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.

An investigation of the relationships between selected characteristics and leadership outcomes of Athletic Training Education Program directors

There is currently no evidence describing what characteristics make an Athletic Training Program Director (PD) an effective leader. An influx of accredited programs resulted in a rapid increase in the demand for PDs, yet training and preparation for these positions has failed to evolve. Although Certified Athletic Trainers (ATs) are trained in specific content areas, they may not always be prepared for the administrative and leadership responsibilities associated with the role of PD (Leone, 2008). This dissertation examined the relationships between selected characteristics and leadership outcomes of Athletic Training Program Directors. Each PD participants (n=27) completed a demographic questionnaire to obtain the leader's academic preparation, accreditation experience and leadership training history. Each participant also completed the Multifactor Leadership Questionnaire (MLQ) to obtain leadership styles, behaviors, and outcomes. Overall, the PDs reported utilizing transformational leadership most often and passive avoidant leadership least often. There was no significant difference between PDs with master's and doctorate degrees on overall leadership outcome. However, participants with a doctorate degree scored significantly different on the effectiveness component of the leadership outcome compared with participants with a master's degree. Those participants who have completed academic coursework on leadership scored significantly different on the leadership outcome compared to those who have not completed academic coursework on leadership. Findings from this study indicate that changes to the current requirements for the role of PD may be warranted. Consideration should be given to increasing the minimum degree requirement and requiring academic coursework on leadership. Future research may be useful in determining specific degree guidelines and types and amounts of leadership training that would be beneficial to Athletic Training PDs.

Children as Change Agents: The Influence of Integrating Environmental Education into Home Learning Projects on Families and Community Members

Environmental education focusing on sustainability should be integrated into the elementary curriculum. Learning experiences should include home learning projects that are relevant to the students, involve active participation, and stimulate discussions with their families. Students can use their knowledge and skills to influence the attitudes and behavior of their parents and other community members.

Characteristics of the Commission on Accreditation of Allied Health Education Programs or National Athletic Trainers' Association -accredited athletic training programs associated with first -attempt passing rates on the NATABOC examination

Athletic training is an allied health profession recognized by the American Medical Association requiring certification by examination. There are two routes towards certification as an athletic trainer: attending a university with an accredited athletic training program or with an internship program By 2004, the only route towards certification will be by attending a Commission on Accreditation of Allied Health Education Programs (CAAHEP) or National Athletic Trainers' Association (NATA) accredited athletic training program. CAAHEP looks at passing rates on the NATA Board of Certification (NATABOC) examination when granting accreditation. This study examined characteristics of programs associated with first time passing rates. ^ Directors from 39 CAAHEP or NATA accredited athletic training programs completed a descriptive 17-question survey regarding academic characteristics, faculty characteristics, and program characteristics. Analysis used Spearman's rho correlation coefficient, with significance of p = <.05. Four program directors were interviewed to gather additional insight. ^ There were three program characteristics that showed a significant positive association with first attempt passing rates: the number of full-time and part-time approved clinical instructors (ACIs), and the number of students in the program. Further investigation found a statistically significant association between a low ratio of ACIs to athletic training students and first time passing rates. ACIs are certified athletic trainers (ATCs) who have received special training in order to supervise athletic training students. CAAHEP mandates a 1:8 ratio of ATCs to athletic training student. This study showed that a smaller ratio of ATC to student in combination with ACI training was significantly associated with higher first time passing rates. The number of courses above the required 13 delineated by the Education Council showed a significant negative association with first attempt passing rates. ^ Universities seeking or maintaining accreditation should incorporate characteristics associated with a higher passing rate on the NATABOC examination. Characteristics include utilizing a large number of full-time and part-time ACIs, admitting a large number of students into the program while maintaining a low ACI to athletic training student ratio, and offering curricula that focuses on the 13 courses that have been deemed relevant to the athletic training curriculum by the Education Council. ^

