ENHANCING ENGAGEMENT FOR INDIVIDUALS WITH PHYSICAL OR COGNITIVE DECLINE THROUGH THE USE OF MULTISENSORY ACTIVITIES

Traditional care models typically have a pre- schedule list of activities for elders to engage in, for the purpose of leisure, enjoyments and fun. However, there are questions remaining about the long term benefits of activities and how many residents participate. “RenewedMe” is a service design project with the goal of “Enhancing engagement in individuals with cognitive or physical decline through multi-sensory activities. This project was inspired by the Montessori method principles of education that foster development, engagement and relationships through developmentally appropriate activities. My approach was to create an “environment” that fosters/sustains individualism, builds confidence and sensorial input and output. An array of activities was used to encourage engagement among residents of nursing homes and also between caregivers and friends. By playfully stimulating cognitive and emotional skills, these activities challenged individuals with cognitive decline. This research draws upon a mixture of primary and secondary sources including research, books and primary field research. Engagement in meaningful social activities is related to quality of life for individuals in assistive care environments. “RenewedMe” aims not to discredit the works of recreational coordinators in assistive care environments. Rather, its objective is to assist in generating better systems to develop more inclusive, interactive and individualized activities that are cognitively beneficial

Exposing Medical Education’s Hidden Curriculum through an Exploration of Teacher-Learner Relationships

The purpose of this study was to explore third-year medical students’ perceptions of their teacher-learner relationships with their clinical educators

A Case Study of National Financial Literacy Programs for Women

The purpose of this research study is to explore (case study) in-depth the pedagogy of financial literacy programs for women and how these programs address their educational needs

Medical Students’ Preparedness for Apprenticeship Learning

This research investigated medical student and clinical faculty perceptions of preparedness for learning in the clinical setting. It also explored their beliefs about the ways in which the curriculum promotes or fails to promote preparedness for apprenticeship learning

A Method for Psychosocial Stress-Induced Reinstatement of Cocaine Seeking in Rats

We describe a novel preclinical model of stress-induced relapse to cocaine use in rats using social defeat stress, an ethologically valid psychosocial stressor in rodents that closely resembles stressors that promote craving and relapse in humans. Rats self-administered cocaine for 20 days. On days 11, 14, 17, and 20, animals were subjected to social defeat stress or a nonstressful control condition following the session, with discrete environmental stimuli signaling the impending event. After extinction training, reinstatement was assessed following re-exposure to these discrete cues. Animals re-exposed to psychosocial stress-predictive cues exhibited increased serum corticosterone and significantly greater reinstatement of cocaine seeking than the control group, and active coping behaviors during social defeat episodes were associated with subsequent reinstatement magnitude. These studies are the first to describe an operant model of psychosocial stress-induced relapse in rodents and lay the foundation for future work investigating its neurobiological underpinnings

Barriers to Healthy Eating Among High School Youth in Rural Southern Appalachia

Introduction: Diet and nutrition play an important role in a child’s health and reduce the risk of numerous health problems including obesity. Dietary habits can be difficult to modify in children, particularly in Appalachia, where access to affordable, healthy foods is limited. Purpose: To examine barriers to healthy eating among Appalachian youth. Methods: In 2013–2014, data were gathered via focus groups and interviews from parents, school personnel, and adolescents (N=99) in six counties across southern Appalachia. Data were analyzed using thematic network analysis. Analysis was completed in 2015. Results: Participants identified multiple barriers to healthy eating among adolescents. Barriers comprised three global themes: cultural norms, school-based nutrition policy and programming, and rurality. Within the individual and home environment, beliefs and practices, time management, and preference for unhealthy foods affected adolescents’ dietary behaviors. Schools faced challenges in terms of translating nutrition policy into practice, providing nutrition education, and engaging stakeholders. Limited socioeconomics and food deserts/swamps were community-level impacts. Implications: Participants discussed how adolescents’ eating behaviors were shaped by social, physical, and environmental factors (e.g., cultural norms, school-based nutrition policy/programming, and rurality). These findings provide important insights into barriers to healthy eating in this population and point to future directions for research and practice. For example, the findings can be used by school personnel to develop ecologic approaches to school-based nutrition programming in Appalachia. Student associations can also use these findings to actively participate in efforts to improve school food offerings

The National School Lunch Program in Rural Appalachian Tennessee – or Why Implementation of the Healthy, Hunger Free Kids Act of 2010 was Met with Challenges: A Brief Report

Purpose: The purpose of this study was to investigate challenges faced by high schools in rural Appalachia in implementing the Healthy, Hunger Free Kids Act of 2010 (HHFKA). Methodology: We used qualitative, secondary analysis to analyze a collection of thirteen focus groups and 22 interviews conducted in 2013-14 among parents, teachers, and high school students in six counties in rural Appalachian Tennessee (n=98). Results: Five basic themes were identified during the thematic analysis: poor food quality prior to implementation of the HHFKA school nutrition reforms; students’ preference for low-nutrient energy-dense foods; low acceptance of healthier options after implementation of the HHFKA school nutrition reforms; HHFKA school nutrition reforms not tailored to unique needs of under-resourced communities; and students opting out of the National School Lunch Program after implementation of the HHFKA school nutrition reforms. Rural communities face multiple and intersecting challenges in implementing the HHFKA school nutrition reforms. Conclusion: As a result, schools in rural Appalachia may be less likely to derive benefits from these reforms. The ability of rural schools to take advantage of school nutrition reforms to improve student health may depend largely on factors unique to each community or school

