Medical student scholarship program, Illinois Department of Public Health, Pursuant to The Family Practice Residency Act (110 ILCS 935.1 et seq) : annual report FY... /

Description based on FY1993 ; title from caption.

Residential and lifestyle changes for adults with an intellectual disability in Queensland 1960-2001

As we celebrate 50 years of the Schonell Special Education Research Centre it is timely to consider changes that have occurred in the provision of residential services for people with an intellectual disability. Before the 1970s adults and children were cared for in large institutions using a medical model of care. In the mid-1970s a new developmental model based on education and training was implemented in response to the principle of normalisation and issues of social justice. The most dramatic changes have occurred in the last ten years with the decision to close large institutions and relocate residents into ordinary homes in the community. This paper describes changes in lifestyle for adults with an intellectual disability as a result of the move from institutional to community residential service provision. The Challinor Centre in Ipswich, Queensland, Australia provides examples of lifestyle changes that have occurred under different models of service provision during this time. Community living is described with research evidence validating the advantages of this type of service provision for residents with an intellectual disability. Outcomes have been documented through the use of group results and a case study of one individual following deinstitutionalisation describes the benefits of this new model of residential accommodation

Early practical experience and the social responsiveness of clinical education: Systematic review

Objectives To find how early experience in clinical and community settings (early experience) affects medical education, and identify strengths and limitations of the available evidence. Design A systematic review rating, by consensus, the strength and importance of outcomes reported in the decade 1992-2001. Data sources Bibliographical databases and journals were searched for publications on the topic, reviewed under the auspices of the recently formed Best Evidence Medical Education (BEME) collaboration. Selection of studies All empirical studies (verifiable, observational data) were included, whatever their design, method, or language of publication. Results Early experience was most commonly provided in community settings, aiming to recruit primary care practitioners for underserved populations. It increased the popularity of primary care residencies, albeit among self selected students. It fostered self awareness and empathic attitudes towards ill people, boosted students' confidence, motivated them, gave them satisfaction, and helped them develop a professional identity. By helping develop interpersonal skills, it made entering clerkships a less stressful experience. Early experience helped students learn about professional roles and responsibilities, healthcare systems, and health needs of a population. It made biomedical, behavioural, and social sciences more relevant and easier to learn. It motivated and rewarded teachers and patients and enriched curriculums. In some countries,junior students provided preventive health care directly to underserved populations. Conclusion Early experience helps medical students learn, helps them develop appropriate attitudes towards their studies and future practice, and orientates medical curriculums towards society's needs. Experimental evidence of its benefit is unlikely to be forthcoming and yet more medical schools are likely to provide it. Effort could usefully be concentrated on evaluating the methods and outcomes of early experience provided within non-experimental research designs, and using that evaluation to improve the quality of curriculums.

Exploring the feasibility and acceptability of using internet technology to promote physical activity within a defined community

ISSUE ADDRESSED: To explore the feasibility of using the Internet and e-mail to promote physical activity in a defined community. METHODS: An online survey was conducted through a community-based Internet Service Provider (ISP). ISP clients were recruited via electronic newsletter and direct e-mail. Data were collected on preferred sources of assistance for physical activity advice and stage of motivational readiness for physical activity. RESULTS: Valid surveys were completed by 797 (9% response rate). Participants were: 55% men; 56% aged >45 years; 57% worked full time; mean BMI was 28+/-8. Thirty-six per cent were in the early stages of motivational readiness for physical activity. More than 70% were somewhat to extremely interested in having access to a physical activity website. CONCLUSION: Promoting physical activity via the Internet and e-mail is feasible and appealing to some people. Expanding the reach, appeal and use of this technology to deliver physical activity programs will be a challenge.

Health-protective behaviours and risk of fall-related hip fractures: a population-based case-control study

