Linguistic and psychometric validation of the diabetes-specific quality-of-life scale in U. K. english for adults with type 1 diabetes

OBJECTIVE To develop a linguistically and psychometrically validated U.K. English (U.K./Ireland) version of the Diabetes-Specific Quality-of-Life Scale (DSQOLS) for adults with type 1 diabetes.

RESEARCH DESIGN AND METHODS We conducted independent forward and backward translation of the validated German DSQOLS. An iterative interview study with health professionals (n = 3) and adults with type 1 diabetes (n = 8) established linguistic validity. The DSQOLS was included in three Dose Adjustment for Normal Eating (DAFNE) studies (total N = 1,071). Exploratory factor analysis (EFA) was undertaken to examine questionnaire structure. Concurrent and discriminant validity, internal consistency, and reliability were assessed.

RESULTS EFA indicated a six-factor structure for the DSQOLS (social aspects, fear of hypoglycemia, dietary restrictions, physical complaints, anxiety about the future, and daily hassles). High internal consistency reliability was found for these factors and the weighted treatment satisfaction scale (α = 0.85–0.94). All subscales were moderately, positively correlated with the Audit of Diabetes-Dependent Quality-of-Life (ADDQoL) measure, demonstrating evidence of concurrent validity. Lower DSQOLS subscale scores [indicating impaired quality of life (QoL)] were associated with the presence of diabetes-related complications.

CONCLUSIONS The DSQOLS captures the impact of detailed aspects of modern type 1 diabetes management (e.g., carbohydrate counting and flexible insulin dose adjustment) that are now routine in many parts of the U.K. and Ireland. The U.K. English version of the DSQOLS offers a valuable tool for assessing the impact of treatment approaches on QoL in adults with type 1 diabetes.

Structured Type 1 Diabetes education delivered within routine care: impact on glycemic control and diabetes-specific quality of life

OBJECTIVE:
To determine whether improvements in glycemic control and diabetes-specific quality of life (QoL) scores reported in research studies for the type 1 diabetes structured education program Dose Adjustment For Normal Eating (DAFNE) are also found when the intervention is delivered within routine U.K. health care.

RESEARCH DESIGN AND METHODS:
Before and after evaluation of DAFNE to assess impact on glycemic control and QoL among 262 adults with type 1 diabetes.

RESULTS:
There were significant improvements in HbA_1c from baseline to 6 and 12 months (from 9.1 to 8.6 and 8.8%, respectively) in a subgroup with suboptimal control. QoL was significantly improved by 3 months and maintained at both follow-up points.

CONCLUSIONS:
Longer-term improved glycemic control and QoL is achievable among adults with type 1 diabetes through delivery of structured education in routine care, albeit with smaller effect sizes than reported in trials.

How are Australian higher education institutions contributing to change through innovative teaching and learning in virtual worlds?

Over the past decade, teaching and learning in virtual worlds has been at the forefront of many higher education institutions around the world. The DEHub Virtual Worlds Working Group (VWWG) consisting of Australian and New Zealand higher education academics was formed on 2009. These educators are investigating the role that virtual worlds play in the future of education and actively changing the direction of their own teaching practice and curricula. 47 academics reporting on 28 Australian higher education institutions present an overview of how they have changed directions through the effective use of virtual worlds for diverse teaching and learning activitiessuch as business scenarios and virtual excursions, role-play simulations, experimentation and language development. The case studies offer insights into the ways in which institutions are continuing to change directions in their teaching to meet changing demands for innovative teaching, learning and research in virtual worlds. This paper highlights the ways in which the authors are using virtual worlds to creat opportunities for rich, immersive and authentic activities that would be difficult or not possible to achieve through traditional approaches

Young people, pleasure, and the normalization of pornography: sexual health and well-being in a time of proliferation?

It has been argued that pornography is the most prominent sex educator for young people today (Flood, M. (2010). Young men using pornography. In E. Boyle (Ed.), Everyday Pornography (pp. 164–178). Oxford: Routledge). Research indicates that first exposure to pornography can be as young as 11 years of age. There is evidence that exposure to pornography is shaping young people’s sexual expectations and practices (H€aggstro ̈ m-Nordin et al. 2005). Many young people are learning what sex looks like from what they – or their partner or peers – observe in pornography. Significantly,pornography is normalizing sex acts that most women do not enjoy and may experience as degrading, painful, or violating. This raises serious implications for young people’s capacity to develop a sexuality that incorporates mutual pleasure, respect, and negotiation of free and full consent.While the results are complex and nuanced, research into the effects of pornography consumption provides reliable evidence that exposure to pornography increases aggressive attitudes and behavior towards women for some viewers (Malamuth et al. Annual Review of Sex Research 11, 26–91, 2000). Pornography consumption also has been found to be associated with sexual health risk taking and can impact negatively on body image and sense of self (Dean, L. (2007). Young Men, Pornography and Sexual Health Promotion, MA Research, Brighton University, Brighton, in possession of the author), and as such is a serious health and well-being issue, particularly for young women.This chapter explores preservice teachers’ reactions to pornography education using two examples from teaching of an elective Teaching Sexuality in the Middle Years, in 2011. These examples explore the complex emotions such teaching can generate and the challenges faced by preservice teachers when they are encouraged to confront the gendered and violent consequences of the normalization of pornography in a coeducational setting.

