Purpose: To educate clinic staff on interventions and education materials which are suitable for implementation in a pediatric primary care setting, and to improve delivery and documentation of appropriate asthma interventions and inhaler/spacer education.

Background: Asthma is a chronic illness that impacts 10.9% of the pediatric population in Arizona. Poor asthma understanding and management leads to high-utilization of emergency rooms and urgent care clinics, negatively impacting the healthcare economy. Poor asthma management also leads to decreased health outcomes and impacts on the child’s academic functioning, mental health, and overall quality of life. Current evidence supports use of written asthma action plans (WAAP) and inhaler/spacer instruction to improve asthma management.

Methods: The intervention was an evidence-based educational session provided to the staff of a military, pediatric primary care clinic in southwest Arizona regarding the use of WAAP, the Asthma Control Test (ACT) and integrated inhaler/spacer instruction. Chart reviews were conducted to evaluate the documentation of use of WAAP, ACT, and inhaler/spacer education.

Results: Charts were collected from pre-intervention (n = 33) and post-intervention (n = 18). Data analysis demonstrated a statistically significant higher use of WAAP (U = 0.008, p < 0.05, d = 0.83). Although there was not a statistically significant change in use of ACT tool, Cohen’s value (d = 0.48) suggested a moderate positive effect. A Pearson correlation coefficient was also calculated for the relationship between use of ACT tool and use of WAAP, demonstrating a moderate positive correlation (r (49) = .372, p < .01).

Conclusions: An evidence-based education session for pediatric staff members is a cost-effective and simple method of improving pediatric asthma management practices.

U.S. based multinational firms are able to use foreign subsidiaries as a means to reduce their overall tax burden. As disclosure requirements are vague, there is very little useful information provided to firm outsiders to analyze a firm’s foreign operations activity and earnings. I demonstrate that even sophisticated financial statement users, financial analysts, have difficulty predicting the effective tax rate for firms with foreign operations, as evidenced by increased forecast errors for multinational firms as compared to domestic firms. I examine factors that may contribute to the increased difficulty of forecasting for multinationals and find that decreased ETR persistence and the presence of a loss may affect the difficulty of the forecasting task, but the presence or quality of management forecasts may not. The market finds tax forecasts important as evidenced by the positive response to the tax and non-tax components of earnings forecasts. This evidence is useful to investors, policy makers, and others interested in the tax activities of multinational firms.

This paper examines whether CEOs with general managerial skills are better at achieving the goals of external communication. Using the General Ability Index developed by Custodio, Ferreira, and Matos (2013) to measure CEOs' general managerial skills, I find that firms with generalist CEOs are more likely to obtain the desired outcomes of communication, including the smaller difference between analyst forecasts and management guidance, less dispersion in analyst forecasts, higher analyst following, and higher institutional ownership, after controlling for CEO talent and the impact of Regulation FD. Moreover, I provide direct evidence that general managerial skills are more important to external communication under poor information environments. I also investigate the characteristics of analysts who follow firms with generalists, and my findings suggest the private interaction with analysts is an important communication channel for generalists. Finally, I find that generalists are able to attract dedicated investors and gain long-term capital for their firms. Overall, I provide evidence on the growing importance of general managerial skills in external communication. This paper offers new insights into why CEOs with general skills are paid at a premium over those with specific skills, as documented in previous studies.

Background. Research suggests that non-O blood types are at an increased risk of thrombosis and related health complications in cardiovascular disease (CVD). This is due in part to higher concentrations of von Willebrand factor (VWF), an important factor involved in blood clotting. Objective. The purpose of this study was to examine the effects of a vegetarian-like diet on blood coagulation and other health parameters in adults with type A blood compared to type O blood over a four week intervention. Given the lack of previous research on blood type and diet, it was hypothesized that no difference in blood coagulation would be observed. Design. This study was a randomized, parallel arm, dietary intervention using healthy, omnivorous adults with blood types A and O. A total of 39 subjects completed the study. Subjects were randomized into two groups: a vegetarian-like diet group made up of 12 type As and 12 type Os and an omnivorous control diet group made up of 11 type As and 12 type Os. At weeks 0 and 4, fasting blood was drawn and analyzed for prothrombin time (PT), activated partial thromboplastin time (APTT), von Willebrand factor (VWF), total cholesterol, LDL, HDL, triglycerides, and CRP. In addition, subjects were weighed and filled out a FFQ at weeks 0 and 4. Results. After adhering to a vegetarian-like diet for four weeks, type Os had a significant increase in PT (+0.24±0.32 sec/ p=0.050), whereas type As saw no significant change. There was a trend of weight loss for type Os in the vegetarian-like diet group (-1.8±2.6 lb/ p=0.092) and significant weight loss for type As (-0.9±2.1 lb/ p=0.037). Both blood types O and A experienced significant decreases in BMI (-0.3±0.4/ p=0.092 and -0.2±0.3/ p=0.037, respectively). No change was seen in APTT, VWF, total cholesterol, LDL, HDL, triglycerides, or CRP. Conclusion. Type Os saw an increase in PT, perhaps indicating a reduction in risk of thrombosis and its related health complications. Type As were less responsive to the dietary intervention and may require more rigid dietary guidelines or a longer time on such a diet to see the benefits.

Existing literature consistently documents a relationship between book-tax differences and future financial performance. Specifically, large book-tax differences are associated with lower earnings persistence. I contend that one reason the tax information contained in financial statements is informative about future earnings is that the relationship between book income and taxable income captures information about a firm's life cycle stage. Using a life cycle measure from the literature, I use fundamental analysis to group firm-year observations into life cycle stages and document a link between book-tax differences and firm life cycle. I build on prior studies that find a relation between earnings persistence and book-tax differences, and earnings persistence and firm life cycle. I find that after controlling for firm life cycle stage, the association between large positive book-tax differences and lower earnings persistence does not hold. My results offer an economic theory based explanation for the relation between book-tax differences and earnings persistence as an alternative explanation to findings in prior research.