Impact of a comprehensive nutrition and lifestyle education intervention on body weight and health-related outcomes in morbidly-obese Hispanic-Americans following laparoscopic Roux-en-Y gastric bypass

As morbid obesity increasingly affects Hispanic-Americans, the incidence of Roux-en-Y gastric bypass procedures (RYGB) among this population rises. Prospective research on the impact of postoperative educational interventions focused on Hispanic- Americans is needed to prevent premature weight loss plateau, weight regain, nutritional deficiencies, and relapse of obesity-related comorbidities. This randomized-controlled study evaluated the impact of a comprehensive nutrition and lifestyle education intervention (6 biweekly postoperative sessions that incorporated motivational strategies for behavioral change) as compared to a non-comprehensive approach (printed guidelines for healthy lifestyle). The variables to consider are body weight, obesity-related comorbidities (depression, diabetes, dyslipidemia, and others), nutrient status, physical activity, and eating habits in 144 morbidly-obese adult Hispanic-Americans 6 to 12 months following RYGB. Patients were randomly assigned to either the comprehensive intervention (n=72) or the comparison group (n=72). Participants (mean age 44.5 ± 13.5 years) were mainly Cuban-born females (83.3%). Intervention sessions attendance was 64%. At 12 months, both groups lost weight significantly, but those in the comprehensive intervention experienced greater excess weight loss than those in the comparison group (80% vs. 64% from preoperative excess weight, P<.001). Intervention participants were significantly more involved in physical activity (+ 14 min/week vs. – 4 min/week), had decreased depression, joint illness, and required less medication for comorbidities than comparison participants. Additionally, those in the comprehensive intervention had sustained supplement intake experiencing less folate deficiency (P=.014). The non-comprehensive intervention group significantly decreased their protein and supplement intake compared to the intervention group. Patients in the comprehensive intervention had significantly better eating habits reflected by fewer episodes of dumping syndrome, constipation, and night eating, than those in the comparison group who reported greater eating in response to negative emotions (P=.003). These findings support the importance of a comprehensive educational approach to achieve more effective weight reduction and health-related outcomes to prevent relapse of obesity-related comorbidities and nutritional deficiencies in Hispanic-Americans 6 to 12 months following RYGB.

The role of spirituality in transformative learning

The purpose of this phenomenological study was to explore the role of spirituality in Mezirow's (1978, 1990, 1991, 1997, 1998, 2000, 2003) 10-phase process of transformative learning. This study used Mezirow's transformative learning theory as its theoretical framework. Semi-structured interviews were conducted, transcribed, and analyzed for 12 doctoral students and candidates who had a transformative learning experience and who identified themselves as being spiritual. Interview data were analyzed using inductive, deductive, and comparative analyses. Four themes emerged from the inductive analysis of the data: (a) the nature of spirituality, (b) the variety of emotions, (c) the influences of spirituality, and (d) the nature of personal changes. The theory's 10 phases were used as a guide in deductively analyzing data concerning the participants' experiences. The deductive analysis revealed that spirituality played a role in at least 7 of the 10 phases of transformative learning for each participant. Overall, from the participants' perspectives, the role of spirituality was that of a guide in influencing their cognition and behavior, and that of a supporter in influencing their emotions. The comparative analysis revealed that at least three of the four themes from the inductive analysis were reflected in each of the 10 phases of transformative learning used in the deductive analysis. Based on the findings from this study, the researcher proposed a modification of Mezirow's phases of transformative learning. An additional phase was identified: framing and naming the transformed perspective, and two phases were renamed. The findings from this study imply that given the importance of the role participants attributed to spirituality in their transformative learning in influencing their cognition, behavior, and emotions, the role of spirituality should be considered for inclusion in transformative learning theory. Recommendations for further research on the validation and replicability of the proposed modification to transformative learning theory are given.

General and special education teachers' knowledge of and attitudes toward students with HIV/AIDS

