Community and cluster centre residential services for adults with intellectual disability: long-term results from an Australian-matched sample

Changes in residential accommodation models for adults with intellectual disability (ID) over the last 20 years in Australia, the United Kingdom and the United States have involved relocation from institutions primarily into dispersed homes in the community. But an evolving alternative service style is the cluster centre. This paper reports on the relocation of a matched group of 30 pairs of adults with moderate and severe IDs and challenging behaviour who were relocated from an institution into either dispersed housing in the community or cluster centres but under the same residential service philosophy. Adaptive and maladaptive behaviour, choice-making and objective life quality were assessed prior to leaving the institution and then after 12 and 24 months of living in the new residential model. Adaptive behaviour, choice-making and life quality increased for both groups and there was no change in level of maladaptive behaviour compared with levels exhibited in the institution. However, there were some significant differences between the community and cluster centre group as the community group increased some adaptive skills, choice-making and objective life quality to a greater extent than the cluster centre group. Both cluster centre and dispersed community living offer lifestyle and skill development advantages compared with opportunities available in large residential institutions. Dispersed community houses, however, offer increased opportunities for choice-making, acquisition of adaptive behaviours and improved life quality for long-term institutionalized adults with IDs.

Website physical activity interventions: preferences of potential users

Information and communication technologies (particularly websites and e-mail) have the potential to deliver health behavior change programs to large numbers of adults at low cost. Controlled trials using these new media to promote physical activity have produced mixed results. User-centered development methods can assist in understanding the preferences of potential participants for website functions and content, and may lead to more effective programs. Eight focus group discussions were conducted with 40 adults after they had accessed a previously trialed physical activity website. The discussions were audio taped, transcribed and interpreted using a themed analysis method. Four key themes emerged: structure, interactivity, environmental context and content. Preferences were expressed for websites that include simple interactive features, together with information on local community activity opportunities. Particular suggestions included online community notice boards, personalized progress charts, e-mail access to expert advice and access to information on specific local physical activity facilities and services. Website physical activity interventions could usefully include personally relevant interactive and environmentally focused features and services identified through a user-centered development process.

Sustainable design practitioners: Why they must be at the centre of discussions on sustainable design education

Sustainable design education is vital for engineering students. This is to allow them to meet the challenges both engineering and the wider community will face in the future. This need has not only been mandated by Engineers Australia’s graduate attributes from an Australian perspective, but more widely the issue of sustainability is one of the greatest challenges humanity has ever faced. Engineers need to be at the forefront of this challenge, because we can not only do the greatest good, but have the potential to cause the greatest harm. The biggest question with respect to the education of engineers about sustainable design is what do engineers need to know, and how best to enable this learning. This paper argues that since the entire phenomenon of sustainable design is constantly growing and changing, it is only by looking at practitioners currently trying design sustainably, and their ways of experiencing sustainable design, can we hope to articulate what it is, and therefore what and how we need to teach engineering students. It also argues that to accommodate sustainable design within engineering, we need to go further and transform the engineering profession to enable it to meet the challenges that sustainability presents. © 2005, Australasian Association for Engineering Education

A BUSCA DO CONHECIMENTO NA MELHOR IDADE: UM ESTUDO SOBRE O IDOSO ANALFABETO

A presente pesquisa investiga o aprender a ler e a escrever do segmento idoso partindo do pressuposto de que a introdução no mundo da leitura e da escrita pode propiciar-lhe, mesmo que tardiamente, a inclusão social e uma transformação na sua vida pessoal. Nesse sentido, foi realizado um estudo sobre o analfabetismo no nosso país amparado em um referencial teórico específico, adotando a visão de homem como um ser inconcluso e em constante processo de construção que pode progredir social, histórica e temporalmente. Para dar concretude a esses objetivos a opção foi pela abordagem qualitativa. São sujeitos deste estudo, alunos matriculados na Educação de Jovens e Adultos de uma Organização Não Governamental (ONG) uma instituição religiosa e também alunos de instituições que atendem ao segmento idoso. Foram aplicados quarenta questionários, por meio dos quais foi possível inferir que esses alunos buscam resgatar a possibilidade de serem incluídos e aceitos socialmente, bem como convívio com os seus pares.