Stepping out of our comfort zones: pre-service teachers' responses to a critical analysis of gender/power relations in sexuality education

This paper discusses pre-service teachers' responses to a critical analysis of gender/power relations using examples from a final assessment for an intensive elective unit called Teaching Sexuality in the Middle Years. This unit critically examines gender/ power relations, the production of difference, heteronormativity and pleasure and desire, employing a feminist post-structural framework. Despite the focus on critical thinking, reflection and interrogating structural inequalities in this unit some students were resistant or unable to engage with this approach in their assessments, although appearing to do so in workshops. We consider the broad range of sexuality education discourses mobilised by this unit to try to make sense of what looks like resistance but may be something more complex and difficult to negotiate. The paper ends with a consideration of some of the implications of this approach for practice.

‘I felt like I was watching porn’: the reality of preparing pre-service teachers to teach about sexual pleasure

Overwhelmingly, school-based sexuality education programmes focus on the prevention of infection, pregnancy and abuse, with little if any attention given to positive views of sexuality and rarely the inclusion of sex positive issues such as pleasure, intimacy and desire. This paper explores the experience of teaching about pleasure to pre-service health and physical education teachers as part of compulsory studies in a unit on sexuality education designed to prepare them to teach sexuality education in secondary schools. Drawing on the aims, theoretical framework, content and pedagogical structure of the unit, and data collected from 42, third-year pre-service teachers (PST) in Australia via surveys and student assessment, the paper provides some practical examples of what teaching about pleasure might look like in practice. It argues that with adequate preparation, a framework to celebrate sex and sexuality, a gender lens to examine normative discourses, and the opportunity for reflection, PST can develop the confidence, skill and willingness to include pedagogies of pleasure in their school-based work.

Change in schools it’s more like sort of turning an oil tanker : creating readiness for health promoting schools

Purpose – The purpose of this paper is to add to the evidence of best practice in the implementation of the Health Promoting Schools (HPS) framework by examining the process of creating readiness for change in a large international school in South-East Asia. Using a settings-based approach and guided by readiness for change theory the data collected reflects which factors were most influential in the decision of the leadership team (LT) to adopt a comprehensive HPS model. It follows the process of creating readiness in the early stages of adopting a HPS approach and captures the critical factors effecting leader’s beliefs and support for the program. Design/methodology/approach – This research is a case study of a large pre-K-12 international school in South-East Asia with over 1,800 students. A mixed methods qualitative approach is used including semi-structured interviews and document analysis. The participants are the 12 members of the LT. Findings – Readiness for change was established in the LT who adopted a HPS approach. That is, they adopted a comprehensive model to address health-related priorities in the school and changed the school’s mission and accountability processes to specifically include health. Uncovering the reasons why the LT supported this change was the primary focus of this research. Building the motivation to change involved establishing a number of key beliefs three of which were influential in bringing about readiness for change in this case study. These included the belief that leadership support existed for the proposed change, a belief that there was a need for change with a clear discrepancy in the present and preferred operations in relation to addressing the health issues of the school and the belief that HPS was the appropriate solution to address this discrepancy. Research limitations/implications – Adopting a HPS approach is the first phase of implementation. Long-term research may show if the integrity of the chosen model is maintained as implementation continues. The belief construct of valence, that is, the belief that the change will benefit the change recipient, was not reliably assessed in this research. Further research needs to be conducted to understand how this construct is interpreted in the school setting. The belief construct of valence was not reliably assessed in this research. Further research needs to be done to understand how this construct fits in the school setting. Practical implications – This paper provides a promising example of how health can be integrated into the school’s Mission and Strategic Learning Plan. The example presented here may provide strategies for others working in the field of HPS. Originality/value – Creating readiness is an often over-looked stage of building sustainable change. International schools cater to more than three million students are a rarely researched in regards to health education. It is predicted that the numbers of students in international schools will grow to more than six million in the next ten years.

Lessons in building capacity in sexuality education using the health promoting school framework: from planning to implementation

Purpose – The health promoting school model is rarely implemented in relation to sexuality education. This paper reports on data collected as part of a five-year project designed to implement a health promoting and whole school approach to sexuality education in a five campus year 1-12 college in regional Victoria, Australia. Using a community engagement focus involving local and regional stakeholders and with a strong research into practice component, the project is primarily concerned with questions of capacity building, impact and sustainability as part of whole school change. The paper aims to discuss this issue. Design/methodology/approach – Using an action research design, data were collected from parents, students, teachers and key community stakeholders using a mixed methods approach involving surveys, interviews, document analysis and participant observation. Findings – Sexuality education has become a key school policy and has been implemented from years 1 to 9. Teachers and key support staff have engaged in professional learning, a mentor program has been set up, a community engagement/parent liaison position has been created, and parent forums have been conducted on all five campuses. Research limitations/implications – The translation of research into practice can be judged by the impact it has on teacher capacity and the students’ experience. Classroom observation and more longitudinal research would shed light on whether the espoused changes are happening in reality. Originality/value – This paper reports on lessons learned and the key enabling factors that have built capacity to ensure that sexuality education within a health promoting, whole school approach will remain sustainable into the future. These findings will be relevant to others interested in building capacity in sexuality education and health promotion more generally.

Gender relations in elite coeducational schools

Coeducational schools have long been regarded as ‘risky’ environments for girls. This ethnographic study of three elite coeducational schools in Melbourne, Australia found that while gender relations continued to be complex, girls and boys worked together as colleagues and friends and the traditional gender hierarchies were disrupted at many points.