AIDS education is mandated in schools throughout the United States to educate students about the disease. Teachers are expected to assume the major role of disseminating this information; therefore it is reasonable to question how knowledgeable teachers are about HIV/AIDS and where their information is coming from. This study explored the knowledge and attitudes of general and special education teachers toward students with HIV/AIDS and investigated whether a relationship between knowledge and attitudes existed. Information was collected using the AIDS Knowledge and Attitude Survey (AKAS). The sample was limited to certified teachers resulting in 318 participants.^ Research questions were analyzed using descriptive statistics, frequencies, t-tests, one-way analysis of variance (ANOVA), Scheffe post hoc analysis, and Pearson Product-Moment Correlation. Results indicated that general and special education teachers did not have complete knowledge about HIV/AIDS. Participants were knowledgeable regarding modes of transmission which may be the area of greatest concern for teachers, however, deficiencies were present within teachers' knowledge of general statements and facts and pathology. Among the ten demographic variables analyzed, six (gender, race/ethnicity, level of education, certification, instructional level taught, and classroom AIDS instruction) contained statistical significance.^ Analysis of attitudes indicated that general and special education teachers' overall attitudes toward students with HIV/AIDS were generally positive within clusters of Instruction and Fear, but not within Sensitivity and Communication. Among the ten demographic variables used for analysis only three (age, graduate enrollment status, and classroom AIDS instruction) produced statistical significance. Results found statistically significant relationships between Total Knowledge, all knowledge subtests, Fear, and Overall Attitudes. Statistical significance was also located on Total Knowledge, Pathology and Transmission knowledge subtests, and Sensitivity, as well as between Pathology and Instruction, and General Statements and Facts and Communication.^ The only variable determined to have statistical significance on both knowledge and attitudes was classroom AIDS instruction. Participants with previous AIDS instruction showed greater knowledge and possessed more positive attitudes. A review of previous research indicated training to be effective in increasing knowledge and fostering more favorable behavior toward persons with AIDS. Therefore, this study finds AIDS training to be beneficial for all teachers and is recommended during preservice education or through inservices for teachers already in the field. ^

A comparative analysis of school satisfaction and dropout risk of middle school students attending programs for students with emotional handicaps, severe emotional disturbance and general education students attending center schools and satellite schools

This study evaluated school satisfaction as an indicator of dropout risk of students with Emotional Handicaps (EH) and students with Severe Emotional Disturbance (SED). The students attended two different kinds of middle schools in a largely urban school district in South Florida. One hundred eight students in grade 8 (ages 13-16) participated in this study. Participants were administered the National Dropout Prevention Assessment (NDPA). Forty participants with EH and SED attended a special center school. Thirty-one participants with EH and SED attended satellite programs in a regular middle school. Thirty-seven general education participants attended the same regular middle school. Overall school satisfaction scores were generated, as well as three primary factors (school, environment and personal) and 16 subscales (school atmosphere, future income, difficulty level of classwork, teacher relationships, peer relationships, intrinsic interest in classwork, school hours, classwork stress, general attitude towards school, family influence, perceived opportunity for career, future goals, travel distance, leisure time, self-appraisal of performance, and self-esteem).^ Comparison of students with EH and SED revealed that both groups of students were rated at "low risk" of becoming dropouts on the Environmental factor and the Difficulty of Schoolwork subscale. Students with EH were rated at "caution risk" risk on the Travel Distance subscale. Students with SED were rated at "high risk" on this subscale.^ There were no significant differences in school satisfaction and dropout risk between different program delivery models. There were also no significant differences for category of students (EH, SED) by school type (center school, satellite program). All students were rated at "low risk" of dropping out of school.^ There were significant differences between general education students and students with EH and SED attending satellite programs. Students with EH and SED were rated at "caution risk" for dropping out on the Travel Distance and the Leisure Time subscales. Discussion of results, implications for practice and recommendations for further research are included. ^

The effects of self-monitoring on homework completion and accuracy rates of students with disabilities in an inclusive general education classroom

This study investigated the effects of self-monitoring on the homework completion and accuracy rates of four, fourth-grade students with disabilities in an inclusive general education classroom. A multiple baseline across subjects design was utilized to examine four dependent variables: completion of spelling homework, accuracy of spelling homework, completion of math homework, accuracy of math homework. Data were collected and analyzed during baseline, three phases of intervention, and maintenance. ^ Throughout baseline and all phases, participants followed typical classroom procedures, brought their homework to school each day and gave it to the general education teacher. During Phase I of the intervention, participants self-monitored with a daily sheet at home and on the computer at school in the morning using KidTools (Fitzgerald & Koury, 2003); a student friendly, self-monitoring program. They also participated in brief daily conferences to review their self-monitoring sheets with the investigator, their special education teacher. Phase II followed the same steps except conferencing was reduced to two days a week, which were randomly selected by the researcher and Phase III conferencing was one random day a week. Maintenance data were taken over a two-to-three week period subsequent to the end of the intervention. ^ Results of this study demonstrated self-monitoring substantially improved spelling and math homework completion and accuracy rates of students with disabilities in an inclusive, general education classroom. On average, completion and accuracy rates were highest over baseline in Phase III. Self-monitoring led to higher percentages of completion and accuracy during each phase of the intervention compared to baseline, group percentages also rose slightly during maintenance. Therefore, results suggest self-monitoring leads to short-term maintenance in spelling and math homework completion and accuracy. ^ This study adds to the existing literature by investigating the effects of self-monitoring of homework for students with disabilities included in general education classrooms. Future research should consider selecting participants with other demographic characteristics, using peers for conferencing instead of the teacher, and the use of self-monitoring with other academic subjects (e.g., science, history). Additionally, future research could investigate the effects of each of the two self-monitoring components used alone, with or without the conferencing.^