Background: fall-related hip fractures are one of the most common causes of disability and mortality in older age. The study aimed to quantify the relationship between lifestyle behaviours and the risk of fall-related hip fracture in community-dwelling older people. The purpose was to contribute evidence for the promotion of healthy ageing as a population-based intervention for falls injury prevention. Methods: a case-control study was conducted with 387 participants, with a case-control ratio of 1:2. Incident cases of fall-related hip fracture in people aged 65 and over were recruited from six hospital sites in Brisbane, Australia, in 2003-04. Community-based controls, matched by age, sex and postcode, were recruited via electoral roll sampling. A questionnaire designed to assess lifestyle risk factors, identified as determinants of healthy ageing, was administered at face-to-face interviews. Results: behavioural factors which had a significant independent protective effect on the risk of hip fracture included never smoking [adjusted odds ratio (AOR): 0.33 (0.12-0.88)], moderate alcohol consumption in mid- and older age [AOR: 0.49 (0.25-0.95)], not losing weight between mid- and older age [AOR: 0.36 (0.20-0.65)], playing sport in older age [AOR: 0.49 (0.29-0.83)] and practising a greater number of preventive medical care [AOR: 0.54 (0.32-0.94)] and self-health behaviours [AOR: 0.56 (0.33-0.94)]. Conclusion: with universal exposures, clear associations and modifiable behavioural factors, this study has contributed evidence to reduce the major public health burden of fall-related hip fractures using readily implemented population-based healthy ageing strategies.

10,000 Steps Rockhampton: A Whole Community Approach to Increasing Levels of Physical Activity

10,000 Steps Rockhampton is a multi-strategy health promotion program which aims to develop sustainable community-based strategies to increase physical activity.The central coordinating focus of the project is the use of pedometers to raise awareness of and provide motivation for physical activity, around the theme of '10,000 steps/day - Every step counts.' To date, five key strategies have been implemented: (1) a media-based awareness raising campaign; (2) promotion of physical activity by health professionals; (3) improving social support for physical activity through group-based programs; (4) working with local council to improve environmental support for physical activity; and (5) establishment of a ‘micro-grants’ fund to which community groups could apply for assistance with small, innovative physical activity enhancing projects. Strategies were introduced on a rolling basis beginning in February 2002 with 'layering' of interventions designed to address the multi-level individual social and environmental determinants of physical activity. The project was quasi-experimental in design, involving collection of baseline and two year follow-up data from community based surveys in Rockhampton and in a matched regional Queensland town. In August 2001,the baseline CATI survey (N=1281)found that 47.9% of men and 33.0% of women were meeting the national guidelines for physical activity. In August 2002, a smaller survey (N=400) found an increase in activity levels among women (39.7% active) but not in men (48.5%). Data from the two year follow up survey, to be conducted in August 2003, will be presented, with discussion of the major successes and challenges of this landmark physical activity intervention. Acknowledgement: This project is supported by a grant from Health Promotion Queensland

Building Community Coalitions for the Promotion of Physical Activity: 10,000 Steps Rockhampton

The 10,000 Steps Rockhampton project is a multi-strategy community-wide, physical activity intervention based on the simultaneous implementation of five strategies, each identified as 'best practice' for the promotion of physical activity. Several community partners were engaged to develop and implement the strategies during the first eighteen months of the project. These included: the local media (TV, newspaper and radio); the local Division of General Practice and other health professional groups; the Heart Foundation and ‘Just Walk It’; the local council; and several large worksites. A local physical activity task force was also formed to administer a 'micro-grants' scheme, and to guide the development of community based strategies. The presentation will focus on the critical elements involved in developing and maintaining relationships with community partners. These include identification and ‘courting’ of potential partners, strategies for keeping them engaged, and the challenges of maintaining the balance between ‘top-down’ (evidence-based) and ‘bottom-up’ (community-driven) strategies. Data on implementation and uptake of the key strategies will also be presented. These include: 1) process data on the number of health

Seasonal dynamic pattern analysis in service of climate change research. A methodical case-study - monitoring and simulation based on an aquatic insect community

Our aim was to approach an important and well-investigable phenomenon – connected to a relatively simple but real field situation – in such a way, that the results of field observations could be directly comparable with the predictions of a simulation model-system which uses a simple mathematical apparatus and to simultaneously gain such a hypothesis-system, which creates the theoretical opportunity for a later experimental series of studies. As a phenomenon of the study, we chose the seasonal coenological changes of aquatic and semiaquatic Heteroptera community. Based on the observed data, we developed such an ecological model-system, which is suitable for generating realistic patterns highly resembling to the observed temporal patterns, and by the help of which predictions can be given to alternative situations of climatic circumstances not experienced before (e.g. climate changes), and furthermore; which can simulate experimental circumstances. The stable coenological state-plane, which was constructed based on the principle of indirect ordination is suitable for unified handling of data series of monitoring and simulation, and also fits for their comparison. On the state-plane, such deviations of empirical and model-generated data can be observed and analysed, which could otherwise remain hidden.