Adapting an apprenticeship model to the needs of English-medium education at the tertiary level in Turkey

Despite the difficulties that we have regarding the use of English in tertiary education in Turkey, we argue that it is necessary for those involved to study in the medium of English. Furthermore, significant advances have been made on this front. These efforts have been for the most part language-oriented, but also include research into needs analysis and the pedagogy of team-teaching. Considering the current situation at this level of education, however, there still seems to be more to do. And the question is, what more can we do? What further contribution can we make? Or, how can we take this process further? The purpose of the study reported here is to respond to this last question. We test the proposition that it is possible to take this process further by investigating the efficient management of transition from Turkish-medium to English-medium at the tertiary level of education in Turkey. Beyond what is achieved by only the language orientation of the EAP approach, and moving conceptually deeper than what has been achieved by the team-teaching approach, the research undertaken for the purpose of this study focuses on the idea of the discourse community that people want to belong to. It then pursues an adaptation of the essentially psycho-social approach of apprenticeship, as people become aspirants and apprentices to that discourse community. In this thesis, the researcher recognises that she cannot follow all the way through to the full implementation of her ideas in a fully-taught course. She is not in a position to change the education system. What she does here is to introduce a concept and sample its effects in terms of motivation, and thereby of integration and of success, for individuals and groups of learners. Evaluation is provided by acquiring both qualitative and quantitative data concerning mature members' perceptions of apprenticed-neophytes functioning as members in the new community, apprenticed-neophytes' perceptions of their own membership and of the preparation process undertaken, and the comparison of these neophytes' performance with that of other neophytes in the community. The data obtained provide strong evidence in support of the potential usefulness of this apprenticeship model towards the declared purpose of improving the English-medium tertiary education of Turkish students in their chosen fields of study.

ALEX:mobile language assistant for low-literacy adults

Basic literacy skills are fundamental building blocks of education, yet for a very large number of adults tasks such as understanding and using everyday items is a challenge. While research, industry, and policy-making is looking at improving access to textual information for low-literacy adults, the literacy-based demands of today's society are continually increasing. Although many community-based organizations offer resources and support to adults with limited literacy skills, current programs have difficulties reaching and retaining those that would benefit most from them. To address these challenges, the National Research Council of Canada is proposing a technological solution to support literacy programs and to assist low-literacy adults in today's information-centric society: ALEX© – Adult Literacy support application for EXperiential learning. ALEX© has been created together with low-literacy adults, following guidelines for inclusive design of mobile assistive tools. It is a mobile language assistant that is designed to be used both in the classroom and in daily life, in order to help low-literacy adults become increasingly literate and independent.

Hidden in plain sight:low-literacy adults in a developed country overcoming social and educational challenges through mobile learning support tools

Illiteracy is often associated with people in developing countries. However, an estimated 50 % of adults in a developed country such as Canada lack the literacy skills required to cope with the challenges of today's society; for them, tasks such as reading, understanding, basic arithmetic, and using everyday items are a challenge. Many community-based organizations offer resources and support for these adults, yet overall functional literacy rates are not improving. This is due to a wide range of factors, such as poor retention of adult learners in literacy programs, obstacles in transferring the acquired skills from the classroom to the real life, personal attitudes toward learning, and the stigma of functional illiteracy. In our research we examined the opportunities afforded by personal mobile devices in providing learning and functional support to low-literacy adults. We present the findings of an exploratory study aimed at investigating the reception and adoption of a technological solution for adult learners. ALEX© is a mobile application designed for use both in the classroom and in daily life in order to help low-literacy adults become increasingly literate and independent. Such a solution complements literacy programs by increasing users' motivation and interest in learning, and raising their confidence levels both in their education pursuits and in facing the challenges of their daily lives. We also reflect on the challenges we faced in designing and conducting our research with two user groups (adults enrolled in literacy classes and in an essential skills program) and contrast the educational impact and attitudes toward such technology between these. Our conclusions present the lessons learned from our evaluations and the impact of the studies' specific challenges on the outcome and uptake of such mobile assistive technologies in providing practical support to low-literacy adults in conjunction with literacy and essential skills training. © 2013 Her Majesty the Queen in Right of Canada.

Tale of two studies:challenges in field research with low-literacy adult learners in a developed country

Efforts to address the problems of literacy are often focused on developing countries. However, functional illiteracy is a challenge encountered by up to 50% of adults in developed countries. In this paper we reflect on the challenges we faced in trying to design and study the use of a mobile application to support adult literacy with two user groups: adults enrolled in literacy classes and carpenters without a high school education enrolled in an essential skills program. We also elaborate on aspects of the evaluations that are specific to a marginalized, functionally illiterate, group in a developed country - aspects that are less frequently present in similar studies of mobile literacy support technologies in developing countries. We conclude with presenting the lessons learnt from our evaluations and the impact of the studies' specific challenges on the outcome and uptake of such mobile assistive technologies in providing practical support to low-literacy adults in conjunction with literacy and essential skills training.