Prevalence of and Risk Factors for Adolescent Obesity in Tennessee Using the 2010 Youth Risk Behavior Survey (YRBS) Data: An Analysis Using Weighted Hierarchical Logistic Regression

Background: The rate of adolescent overweight and obesity has more than quadrupled over the past few decades, and has become a major public health problem [1]. In 2011, 55% of 12-19 year olds in the United States (U.S.) were overweight or obese [2]. Adolescence is a pivotal time in which many health risk behaviors such as tobacco, alcohol, and drug use are initiated. Such health risk behaviors have been significantly associated with overweight and obesity among adolescents. Objective: The purpose of this study is to evaluate the relationship between obesity and the health risk behaviors most commonly associated with premature morbidity and mortality among adolescents with a novel micro area estimate approach that uses weighted hierarchical logistic regression to nest individuals in classes, classes in schools, and schools in districts. Methods: This study is a secondary analysis of a state-wide representative sample of middle school students that participated in the 2010 Tennessee Middle School Youth Risk Behavior Survey (YRBS). Data was collected from 119 (85.6%) of Tennessee’s local education agencies (LEAs), 456 (95.2%) schools, and 64,790 of 78,441 (82.6%) students. The outcome variable was adolescent obesity (≥ 95th BMI percentile). Explanatory variables were divided into four levels [1] district level: use seatbelt/helmet, asked to show ID for tobacco purchase; [2] school level: ever tried smoking, received HIV education in school; [3] class level: average number of days smoked, having ever exercised to lose weight; [4] individual level: having ever been in fight, early onset of substance use, physical activity, and thought about, planed, or attempted suicide. Weighted hierarchical logistic regression analysis was performed to assess the association between risk factors or protective factors and obesity using effect size (ES) and odds ratio (OR) estimates. Results: The study sample included 64,790 middle school students in the state of Tennessee with a mean age of 12.8 years, of which (49.42%) were females and (50.58%) were males. Nearly one-fourth of the students had a BMI at or above the 95th percentile (22.30%). Weighted hierarchical logistic regression analysis shows that seatbelt and helmet use [ES: -2.161 OR: 0.020, 95% CI: (0.006, 0.070)], and weight misperception [ES: 1.256 OR: 9.720, 95% CI: (9.216, 10.251)], having ever exercised to lose weight [ES: -0.340 OR: 0.540, 95% CI: (0.446, 0.654)], having ever tried smoking [ES: 0.705 OR: 3.581, 95% CI: (2.637, 4.863)] and gender (male vs female) [ES: 0.327 OR: 1.810, 95% CI: (1.740, 1.880)] were strongly associated with adolescent obesity. Results from this study also showed that Black, Hispanic or Latino adolescents were more likely to be obese than Whites, Indian, and Asian adolescent [ES: 0.129 OR: 1.260, 95% CI: (1.200, 1.330)], students with grades of mostly C, D and F were more likely to be obese than those with grades of mostly A and B [ES: 0.189 OR: 1.409, 95% CI: (1.303, 1.523)], and that students having an eating disorder [ES: 0.251 OR: 1.576, 95% CI: (1.508, 1.648)] and/or engagement in sports teams [ES: -0.197 OR: 0.700, 95% CI: (0.674, 0.728)] had small or medium ES association with adolescent obesity. Conclusion:This study uses small area estimates in weighted hierarchical logistic regression models to describe the prevalence and distribution of health risk behaviors associated with adolescent obesity among middle school student subpopulations in Tennessee. The value of small area estimates has been demonstrated previously in a variety of other contexts, and again here offers important insights for intervention design and resource allocation at different micro-levels within small and large areas (i.e., district, school, and class). This work adds to the growing body of research that supports community-driven school-based lifestyle interventions targeting early-onset chronic disease and, more specifically, enhances the geographic resolution with which adolescent obesity can be addressed in middle school populations across Tennessee

Voices from the classroom : an exploration of the perceptions of teaching assistants

This research gave voice to teaching assistants, exploring their experiences and perceptions, in terms of their backgrounds, roles and responsibilities, experiences whilst studying on an NVQ programme, support from their schools, their aspirations and the progression routes available to them. A small-scale phenomenological study approach was adopted, aimed to interpret and explain human actions and thought through descriptions, capturing first person accounts. Qualitative data was collected from focus group interviews. The research found that the main entry route into the role of teaching assistant was that of parent-helper at the school their child(ren) attended. Previous employment was varied, however, previous skills and experience was not drawn upon or utilised by the schools. Differences in job titles were not reflected by the roles performed by the participants. Support from their schools for undertaking qualifications was limited and participants had little knowledge of progression routes available to them. The research concluded that there is a need for a transparent career structure, which indicates levels of responsibility. Linked to this should be nationally recognised qualifications, which every member of support staff would have to gain, at the appropriate level for the role they fulfil. Wages should reflect the roles and associated qualifications, bringing about a clearer picture of the job of ‘teaching assistant’.EThOS - Electronic Theses Online ServiceGBUnited Kingdo