Nursing faculty intention to use service learning as pedagogy in higher education

The purpose of this study was to identify the factors that motivate nursing faculty to use service learning. The study was based on the theory of planned behavior (TPB), which implies that the target behavior of intention to use service learning in higher education is influenced by the predictor variables of behavior beliefs (attitude), normative beliefs (peer influence), and control beliefs (confidence and resources). External variables were also considered (years of teaching experience, tenure status, and the type of curriculum). ^ Group interviews and a pilot test were conducted to create the instrument for the study, and Cronbach alpha were calculated for survey item reliability. The participants were full time undergraduate nursing faculty members ( n = 160) in the Southeastern United States who taught in universities with accredited nurse education programs. Demographic data as well as scores on scaled survey responses were used to evaluate the intention of nursing faculty to use service learning in their classes. ^ Pearson product moment correlation coefficient and path analysis were applied to the data. The correlation findings indicated that there were statistically significant relationships between behavior beliefs, normative beliefs, and control beliefs and nursing faculty intention to use service learning. The path analysis also indicated that behavior beliefs and normative beliefs were significant, while control beliefs were not a strong influence on intention to use service learning. Normative beliefs showed the strongest direct influence. The use of a community based curriculum also had a positive influence on intention, and faculty with tenure status were more likely to have positive behavior beliefs (attitude) towards service learning. Finally, as teaching experience increased, positive attitudes towards the intention to use service learning decreased. Seventy-nine percent of the variation in the intention to use service learning was explained by the theory of planned behavior, the type of curriculum, teaching experience, and tenure status. These results will assist nursing administration and faculty to design strategies to facilitate the implementation of service learning pedagogy, as well as a community based curriculum which will help meet the 21st century goals set forth from the American Association of Colleges of Nursing. ^

An interview study of community college student perspectives on service -learning

Over the past two decades, the community college in the United States has boasted a leadership role in the movement to make education community-based and performance-oriented. This has led to an intensification in attempts to search for more innovative means to make education more experiential and relevant to students' lived experiences. ^ One such innovative program that holds promise to meet this challenge is service-learning. This paradigm attempts to relate the academic education in the classroom to community-based problems, which fits in neatly with the community-based characteristics of the community college. It promises to link ideas developed in the classroom and their practical application within the community through guided reflection. It is designed to enhance and enrich student learning of course material by combining citizenship, academic subjects, skills, and values. ^ Though many studies have been carried out in regard to the outcomes of service-learning through quantitative means, relatively few qualitative studies are available, and those available have primarily studied traditional students at four-year residential colleges or universities. Therefore, there is an urgent need to study non-traditional students' perspectives at the community college level. ^ The purpose of this study was to describe and explain the perspectives of five students at Broward Community College, Central Campus, Ft. Lauderdale, Florida. The following exploratory questions guided this study: (1) What elements constitute these students' perspectives? (2) What variables influence their perspectives? (3) What beliefs do these students hold about their service-learning experience which support or are contrary to their perspectives? ^ This ethnographic interview study was conducted over a period of twelve months and consisted of three interviews for each of the five participants. The analysis of the data was conducted following the stringent principles of ethnographic research which included constant comparative analysis. The interviews were tape recorded with the participants' permission, transcribed verbatim, and organized into categories for in-depth understanding. Furthermore, these categories were developed from the data collected and an organizational scheme for understanding and interpreting of these perspectives emerged. The researcher, as well, kept a reflective journal of the research process as part of the data set. ^ The results of this study show the need for a better grasp of the concepts of service-learning on the part of all involved with its implementation. In spite of this, all of the participants displayed gains to a greater or lesser degree in personal growth, academic skills, and citizenship skills. ^

Health changes in Hispanic older adults in a Spanish arthritis self -management education program

Arthritis is the most common chronic condition affecting older people and is a major cause of limited activity. Arthritis education programs in English have demonstrated a positive impact on health but these programs have not reached the Hispanic communities where arthritis is the leading cause of disability. Minorities, such as Hispanics, have traditionally been reluctant to pursue self-help programs, and have been identified as an under-served population in terms of medical care. This study examined the effectiveness of one community health adult education program targeting Hispanic older adults with arthritis, the Spanish Arthritis Self Management Education Program (SASMEP), by evaluating changes in the participants' general health, pain, disability, self-efficacy, health perceptions, frequency of physician visits, and exercise. A pre and post control group experimental design and analyses of covariance were used to determine the pre and post differences in health status and health behaviors for a group participating in the SASMEP and a group who did not using gender and age as covariates. A repeated measures design was also used, and repeated measures analyses of variance and post hoc tests were done on health status and health behavior data collected pre, post and one-year post education to determine long-term differences. ^ Results indicated the participants' health status significantly improved in general health, significantly decreased in pain, and significantly decreased in arthritic disability immediately following the education. Self-efficacy and health perceptions increased for both groups but not significantly. The participants' health behaviors showed significantly fewer physician visits and significantly increased time spent performing stretching and strengthening exercise and time spent performing aerobic exercise. No group differences were found in the frequency of arthritis physician visits. ^ The improvements seen immediately after the SASMEP participation were not reflected in the post one-year scores. No significant differences were found for the participants' health status or health behaviors one year following the education. Health status and health behaviors did not return below baseline scores after one year suggesting the participants' health, although not improved, did not deteriorate. Therefore, the SASMEP education provided short-term health benefits for older Hispanic adults with arthritis, but not long-term health benefits. ^