Changing Parental Perceptions of Math and Science Curriculum Through Hands-on Workshops

Many parents hold negative perceptions of math and science because they have never been taught these domains from a hands-on, constructivist approach. Only 20 - 30% of adults have actually experienced activity-based science inquiry. Instead, these individuals were exposed to didactic science programs that emphasize drill, skill and memorization (Shymanksy, 2000). This has had a negative impact upon their content knowledge in these areas and their perceptions of math and science. Consequently, parents are hesitant to incorporate math and science into their home life. There is a dire need to determine if parental perceptions of math, science, and their content knowledge will be positively effected as a result of participation in hands-on science workshops.

Adult Learners and the Work of Amnesty International

This study explores how various adults perceive their work and learning in a chapter of a human rights-based non-governmental organization using the Characteristics of Adults as Learners (Cross, 1981) model of adult learning.

Medical advice and diabetes self-management reported by Mexican-American, Black- and White-non-Hispanic adults across the United States

Background Diabetes has reached epidemic proportions in the United States, particularly among minorities, and if improperly managed can lead to medical complications and death. Healthcare providers play vital roles in communicating standards of care, which include guidance on diabetes self-management. The background of the client may play a role in the patient-provider communication process. The aim of this study was to determine the association between medical advice and diabetes self care management behaviors for a nationally representative sample of adults with diabetes. Moreover, we sought to establish whether or not race/ethnicity was a modifier for reported medical advice received and diabetes self-management behaviors. Methods We analyzed data from 654 adults aged 21 years and over with diagnosed diabetes [130 Mexican-Americans; 224 Black non-Hispanics; and, 300 White non-Hispanics] and an additional 161 with 'undiagnosed diabetes' [N = 815(171 MA, 281 BNH and 364 WNH)] who participated in the National Health and Nutrition Examination Survey (NHANES) 2007-2008. Logistic regression models were used to evaluate whether medical advice to engage in particular self-management behaviors (reduce fat or calories, increase physical activity or exercise, and control or lose weight) predicted actually engaging in the particular behavior and whether the impact of medical advice on engaging in the behavior differed by race/ethnicity. Additional analyses examined whether these relationships were maintained when other factors potentially related to engaging in diabetes self management such as participants' diabetes education, sociodemographics and physical characteristics were controlled. Sample weights were used to account for the complex sample design. Results Although medical advice to the patient is considered a standard of care for diabetes, approximately one-third of the sample reported not receiving dietary, weight management, or physical activity self-management advice. Participants who reported being given medical advice for each specific diabetes self-management behaviors were 4-8 times more likely to report performing the corresponding behaviors, independent of race. These results supported the ecological model with certain caveats. Conclusions Providing standard medical advice appears to lead to diabetes self-management behaviors as reported by adults across the United States. Moreover, it does not appear that race/ethnicity influenced reporting performance of the standard diabetes self-management behavior. Longitudinal studies evaluating patient-provider communication, medical advice and diabetes self-management behaviors are needed to clarify our findings.

Medical Advice and Diabetes Self-Management Reported by Mexican-American, Black- and White-Non-Hispanic Adults Across the United States

Background: Diabetes has reached epidemic proportions in the United States, particularly among minorities, and if improperly managed can lead to medical complications and death. Healthcare providers play vital roles in communicating standards of care, which include guidance on diabetes self-management. The background of the client may play a role in the patient-provider communication process. The aim of this study was to determine the association between medical advice and diabetes self care management behaviors for a nationally representative sample of adults with diabetes. Moreover, we sought to establish whether or not race/ethnicity was a modifier for reported medical advice received and diabetes self-management behaviors. Methods: We analyzed data from 654 adults aged 21 years and over with diagnosed diabetes [130 MexicanAmericans; 224 Black non-Hispanics; and, 300 White non-Hispanics] and an additional 161 with ‘undiagnosed diabetes’ [N = 815(171 MA, 281 BNH and 364 WNH)] who participated in the National Health and Nutrition Examination Survey (NHANES) 2007-2008. Logistic regression models were used to evaluate whether medical advice to engage in particular self-management behaviors (reduce fat or calories, increase physical activity or exercise, and control or lose weight) predicted actually engaging in the particular behavior and whether the impact of medical advice on engaging in the behavior differed by race/ethnicity. Additional analyses examined whether these relationships were maintained when other factors potentially related to engaging in diabetes self management such as participants’ diabetes education, sociodemographics and physical characteristics were controlled. Sample weights were used to account for the complex sample design. Results: Although medical advice to the patient is considered a standard of care for diabetes, approximately onethird of the sample reported not receiving dietary, weight management, or physical activity self-management advice. Participants who reported being given medical advice for each specific diabetes self-management behaviors were 4-8 times more likely to report performing the corresponding behaviors, independent of race. These results supported the ecological model with certain caveats. Conclusions: Providing standard medical advice appears to lead to diabetes self-management behaviors as reported by adults across the United States. Moreover, it does not appear that race/ethnicity influenced reporting performance of the standard diabetes self-management behavior. Longitudinal studies evaluating patient-provider communication, medical advice and diabetes self-management behaviors are needed to clarify our findings.