The effects of health education on student health -related behaviors

During their transitional period from childhood to adulthood, adolescents engage in risk-taking behaviors that become public health concerns. It is important for school health education professionals to design instructional programs that focus on adolescents' developmental needs and foster healthier lifestyles. The goal of health education is to help students acquire health skills that are necessary to succeed in school and in life. This is especially important because the increase in teenagers' risky behaviors can affect their health, well being, and eventually the course of their lives. ^ This study examined the effects of health education on health-related behaviors of public high school students. A multivariate analysis of variance was conducted to determine whether the comprehensive approach based on The Jessors' Problem Behavior Theory (PBT) had a greater impact on adolescents' risk-taking behaviors than the traditional approach. After 18 weeks of health instruction using one of these approaches, the Youth Risk Behavior Survey (YRBS) was administered to measure the level of subjects' self-reported behaviors in six categories of adolescent risky behaviors: the use of tobacco; the use of alcohol and other drugs; engagement in injurious activities; consumption of unhealthy diet; an inadequate level of participation in physical activities; and engagement in risky sexual activities. ^ The results of this study did not support the hypothesis that using the comprehensive health education approach was more influential than the traditional health education approach in improving students' health-risk behaviors. Further research studies based on bio-psychosocial theories are needed to develop and evaluate methods of instruction and delivery of health skills. ^

The contribution of higher education to economic *development in a globalized environment

Amidst concerns about achieving high levels of technology to remain competitive in the global market without compromising economic development, national economies are experiencing a high demand for human capital. As higher education is assumed to be the main source of human capital, this analysis focused on a more specific and less explored area of the generally accepted idea that higher education contributes to economic growth. The purpose of this study, therefore, was to find whether higher education also contributes to economic development, and whether that contribution is more substantial in a globalized context. ^ Consequently, a multiple linear regression analysis was conducted to support with statistical significance the answer to the research question: Does higher education contributes to economic development in the context of globalization? The information analyzed was obtained from historical data of 91 selected countries, and the period of time of the study was 10 years (1990–2000). Some variables, however, were lagged back 5, 10 or 15 years along a 15-year timeframe (1975–1990). The resulting comparative static model was based on the Cobb-Douglas production function and the Solow model to specify economic growth as a function of physical capital, labor, technology, and productivity. Then, formal education, economic development, and globalization were added to the equation. ^ The findings of this study supported the assumption that the independent contribution of the changes in higher education completion and globalization to changes in economic growth is more substantial than the contribution of their interaction. The results also suggested that changes in higher and secondary education completion contribute much more to changes in economic growth in less developed countries than in their more developed counterparts. ^ As a conclusion, based on the results of this study, I proposed the implementation of public policy in less developed countries to promote and expand adequate secondary and higher education systems with the purpose of helping in the achievement of economic development. I also recommended further research efforts on this topic to emphasize the contribution of education to the economy, mainly in less developed countries. ^

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.

Retention and special education referral practices before and after the implementation of high-stakes testing

The rewards and sanctions associated with high-stakes testing may induce educators to participate in practices that will ensure the elimination of the scores of low-achieving students from the testing pool. Two ways in which scores may be eliminated is through retention or referral to special education. This study examined the use of these practices at 179 elementary schools in Miami-Dade County Public Schools, the 4th largest school district in the country. Between- and within-subjects designs were analyzed using repeated measures analysis of variance to compare retention and referral to special education practices over a five-year period of time, two years prior to and two years after the implementation of Florida's high-stakes test, the Florida Comprehensive Assessment Test, FCAT. Significant main effects for referral and retention over time were demonstrated. The use of retention steadily increased over the first three years, with its usage maintained during the fourth year. While the use of referral actually decreased from the first to second years, a significant change occurred after the implementation of the FCAT. Examination of the use of these practices according to student and school characteristics revealed significant differences. Increases in the use of referral across time was significant for Black, non-Hispanic and Hispanic students, all limited English proficiency population categories, medium and low socioeconomic status category schools, all grade levels, and for schools with accountability grades of A, C, D and F with the most striking absolute increase occurring for F schools. Increases in the use of retention across time were significant for all ethnic groups, limited English proficiency categories, and socioeconomic status categories, for grades kindergarten through four and by gender. Significant increases occurred for schools with accountability performance grades of C, D and F; however the most dramatic increase occurred for the F schools. A direct relationship between performance category grade of school and their use of retention was demonstrated. The results suggest that schools changed their use of referral and retention in response to the implementation of the FCAT.