Foreign Language Education in Colombia: A Qualitative Study of Escuela Nueva

Since 2004 the Colombian Ministry of Education has been implementing the Programa Nacional de Bilingüismo (PNB) with the goal of having bilingual high school graduates in English and Spanish by 2019. However, implementation of the PNB has been criticized by English Language Teaching (ELT) specialists in the country who say, among other things, that the PNB introduced a discourse associated exclusively with bilingualism in English and Spanish. This study analyzed interviews with 15 participants of a public school of the Colombian Escuela Nueva, a successful model of community-based education that has begun a process of internationalization, regarding the participants’ perceptions of foreign language education and the policies of the PNB. Six students, five teachers, and four administrators were each interviewed twice using semi-structured interviews. To offer a critique of the PNB, this study tried to determine to what extent the school implemented the elements of Responsible ELT, a model developed by the researcher incorporating the concepts of hegemony of English, critical language-policy research, and resistance in ELT. Findings included the following: (a) students and teachers saw English as the universal language whereas most administrators saw English imposed due to political and economic reasons; (b) some teachers misinterpreted the 1994 General Law of Education mandating the teaching of a foreign language as a law mandating English; and (c) some teachers and administrators saw the PNB’s adoption of competence standards based on the Common European Framework of Reference for languages as beneficial whereas others saw it as arbitrary. Conclusions derived from this study of this Escuela Nueva school were: (a) most participants found the goal of the PNB unrealistic; (b) most teachers and administrators saw the policies of the PNB as top-down policies without assessment or continuity; and (c) teachers and administrators mentioned a disarticulation between elementary and high school ELT policies that may be discouraging students in public schools from learning English. Thus, this study suggests that the policies of the PNB may be contributing to English becoming a gatekeeper for higher education and employment thereby becoming a tool for sustaining inequality in Colombia.

An interview study of community college student perspectives on service-learning

Over the past two decades, the community college in the United States has boasted a leadership role in the movement to make education community-based and performance-oriented. This has led to an intensification in attempts to search for more innovative means to make education more experiential and relevant to students' lived experiences. One such innovative program that holds promise to meet this challenge is service- learning. This paradigm attempts to relate the academic education in the classroom to community-based problems, which fits in neatly with the community-based characteristics of the community college. It promises to link ideas developed in the classroom and their practical application within the community through guided reflection. It is designed to enhance and enrich student learning of course material by combining citizenship, academic subjects, skills, and values. Though many studies have been carried out in regard to the outcomes of service-learning through quantitative means, relatively few qualitative studies are available, and those available have primarily studied traditional students at four-year residential colleges or universities. Therefore, there is an urgent need to study non-traditional students' perspectives at the community college level. The purpose of this study was to describe and explain the perspectives of five students at Broward Community College, Central Campus, Ft. Lauderdale, Florida. The following exploratory questions guided this study: 1. What elements constitute these students' perspectives? 2. What variables influence their perspectives? 3. What beliefs do these students hold about their service-learning experience which support or are contrary to their perspectives? This ethnographic interview study was conducted over a period of twelve months and consisted of three interviews for each of the five participants. The analysis of the data was conducted following the stringent principles of ethnographic research which included constant comparative analysis. The interviews were tape recorded with the participants' permission, transcribed verbatim, and organized into categories for in-depth understanding. Furthermore, these categories were developed from the data collected and an organizational scheme for understanding and interpreting of these perspectives emerged. The researcher, as well, kept a reflective journal of the research process as part of the data set. The results of this study show the need for a better grasp of the concepts of service-learning on the part of all involved with its implementation. In spite of this, all of the participants displayed gains to a greater or lesser degree in personal growth, academic skills, and citizenship skills.