Inquiring Minds Want to Know: Inquiry-Based Learning in the General Education and Inclusion Science Classroom

This study sought to apply the concepts of inquiry-based learning by increasing the number of laboratory experiments conducted in two science classes, and to identify the challenges of this instruction for students with special needs. Results showed that the grades achieved through lab write-ups greatly improved grades overall.

Effect of an inservice on the teachers' knowledge of general school law, Section 504, and the Meta Consent Decree

It is generally assumed by educators that inservice training will make a significant difference in teacher knowledge of topics related to education. This investigation addressed that assumption by examining the effects of various factors, e.g., amount and timing of inservice training, upon teacher knowledge of educational law. Of special interest was teacher knowledge of the law as it pertained to ethnic and other characteristics of students in urban school settings. This study was deliberately designed to determine which factors should be later investigated in a more deterministic form, e.g., an experimental design.^ The investigation built upon that of Ogletree (1985), Osborne (1996) and others who focused on the importance of teacher development as a method to enhance professional abilities. The main question addressed in this study was, "How knowledgeable are teachers of school law, especially with regard to general school law, the Meta Consent Decree and Section 504 of the Rehabilitation Act of 1973."^ The study participants (N = 302) were from the Dade County School System, the fourth largest in the U.S. The survey design (approved by the System), specified participants from all levels and types of schools and geographic representations. A survey instrument was created, pilot tested, revised and approved for use by the district official representatives. After administration of the instrument, the resultant data was treated by several appropriate tests, e.g., multivariate analysis of variance (ANOVA).^ Several findings emerged from the analysis of the data: in general, teachers did not have sufficient knowledge of school law; factors, such as amount and level of education, and status and position were positively correlated with increased knowledge; factors such as years of experience, gender, race and ethnicity were not correlated with higher levels of knowledge. The most significant, however, was that when teachers had participated in several inservice training experiences, typically workshops, and, when combined with other factors noted above, their knowledge of school law was significantly higher. Specific recommendations for future studies were made. ^

Adult education directors' perceptions of performance indicators for adult education programs in the state of Florida

Current demands for accountability in education emphasize outcome-based program evaluation and tie program funding to individual student performance. As has been the case for elementary and secondary programs, demands for accountability have increased pressure on adult educators to show evidence of the benefits of their programs in order to justify their financial support. In Florida, recent legislation fundamentally changes the delivery of adult education in the state by establishing a performance-based funding system that is based on outcomes related to the retention, completion, and employment of program participants.^ A performance-based funding system requires an evaluation process that stresses outcome indicators over indicators that focus on program context or process. Although the state has adopted indicators of program quality to evaluate its adult education programs, these indicators focus mostly on program processes rather than student outcomes. In addition, the indicators are not specifically tied to workforce development outcomes, a priority to federal and local funding agents.^ Improving the accountability of adult education programs and defining the role of these programs in Florida's Workforce Development System has become a priority to policy makers across the state. Another priority has been to involve adult education practitioners in every step of this process.^ This study was conducted in order to determine what performance indicators, as judged by the directors and supervisors of adult education programs in the state of Florida, are important and feasible in measuring the quality and effectiveness of these programs. The results of the study indicated that, both statewide and by region, the respondents consistently gave the highest ratings on both importance and feasibility to the indicators of Program Context, which reflect the needs, composition, and structure of the programs, and to the indicators of Educational Gain, which reflect learner progress in the attainment of basic skills and competencies. In turn, the respondents gave the lowest ratings on both importance and feasibility to the indicators in the areas of Return on State's Investment, Efficiency, Retention, and Workforce Training. In general, the indicators that received high ratings for importance also received high ratings for feasibility. ^

An examination of parental opinions regarding the inclusion of disabled students in regular education classes