Can a Broader Education Narrow the Gap? Evidence on Non-Academic Features of Schooling

Empirical studies of education programs and systems, by nature, rely upon use of student outcomes that are measurable. Often, these come in the form of test scores. However, in light of growing evidence about the long-run importance of other student skills and behaviors, the time has come for a broader approach to evaluating education. This dissertation undertakes experimental, quasi-experimental, and descriptive analyses to examine social, behavioral, and health-related mechanisms of the educational process. My overarching research question is simply, which inside- and outside-the-classroom features of schools and educational interventions are most beneficial to students in the long term? Furthermore, how can we apply this evidence toward informing policy that could effectively reduce stark social, educational, and economic inequalities?

The first study of three assesses mechanisms by which the Fast Track project, a randomized intervention in the early 1990s for high-risk children in four communities (Durham, NC; Nashville, TN; rural PA; and Seattle, WA), reduced delinquency, arrests, and health and mental health service utilization in adolescence through young adulthood (ages 12-20). A decomposition of treatment effects indicates that about a third of Fast Track’s impact on later crime outcomes can be accounted for by improvements in social and self-regulation skills during childhood (ages 6-11), such as prosocial behavior, emotion regulation and problem solving. These skills proved less valuable for the prevention of mental and physical health problems.

The second study contributes new evidence on how non-instructional investments – such as increased spending on school social workers, guidance counselors, and health services – affect multiple aspects of student performance and well-being. Merging several administrative data sources spanning the 1996-2013 school years in North Carolina, I use an instrumental variables approach to estimate the extent to which local expenditure shifts affect students’ academic and behavioral outcomes. My findings indicate that exogenous increases in spending on non-instructional services not only reduce student absenteeism and disciplinary problems (important predictors of long-term outcomes) but also significantly raise student achievement, in similar magnitude to corresponding increases in instructional spending. Furthermore, subgroup analyses suggest that investments in student support personnel such as social workers, health services, and guidance counselors, in schools with concentrated low-income student populations could go a long way toward closing socioeconomic achievement gaps.

The third study examines individual pathways that lead to high school graduation or dropout. It employs a variety of machine learning techniques, including decision trees, random forests with bagging and boosting, and support vector machines, to predict student dropout using longitudinal administrative data from North Carolina. I consider a large set of predictor measures from grades three through eight including academic achievement, behavioral indicators, and background characteristics. My findings indicate that the most important predictors include eighth grade absences, math scores, and age-for-grade as well as early reading scores. Support vector classification (with a high cost parameter and low gamma parameter) predicts high school dropout with the highest overall validity in the testing dataset at 90.1 percent followed by decision trees with boosting and interaction terms at 89.5 percent.

Application of an Education Research Lab (ERL) Model to a Community Sailing Program

This presentation showcases the application of a university-based education research lab (ERL) model to the evaluation of a community sailing program for individuals with disabilities. Presenters conceptualize the ERL model as a mutually beneficial relationship between universities and community education agencies.

The Impact of Geographic Mobility on Canadian Military families and their Children’s Access Special Education Services

To achieve academic success, children with learning-related disabilities often receive special education supports at school. Currently, Canada does not have a federal department or integrated national system of education. Instead, each province and territory has a separate department or ministry that is responsible for the organization and delivery of education, including special education, at the elementary level. At the macro (national) level, inclusive education is the policy across Canada. However, each province and territory has its own legislation, definitions, and policies mandating special education services. These variations result in little consistency at the micro (individual school) level. Differences between eligibility requirements, supports offered, and delivery methods may present challenges for highly mobile families who must navigate new special education systems on behalf of their children with medical or learning challenges. One of the defining features of the Canadian military lifestyle is geographic mobility. As a result, many families are tasked with navigating new school systems for their children, a task that may be more difficult when children require special education services. The purpose of this study is to explore the impact of geographic mobility on Canadian military families and their children’s access to special education services. The secondary objective was to gain insight into supports that helped facilitate access to services, as well as supports that participants believe would have helped facilitate access. A qualitative approach, interpretive phenomenological analysis (IPA), was employed due to of its focus on individuals’ experiences and their understandings of a particular phenomenon. IPA allowed participants to reflect on the significance of their experiences, while the researcher engaged with these reflections to make sense of the meanings associated with their experiences. Nine semi-structured interviews were conducted with civilian caregivers who have a child with special education needs. An interview guide and probes were used to elicit rich, detailed, first-person accounts of their experiences navigating new special education systems. The main themes that emerged from the participants’ combined experiences addressed the emotional components of experiencing a transition, factors that may facilitate access to special education services, and career implications associated with accessing and maintaining special education services. Findings from the study illustrate that Canadian families experience many, and often times severe, barriers to accessing special education services after a posting. Furthermore, the impacts reported throughout the study echo the existing American literature on geographic mobility and access to special education services. Building on the literature, this study also highlights the need for further research exploring factors that create unique barriers to access in a Canadian context, resulting from the current special education climate, military policies, and military family support services.

