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.

A hermeneutic phenomenology of graduate education students' understandings of instructor power in a higher education classroom

Higher education is a distribution center of knowledge and economic, social, and cultural power (Cervero & Wilson, 2001). A critical approach to understanding a higher education classroom begins with recognizing the instructor's position of power and authority (Tisdell, Hanley, & Taylor, 2000). The power instructors wield exists mostly unquestioned, allowing for teaching practices that reproduce the existing societal patterns of inequity in the classroom (Brookfield, 2000). ^ The purpose of this hermeneutic phenomenological study was to explore students' experiences with the power of their instructors in a higher education classroom. A hermeneutic phenomenological study intertwines the interpretations of both the participants and the researcher about a lived experience to uncover layers of meaning because the meanings of lived experiences are usually not readily apparent (van Manen, 1990). Fifteen participants were selected using criterion, convenience, and snowball sampling. The primary data gathering method were semi-structured interviews guided by an interview protocol (Creswell, 2003). Data were interpreted using thematic reflection (van Manen, 1990). ^ Three themes emerged from data interpretation: (a) structuring of instructor-student relationships, (b) connecting power to instructor personality, and (c) learning to navigate the terrains of higher education. How interpersonal relationships were structured in a higher education classroom shaped how students perceived power in that higher education classroom. Positive relationships were described using the metaphor of family and a perceived ethic of caring and nurturing by the instructor. As participants were consistently exposed to exercises of instructor power in a higher education classroom, they attributed those exercises of power to particular instructor traits rather than systemic exercises of power. As participants progressed from undergraduate to graduate studies, they perceived the benefits of expertise in content or knowledge development as secondary to expertise in successfully navigating the social, cultural, political, and interpersonal terrains of higher education. Ultimately, participants expressed that higher education is not about what you know; it is about learning how to play the game. Implications for teaching in higher education and considerations for future research conclude the study.^

The effect of young adult literature on adolescents' rape myth acceptance

This quasi-experimental study (N = 139) measured the effect of a reader response based instructional unit of the novel Speak on adolescents' rape myth acceptance. Participants were eighth grade language arts students at a Title I middle school in a major metropolitan school district. Seven classes were randomly assigned to treatment ( n = 4) or control (n = 3) condition. Two teachers participated in the study and both taught both treatment and control classes. The study lasted a period of five weeks. Participants were pretested using the Rape Myth Acceptance Scale (Burt, 1980) and a researcher created scale, the Adolescent Date Rape Scale (ADRMS). Analysis of pretests showed the ADRMS to be a reliable and valid measure of rape myth acceptance in adolescents. Factor analysis revealed it to have two major components: "She Wanted It" and "She Lied." Pretests supported previous studies which found girls to have significantly lower initial levels of rape myth acceptance than boys (p < .001). A 2 (group) x 2 (instructor) x 2 (sex) ANCOVA using ADRMS pretest as a covariate and ADRMS posttest as a dependent variable found that treatment was effective in reducing rape myth acceptance (p < .001, η2 = .15). Boys with high rape myth acceptance as demonstrated by pretest scores of 1 standard deviation above the mean on ADRMS did not have a backlash to treatment. Extended analysis revealed that participants had significantly lower scores posttest on Factor 1, "She Wanted It" (p < .001, η2 = .27), while scores on Factor 2, "She Lied" were not significantly lower (p = .07). This may be because the content of the novel primarily deals with issues questioning whether the main characters assault was a rape rather than a false accusation. Attrition rates were low (N = 15) and attrition analysis showed that drop outs did not significantly alter the treatment or control groups. Implications for reader response instruction of young adult literature, for research on rape myth acceptance in secondary schools, and for statistical analysis of effect size using pretests as filters are discussed.

Adult Curiosity Dimensionality

The need to discern the dimensions of curiosity is compelling as researchers strive to understand better the developmental implications of learning. Six hundred and two participants completed 10 curiosity scales. Scores were factored using Principal Components Analysis and a varimax solution. A threefactor interpretation of the curiosity construct was supported.

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.

