care Center In Turkey, Süheyla Kömür, Ayşe Seza İnal, Behi̇ce Kurtaran, Aslihan Ulu, Aysun Uğuz, Hasan Sali̇h Zeki̇ Aksu, Yeşi̇m Taşova
Turkish Journal of Medical Sciences
Background/aim: Mucormycosis is a rare invasive fungal infection most commonly encountered in the immunocompromised host. We analyzed 51 adult patients treated for mucormycosis between 2003 and 2013 and recorded at a tertiary university hospital in Turkey. Materials and methods: We examined the following data for all patients: age, sex, predisposing disease, symptoms, treatment, surgical procedure, concomitant infections, intensive care requirement, and outcomes. Results: During the study period 51 cases of mucormycosis were documented; 54.9% of the patients were female. The mean age was 44.2 ± 18.2 years. Rhinocerebral presentation was reported in 94.1% of patients. Almost all patients (88.2%) had …
Plasma Lipoprotein(A) Levels Are Associated With The Severity Of Coronaryheart Disease In Han Chinese People, Li Zhu, Zhan Lu, Liren Zhu, Xiaoxiao Ouyang, Yang Yang, Yanping Feng, Ping Li, Wenjing Ye, Xiaoming Zhang, Xiuyun Zhang, Yongyan Song
Plasma Lipoprotein(A) Levels Are Associated With The Severity Of Coronaryheart Disease In Han Chinese People, Li Zhu, Zhan Lu, Liren Zhu, Xiaoxiao Ouyang, Yang Yang, Yanping Feng, Ping Li, Wenjing Ye, Xiaoming Zhang, Xiuyun Zhang, Yongyan Song
Turkish Journal of Medical Sciences
Background/aim: The aim of this study was to investigate the association of lipoprotein(a) [Lp(a)] with the severity of coronary heart disease (CHD) in Han Chinese people. Materials and methods: Six hundred and seventy-nine patients with angiographically defined CHD were enrolled in this cross-sectional study. Fasting lipids were measured, and the severity of CHD was quantitatively assessed for each patient according to the number of stenotic coronary branches and the Gensini scoring system. Results: The levels of Lp(a), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), very low-density lipoprotein cholesterol (VLDL-C), and apolipoprotein (apo) B100 increased, while high-density lipoprotein cholesterol (HDL-C) and …
The Efficacy Of Kaolin Clay In Reducing The Duration And Severity Of `Heat' Diarrhea In Foals, Magdalena Pieszka, Jaroslaw Luszczynski, Magdalena Hedrzak, Katerina Goncharova, Stefan G. Pierzynowski
The Efficacy Of Kaolin Clay In Reducing The Duration And Severity Of `Heat' Diarrhea In Foals, Magdalena Pieszka, Jaroslaw Luszczynski, Magdalena Hedrzak, Katerina Goncharova, Stefan G. Pierzynowski
Turkish Journal of Veterinary & Animal Sciences
'Heat' diarrhea in foals is an onerous but not life-threatening ailment, which indicates that it may be of osmotic origin. This was confirmed by a successful attempt, presented in this paper, to alleviate the severity and duration of foal heat diarrhea with the use of a typical absorbent, kaolin clay, as a feed additive, usually applied in feed production as an anticaking agent. Based on the present results, it can be concluded that treatment of foals maintained on different stud farms with a kaolin paste reduced the duration of heat diarrhea and alleviated its severity (P < 0.05 and P = 0.001). The observed action of kaolin clay, an excellent absorbent, suggests that the so-called heat diarrhea can be caused by disturbances in the intestinal osmotic balance at this specific age of foals. The use of this preparation can reduce the risk of secondary pathological viral or bacterial diarrhea and the requirement for veterinary intervention in foal management. It can also shorten the care period and increase foal well-being, essential for the normal development of a young horse. In addition, prophylactic application of an antidiarrheal preparation based on an industrial by-product, i.e. A cheap component, will reduce the costs of foal care.
Effect Of Retinol And Retinol Esters On Performance, Egg Quality, And Blood And Egg Vitamin A Levels In Laying Quails, Murat İlhan, Tuba Bülbül
Effect Of Retinol And Retinol Esters On Performance, Egg Quality, And Blood And Egg Vitamin A Levels In Laying Quails, Murat İlhan, Tuba Bülbül
Turkish Journal of Veterinary & Animal Sciences
This study aimed to determine the effects of retinol and retinol ester supplementation on performance, egg quality, serum and egg oxidative status, and vitamin A levels in laying quails. Three hundred quails were divided into 5 groups. The control group received a basal diet that contained vitamin premix without vitamin A or vitamin A precursors. The treatment groups received dietary supplementation with retinol and retinol esters [retinyl acetate (R-acetate), retinyl palmitate (R-palmitate), retinyl propionate (R-propionate), 3300 IU/kg]. Egg production and feed conversion ratio improved in all experimental groups. Serum β-carotene and malondialdehyde (MDA) levels decreased and serum retinol levels increased …
The Problematic Applicability Of Subsidiarity To International Law, Paolo G. Carozza
The Problematic Applicability Of Subsidiarity To International Law, Paolo G. Carozza
Journal Articles
This article seeks to explore some of the reasons why the principle of subsidiarity, although applicable in some sectors of international law and particularly in the field of international human rights law, has difficulty in serving as a general principle of public international law more broadly. The obstacles to advancing a more robust understanding of subsidiarity's place in the current structure of global norms and institutions include: the normative and institutional fragmentation of international law; the continuing centrality of state sovereignty in the international legal system; and the endemic weaknesses and incapacity of states and sub-state communities with respect to …
The Future Of Abortion Law In The United States, Gerard V. Bradley
The Future Of Abortion Law In The United States, Gerard V. Bradley
Journal Articles
In 1971, Judith Jarvis Thomson published what was then and still often is regarded as a trailblazing philosophical defense of a woman’s right to have a lawful abortion. It is time to revisit Thomson’s paper. The aim here is not to engage Thomson’s pro-choice conclusions, which are indeed mistaken, but to show that her question—to what extent can abortion be morally justified, assuming that it is the deliberate killing of one person by his or her mother—is the question today in American law concerning abortion. Pro-life people and groups argue among themselves about the prudence of political efforts to roll …
Affirmatively Furthering Neighborhood Choice: Vacant Property Strategies And Fair Housing, James J. Kelly Jr.