This study investigated the opinions regarding inclusion of parents of both disabled and nondisabled elementary children from a large suburban county. An opinion survey combining Wilczenski's Attitudes Toward Inclusive Education Scale with additional questions was distributed to 1170 children from 24 schools. Three research questions focused on differences between mean parental responses as they related to the inclusion and disability status of the parent's child. Results from the 270 respondents indicated that parents with disabled children had more favorable opinions about inclusion than did those with nondisabled children. Parents with included children were more favorable toward inclusion than were parents whose children were not included. Parents with included disabled children were more accepting of inclusion than were those with nondisabled children in inclusive settings. Parents' answers differed depending on the type of disability being included. Regardless of their child's disability or inclusion status, the ranking for disability types from most acceptable for inclusion to least acceptable were: social, sensory, motor, academic and behavioral. Results across types of questions, including questions relating to acceptance and general inclusion issues, indicated consistently more favorable opinions of parents with disabled children, included children and disabled children in inclusive classes. Two additional research questions examined parental responses as they related to demographic characteristics of the parents and of the schools their children attended. Analysis of Variance found only one significant main effect for any parental demographic variable. This difference was for the number of parents' elementary children when comparing parents with and without disabled children. The only significant main effects of demographics of schools the parents' children attended were for the area of the county and for schools with differing percentages of severely disabled students when comparing responses of parents with disabled and nondisabled children. For all research questions, tests indicated low effect sizes and moderate to high power levels. These results, and the fact that means for all groups were in the middle range of response choices, indicate that there may be little practical significance to the overall results. Further studies should investigate the trends found in this study. ^

The effect of cooperative learning on the attitudes toward science and the achievement of students in a non-science majors' general biology laboratory course at an urban community college

The purpose of this study was to evaluate the effect of cooperative learning strategies on students' attitudes toward science and achievement in BSC 1005L, a non-science majors' general biology laboratory course at an urban community college. Data were gathered on the participants' attitudes toward science and cognitive biology level pre and post treatment in BSC 1005L. Elements of the Learning Together model developed by Johnson and Johnson and the Student Team-Achievement Divisions model created by Slavin were incorporated into the experimental sections of BSC 1005L.^ Four sections of BSC 1005L participated in this study. Participants were enrolled in the 1998 spring (January) term. Students met weekly in a two hour laboratory session. The treatment was administered to the experimental group over a ten week period. A quasi-experimental pretest-posttest control group design was used. Students in the cooperative learning group (n$\sb1$ = 27) were administered the Test of Science-Related Attitudes (TOSRA) and the cognitive biology test at the same time as the control group (n$\sb2$ = 19) (at the beginning and end of the term).^ Statistical analyses confirmed that both groups were equivalent regarding ethnicity, gender, college grade point average and number of absences. Independent sample t-tests performed on pretest mean scores indicated no significant differences in the TOSRA scale two or biology knowledge between the cooperative learning group and the control group. The scores of TOSRA scales: one, three, four, five, six, and seven were significantly lower in the cooperative learning group. Independent sample t-tests of the mean score differences did not show any significant differences in posttest attitudes toward science or biology knowledge between the two groups. Paired t-tests did not indicate any significant differences on the TOSRA or biology knowledge within the cooperative learning group. Paired t-tests did show significant differences within the control group on TOSRA scale two and biology knowledge. ANCOVAs did not indicate any significant differences on the post mean scores of the TOSRA or biology knowledge adjusted by differences in the pretest mean scores. Analysis of the research data did not show any significant correlation between attitudes toward science and biology knowledge. ^

The effect of vocational education on high school students in a large urban multicultural school district

The completion of and graduation from high school is a major problem that must be resolved. A 6% random sample of the students (1,059) who were in the 9th grade in Miami-Dade Public Schools, a large urban school district, September 1992, were selected for this study. The sample was divided into 2 groups, advanced academic and general track students. Each group was then divided into vocational and non-vocational. A causal comparative design was used to evaluate the results for graduate vs. non-graduate. The indicators were the program of study, attendance, standardized test scores, grade point average, ethnicity and gender. It was found that both advanced academic and general track students had significantly higher graduation rates at the .01 level when a vocational education program was part of their studies. All of the other indicators did not show any significant differences. If we arc to improve students educational outcomes and reduce the dropout rate, vocational education should be part of every student's education.^

A comparison of the academic performance of students with General Educational Development credentials and high school diplomas at a selected community college