Sexiles in the Classroom: Understanding Intersectionalities of Sexuality, Immigration, and Education

This paper presents an overview of literature on adult educators who are both queer and immigrant. Although very little scholarly writing exists, several scholars describe the experiences of queer immigrants as being anchored to systemic heteronormativity. Additionally, the experiences of immigrant adult educators suggest difficult encounters with racism and sexism.

Disorienting Dilemmas: Their Effects on Learners, Impact on Performance, and Implications for Adult Educators

Disorienting dilemmas induced by adult educators have varied and often adverse effects on learners. Although this may lead to transformative learning, it can have both positive and negative impacts on their performance. Adult educators need to be wary in their efforts to foster and facilitate transformative learning.

Attachment Theory Shaping Adult Development: Impact on Mentoring Experiences

Mentoring is increasingly used for career and psychosocial development. Very few studies that have investigated the role of individual differences in mentoring relationships have addressed the attachment styles of mentors and protégés. The purpose of this study is to find the connections between attachment styles, adult development, and mentoring experiences.

Emotions and Their Effect on Adult Learning: A Constructivist Perspective

Adult educators are only beginning to understand the interaction between learning and emotion (Dirkx, 2006; O’Regan, 2003). Understanding these concepts and their interaction through the constructivist perspective presents a unique opportunity to appreciate the learner’s perspective and the construction of knowledge through experience.

The Integrated Process of Engagement in Adult Learning

This paper explores the role of engagement in adult learning based on Illeris’ three dimensional model of learning and Yang’s holistic theory of knowledge and learning. Engagement and learning are integrated processes by which adult learners gain a deeper understanding and make meaning of the activities he or she is exposed to in a given learning environment.

Perceptions of French and Creole Among First-Generation Adult Haitian English Language Learners

Context: Due to a unique combination of factors, outdoor athletes in the Southeastern United States are at high risk of lightning deaths and injuries. Lightning detection methods are available to minimize lightning strike victims. Objective: Becoming aware of the risk factors that predispose athletes to lightning strikes and determining the most reliable detection method against hazardous weather will enable Certified Athletic Trainers to develop protocols that protect athletes from injury. Data Sources: A comprehensive literature review of Medline and Pubmed using key words: lightning, lightning risk factors, lightning safety, lightning detection, and athletic trainers and lightning was completed. Data Synthesis: Factors predisposing athletes to lighting death or injury include: time of year, time of day, the athlete’s age, geographical location, physical location, sex, perspiration level, and lack of education and preparedness by athletes and staff. Although handheld lightning detectors have become widely accessible to detect lightning strikes, their performance has not been independently or objectively confirmed. There is evidence that these detectors inaccurately detect strike locations by recording false strikes and not recording actual strikes. Conclusions: Lightning education and preparation are two factors that can be controlled. Measures need to be taken by Certified Athletic Trainers to ensure the safety of athletes during outdoor athletics. It is critical for athletic trainers and supervising staff members to become fully aware of the risks of lightning strikes in order to most effectively protect everyone under their supervision. Even though lightning detectors have been manufactured in an attempt to minimize death and injuries due to lightning strikes, none of the detectors have been proven to be 100% effective. Educating coaches, athletes, and parents on the risks of lightning and the detection methods available, while implementing an emergency action plan for lightning safety, is crucial to ensure the well being of the student-athlete population.

Neuroangradogy in Online Education

The purpose of this perspective in practice essay is to address the effectiveness of online learning based on adult brain-based education. This essay attempts to answer the question: Do what we know about the brain (neurology) and adult teaching methods (andragogy) play a key role in learning in online courses?

Perceptions of French and Creole Among First-Generation Adult Haitian English Language Learners

This basic interpretive study investigated the literacy experiences of seven first-generation Haitian English language learners. During interviews and focus groups, participants expressed ambivalent feelings toward Creole and French and explained how their knowledge of these languages supported their English language learning.