Affirmatively Furthering Neighborhood Choice: Vacant Property Strategies And Fair Housing, James J. Kelly Jr.
Journal Articles
When many of us think about fair housing enforcement, scenes involving undercover apartment applicants ferreting out racially biased landlords come to mind. Indeed, fair housing "testers" have been and continue to be an important element of civil rights accountability.' However, implementation of the Fair Housing Act of 1968 has had at least as much to do with increasing the supply of decent, affordable housing options to members of protected groups as with assuring those individuals that they will not be denied a particular housing unit because of the color of their skin or a disability.
This macro aspect of fair …
A Code-Based Approach To Unauthorized Access Under The Computer Fraud Abuse Act, Patricia L. Bellia
A Code-Based Approach To Unauthorized Access Under The Computer Fraud Abuse Act, Patricia L. Bellia
Journal Articles
Thirty years ago, Congress passed the Computer Fraud and Abuse Act (CFAA) to combat the emerging problem of computer crime. The statute’s core prohibitions targeted one who “accesses” a computer “without authorization” or who “exceeds authorized access.” Over time, incremental statutory changes and large-scale technical changes have dramatically expanded the potential scope of the CFAA. The question of what constitutes unauthorized access has taken on far greater significance than it had thirty years ago, and courts remain deeply divided on this question. This Article explores the text, purpose, and history of the CFAA, as well as a range of normative …
Modern-Day Monitorships, Veronica Root
Modern-Day Monitorships, Veronica Root
Journal Articles
When a sexual abuse scandal rocked Penn State, when Apple engaged in anticompetitive behavior, and when servicers like Bank of America improperly foreclosed upon hundreds of thousands of homeowners, each organization entered into a Modern-Day Monitorship. Modern-Day Monitorships are utilized in an array of contexts to assist in widely varying remediation efforts. They provide outsiders a unique source of information about the efficacy of the tarnished organization’s efforts to remediate misconduct. Yet despite their use in high-profile and serious matters of organizational wrongdoing, they are not an outgrowth of careful study and deliberate planning. Instead, Modern-Day Monitorships have been employed …
Guidance For The Practical Management Of The Heparin Anticoagulants In The Treatment Of Venous Thromboembolism., Maureen A. Smythe, Jennifer Priziola, Paul P. Dobesh, Diane Wirth, Adam Cuker, Ann K. Wittkowsky
Guidance For The Practical Management Of The Heparin Anticoagulants In The Treatment Of Venous Thromboembolism., Maureen A. Smythe, Jennifer Priziola, Paul P. Dobesh, Diane Wirth, Adam Cuker, Ann K. Wittkowsky
Journal Articles: Pharmacy Practice
Venous thromboembolism (VTE) is a serious and often fatal medical condition with an increasing incidence. Despite the changing landscape of VTE treatment with the introduction of the new direct oral anticoagulants many uncertainties remain regarding the optimal use of traditional parenteral agents. This manuscript, initiated by the Anticoagulation Forum, provides clinical guidance based on existing guidelines and consensus expert opinion where guidelines are lacking. This specific chapter addresses the practical management of heparins including low molecular weight heparins and fondaparinux. For each anticoagulant a list of the most common practice related questions were created. Each question was addressed using a …
Access And Barriers To Care During Transition From Active Duty To Veteran Status In Veterans With Diabetes: A Look At Health Literacy, Change, And Ongoing Diabetes Self-Management Education, Mark R. Malebranche
Access And Barriers To Care During Transition From Active Duty To Veteran Status In Veterans With Diabetes: A Look At Health Literacy, Change, And Ongoing Diabetes Self-Management Education, Mark R. Malebranche
Dissertations
Background and Rationale: Transition from active duty to veteran status may be a challenging time, especially for veterans with diabetes. These veterans face multiple changes that can cause distress. Most veterans with diabetes have type 2 diabetes, however a diagnosis of type 1 diabetes on active duty is cause for discharge for active duty.
Purposes and Aims: The purpose of this study was to describe the transition experience of veterans diagnosed with diabetes while on active duty from active duty to veteran status. The study describes barriers and facilitators to healthcare and diabetes self-care management. The four aims of the …