Concept maps as a tool to analyze the ideas of teacher training students regarding what to teach on human nutrition in Primary Education

Concept maps are a technique used to obtain a visual representation of a person's ideas about a concept or a set of related concepts. Specifically, in this paper, through a qualitative methodology, we analyze the concept maps proposed by 52 groups of teacher training students in order to find out the characteristics of the maps and the degree of adequacy of the contents with regard to the teaching of human nutrition in the 3rd cycle of primary education. The participants were enrolled in the Teacher Training Degree majoring in Primary Education, and the data collection was carried out through a training activity under the theme of what to teach about Science in Primary School? The results show that the maps are a useful tool for working in teacher education as they allow organizing, synthesizing, and communicating what students know. Moreover, through this work, it has been possible to see that future teachers have acceptable skills for representing the concepts/ideas in a concept map, although the level of adequacy of concepts/ideas about human nutrition and its relations is usually medium or low. These results are a wake-up call for teacher training, both initial and ongoing, because they shows the inability to change priorities as far as the selection of content is concerned.

Ultrasound in undergraduate medical education: A systematic and critical review

Introduction: Point-of-care ultrasound (POCUS) use in clinical care is growing rapidly, and advocates have recently proposed the integration of ultrasound into undergraduate medical education (UME). The evidentiary basis for this integration has not been evaluated critically or systematically. In this study, we conducted a critical and systematic review framed by the rationales enumerated by advocates of ultrasound in UME in academic publications.

Methods: This research was conducted in two phases. First, the dominant discursive rationales for the integration of ultrasound in UME were identified using techniques from Foucauldian critical discourse analysis (CDA) from an archive of 403 academic publications. We then sought empirical evidence in support of theses rationales, using a critical synthesis methodology also adapted from CDA.

Results: We identified four dominant discursive rationales, with different levels of evidentiary support. Ultrasound was not demonstrated to improve students’ understanding of anatomy. The benefit of ultrasound in teaching physical examination was inconsistent,and rests on minimal evidence. With POCUS, students’ diagnostic accuracy was improved for certain pathologies, but findings were inconsistent for others. Finally, the rationale that ultrasound training in UME will improve quality of patient care was difficult to evaluate.

Discussion: Our analysis has shown that the frequently repeated rationales for the integration of ultrasound in UME are not supported by a sufficient base of empirical research. The repetition of these dominant discursive rationales in academic publications legitimizes them and may preclude further primary research. Since the value of clinical ultrasound use by medical students remains unproven, educators must consider whether the associated financial and temporal costs are justified or whether more research is required.

Using assistive robots to promote inclusive education

Purpose: This paper describes the development and test of physical and virtual integrated augmentative manipulation and communication assistive technologies (IAMCATs) that enable children with motor and speech impairments to manipulate educational items by controlling a robot with a gripper, while communicating through a speech generating device. Method: Nine children with disabilities, nine regular and nine special education teachers participated in the study. Teachers adapted academic activities so they could also be performed by the children with disabilities using the IAMCAT. An inductive content analysis of the teachers’ interviews before and after the intervention was performed. Results: Teachers considered the IAMCAT to be a useful resource that can be integrated into the regular class dynamics respecting their curricular planning. It had a positive impact on children with disabilities and on the educational community. However, teachers pointed out the difficulties in managing the class, even with another adult present, due to the extra time required by children with disabilities to complete the activities. Conclusions: The developed assistive technologies enable children with disabilities to participate in academic activities but full inclusion would require another adult in class and strategies to deal with the additional time required by children to complete the activities. IMPLICATIONS FOR REHABILITATION - Integrated augmentative manipulation and communication assistive technologies are useful resources to promote the participation of children with motor and speech impairments in classroom activities. - Virtual tools, running on a computer screen, may be easier to use but further research is needed in order to evaluate its effectiveness when compared to physical tools. - Full participation of children with motor and speech impairments in academic activities using these technologies requires another adult in class and adequate strategies to manage the extra time the child with disabilities may require to complete the activities.