The influence of neighbourhood formality status and socio-economic position on self-rated health among adult men and women: a multilevel, cross sectional, population study from Aleppo, Syria

Background There is substantial evidence from high income countries that neighbourhoods have an influence on health independent of individual characteristics. However, neighbourhood characteristics are rarely taken into account in the analysis of urban health studies from developing countries. Informal urban neighbourhoods are home to about half of the population in Aleppo, the second largest city in Syria (population>2.5 million). This study aimed to examine the influence of neighbourhood socioeconomic status (SES) and formality status on self-rated health (SRH) of adult men and women residing in formal and informal urban neighbourhoods in Aleppo. Methods The study used data from 2038 survey respondents to the Aleppo Household Survey, 2004 (age 18–65 years, 54.8% women, response rate 86%). Respondents were nested in 45 neighbourhoods. Five individual-level SES measures, namely education, employment, car ownership, item ownership and household density, were aggregated to the level of neighbourhood. Multilevel regression models were used to investigate associations. Results We did not find evidence of important SRH variation between neighbourhoods. Neighbourhood average of household item ownership was associated with a greater likelihood of reporting excellent SRH in women; odds ratio (OR) for an increase of one item on average was 2.3 (95% CI 1.3-4.4 (versus poor SRH)) and 1.7 (95% CI 1.1-2.5 (versus normal SRH)), adjusted for individual characteristics and neighbourhood formality. After controlling for individual and neighbourhood SES measures, women living in informal neighbourhoods were less likely to report poor SRH than women living in formal neighbourhoods (OR= 0.4; 95% CI (0.2- 0.8) (versus poor SRH) and OR=0.5; 95%; CI (0.3-0.9) (versus normal SRH). Conclusions Findings support evidence from high income countries that certain characteristic of neighbourhoods affect men and women in different ways. Further research from similar urban settings in developing countries is needed to understand the mechanisms by which informal neighbourhoods influence women’s health.

Toward understanding the study experience of culturally sensitive graduate students in *American distance education programs

The purpose of this research was to gain an understanding of the study experience of non-American graduate students living outside of the United States and formally engaged in graduate studies in an American Distance Education (DE) Program. These students have been labeled “culturally sensitive.” The nature of this study dictated a qualitative case study methodology using in-depth interviews to collect the data and the hermeneutic approach to understanding and description. This study aims at generating questions and hypotheses that will lead to further investigations that explore the need for cultural and contextual sensitivity in order to provide more equitable and accessible higher education for all. ^ The study attempted to answer the question: What is the study experience of “culturally sensitive” graduate students in American DE Programs? The underlying issue in this study is whether education designed and provided by educators of different socio-cultural backgrounds from that of the students could be content relevant and instructionally appropriate, resulting in educational enhancement and/or prepare students to function adequately in their own communities. ^ Participants in this study (n = 12) were engaged in Master's level (n = 2) and Doctoral level (n = 10) DE programs at American Universities, and were interviewed by E-mail, face-to-face, or using a combination of the two. Data analysis compared interviews and highlighted repetitive patterns. Interview data was triangulated with recent related literature and data from document reviews of archived E-mail conversations between students and their professors. The patterns that emerged were coded and categorized according to generative themes. The following themes were identified in order to analyze the data and confirmed through participant check-back: program benefits, communication, technology, culture and methodology, and reflectivity. ^ Major findings in this study indicate that culture plays an important role in cross-cultural encounters for students in American DE programs vis-à-vis student perceptions as to whether their study needs were being met. Most notably, it was found that the coupling of cultural perceptual differences with transactional distance created a potential barrier to communication that could affect short-term success in American DE programs. To overcome this barrier, students cited good communication as essential in meeting student's needs, especially those communications that were supportive and full of detail and context and from a primary source (ex. directly from the professor). Evaluation was a particularly sensitive issue, especially when students were unaware of their professor's cultural and contextual intricacies and therefore were uncertain about expectations and intended meaning. CSGS were aware of their position and the American rather than global context in which they were participating. Students appear to have developed “extended identities”, meaning that they acculturated in varying degrees in order to be successful in their program but that their local cultural identity was not compromised in any way. For participants from Venezuela access to higher DE has been a limiting factor to participation, due to the high cost of technology and telephone lines for communication. ^