Phylloquinone (Vitamin K₁) Intake and Pulse Pressure as a Measure of Arterial Stiffness in Older Adults

This study examined the relationships among ethnicity/race, lifestyle factors, phylloquinone (vitamin K₁) intake, and arterial pulse pressure in a nationally representative sample of older adults from four ethnic/racial groups: non-Hispanic Whites, non-Hispanic Blacks, Mexican Americans, and other Hispanics. This was a cross-sectional study of U.S. representative sample with data from the National Health and Nutrition Examination Surveys, 2007-2008 and 2009-2010 of adults aged 50 years and older (N = 5296). Vitamin K intake was determined by 24-hour recall. Pulse pressure was calculated as the difference between the averages of systolic blood pressure and diastolic blood pressure. Compared to White non-Hispanics, the other ethnic/racial groups were more likely to have inadequate vitamin K₁ intake. Inadequate vitamin K₁ intake was an independent predictor of high arterial pulse pressure. This was the first study that compared vitamin K₁ inadequacy with arterial pulse pressure across ethnicities/races in U.S. older adults. These findings suggest that vitamin K screening may be a beneficial marker for the health of older adults.

The rise of Islamism amongst Muslim youth in the UK

The purpose of this study was to examine the possible reasons why Muslim youth are increasingly becoming attracted to radical Islam in the UK. Recent studies involving focus groups of Muslim youth across the UK and opinion surveys were used to measure youth's level of religious guidance, integration in society and feelings of hostility or of an enemy image of Islam. It was found that alienation from traditional methods of religious education, parents/ imams, is the possible first step that makes youth more vulnerable to outside Islamist groups. The second step is the lack of integration due to discrimination and feeling as an enemy within society. The enemy image includes the government's decision to invade Iraq and the perception that Muslims and Islam are under attack. There is a strong need for youth to reconcile their national and religious identities in order to be active citizens in the future.

Impact of nutrition education on knowledge and eating patterns in HIV-infected individuals

Acquired Immune Deficiency Syndrome (AIDS) and impaired or threatened nutritional status seem to be closely related. It is now known that AIDS results in many nutritional disorders including anorexia, vomiting, protein-energy malnutrition (PEM), nutrient deficiencies, and gastrointestinal, renal, and hepatic dysfunction (1-7, 8). Reversibly, nutritional status may also have an impact on the development of AIDS among HIV-infected people. Not all individuals who have tested antibody positive for the Human Immunodeficiency Virus (HIV) have developed AIDS or have even shown clinical symptoms (9, 10). A poor nutritional status, especially PEM, has a depressing effect on immunity which may predispose an individual to infection (11). It has been proposed that a qualitatively or quantitatively deficient diet could be among the factors precipitating the transition from HIV-positive to AIDS (12, 13). The interrelationship between nutrition and AIDS reveals the importance of having a multidisciplinary health care team approach to treatment (11), including having a registered dietitian on the medical team. With regards to alimentation, the main responsibility of a dietitian is to inform the public concerning sound nutritional practices and encourage healthy food habits (14). In individuals with inadequate nutritional behavior, a positive, long-term change has been seen when nutrition education tailored to specific physiological and emotional needs was provided along with psychological support through counseling (14). This has been the case for patients with various illnesses and may also be true in AIDS patients as well. Nutritional education specifically tailored for each AIDS patient could benefit the patient by improving the quality of life and preventing or minimizing weight loss and malnutrition (15-17). Also, it may influence the progression of the disease by delaying the onset of the most severe symptoms and increasing the efficacy of medical treatment (18, 19). Several studies have contributed to a dietary rationale for nutritional intervention in HIV-infected and AIDS patients (2, 4, 20-25). Prospective, randomized clinical research in AIDS patients have not yet been published to support this dietary rationale; however, isolated case reports show its suitability (3). Furthermore, only nutrition intervention as applied by a medical team in an institution or hospital has been evaluated. Research is lacking concerning the evaluation of nutritional education of either non-institutionalized or hospitalized groups of persons who are managing their own food choice and intake. This study compares nutrition knowledge and food intakes in HIV-infected individuals prior to and following nutrition education. It was anticipated that education would increase the knowledge of nutritional care of AIDS patients and lead to better implementation of nutrition education programs.