This study compared the performance of students who earned GED credentials in Florida with that of graduates of Florida high schools, when members of both groups enrolled for the first time in fall 1992 at an urban multicultural community college in south Florida. GED's and HSD's were matched on gender, race, age range, placement levels, and enrollment in college preparatory courses (reading, English, mathematics). The paired samples t-test compared course grades, first semester GPA, and total college GPA for the groups and subgroups of matched students at a probability level of .05. The McNemar test compared how many students in each group and subgroup re-enrolled for a second and third term, or ever; how many were placed on special academic status during their college enrollment; and how many graduated within 16 semesters. Differences between groups were found only for placement on probation—with HSD's on probation in significantly higher proportion than GED's. ^ Additional findings among subgroups revealed that male and Caucasian HSD subjects earned higher math grades than their GED counterparts. Male HSD's were more likely than male GED's to return to the college at some point after the first term. However, male HSD's were placed on probation in greater proportion than the GED's with whom they were matched. ^ Female GED's earned higher English grades and higher first semester and cumulative GPA's and returned to the college in greater proportion than their HSD counterparts. Black GED's earned higher first-semester GPA's, re-enrolled in terms 2 and 3 and graduated from the college in higher percentages than Black HSD's. Black HSD's were placed on probation in higher proportion than Black GED's. Lastly, greater percentages of HSD than GED subjects in the lowest age range (16–19) were placed on probation. ^ Results connected to the performance of Black GED subjects are likely to have been affected by the fact that 50% of Black study subjects had been born in Jamaica. The place of the GED in the constellation of methods for earning credit by examination is explored, future implications are discussed, and further study is recommended. ^

Education, earnings, and rates of return: The case of Taiwan

Educational planners and economists have long recognized the importance of education as a form of productive investment in both advanced countries and developing countries. In the case of Taiwan, along with impressive economic growth, there was an even faster rate of growth of the government's investment in education. This leads some to question whether education has any role in economic development. ^ The purpose of this study is to provide a broad overview of the role of education, in terms of private rates of return to education, in Taiwan. In the process, a variety of hypotheses about human capital theory are examined and an empirical study of Taiwan's earnings functions are tested to show that education can be an important instrument to increase private rate of return, even under conditions of scarcity of natural and physical resources. Data was collected using the Manpower Survey and Manpower Utilization Survey, conducted by the government. Research questions were analyzed using descriptive statistics, frequencies, and regression analysis. ^ Results indicated that the Manpower Development Plans have been the decisive influence in allowing Taiwan to develop its human resources and achieve success in meeting the needs of Taiwan's economy. The structure of age-earnings profiles showed a strong relationship between earnings and education, and the profiles that successively shift upward are associated with higher levels of education. In the cross-sectional results of the rate of return in 1997, each additional year of schooling leads to a 6.2% increase in income. As to the private rates of return to different levels of education, the results found that the private rates of return are 2.88%, 4.85% and 10.05% for primary, secondary and higher education respectively. In an intertemporal comparison for 1980, 1985, 1990 and 1997, the results showed no significant trend except the private rates of return for primary education have been falling from 3.9% to 2.88%. ^ On the basis of this study, for individual student or family in Taiwan, there is likely to be a strong demand for education, particularly at the higher level. Therefore, a well-developed higher educational level becomes essential and the content of curriculum in higher education becomes another crucial question facing planners in Taiwan if they are going to use education as a means to foster economic development. ^

The knowledge and use of critical thinking teaching strategies of faculty in associate degree nursing education programs

The purpose of this study was to determine the knowledge and use of critical thinking teaching strategies by full-time and part-time faculty in Associate Degree Nursing (ADN) programs. ^ Sanders CTI (1992) instrument was adapted for this study and pilot-tested prior to the general administration to ADN faculty in Southeast Florida. This modified instrument, now termed the Burroughs Teaching Strategy Inventory (BTSI), returned reliability estimates (Cronbach alphas of .71, .74, and .82 for the three constructs) comparable to the original instrument. The BTSI was administered to 113 full-time and part-time nursing faculty in three community college nursing programs. The response rate was 92% for full-time faculty (n = 58) and 61% for part-time faculty (n = 55). ^ The majority of participants supported a combined definition of critical thinking in nursing which represented a composite of thinking skills that included reflective thinking, assessing alternative viewpoints, and the use of problem-solving. Full-time and part-time faculty used different teaching strategies. Full-time faculty most often used multiple-choice exams and lecture while part-time faculty most frequently used discussion within their classes. One possible explanation for specific strategy choices and differences might be that full-time faculty taught predominately in theory classes where certain strategies would be more appropriate and part-time faculty taught predominately clinical classes. Both faculty types selected written nursing care plans as the second most effective critical thinking strategy. ^ Faculty identified several strategies as being effective in teaching critical thinking. These strategies included discussion, case studies, higher order questioning, and concept analysis. These however, were not always the strategies that were used in either the classroom or clinical setting. ^ Based on this study, the author recommends that if the profession continues to stress critical thinking as a vital component of practice, nursing faculty should receive education in appropriate critical teaching strategies. Both in-service seminars and workshops could be used to further the knowledge and use of critical thinking strategies by faculty. Qualitative research should be done to determine why nursing faculty use self-selected teaching strategies. ^