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Increasing the independence of students with disabilities involves an in-depth assessment of their inclusion in driver’s education. This study addresses (a) the plight of disabled students within the state of New Jersey who are unable to access driver’s education, despite the provisions of the Americans with Disabilities Act; (b) the need to evaluate the potential role of health educators in conducting individualized health assessments to determine the readiness, motivation, and self-efficacy of students with disabilities to participate in driver’s education; (c) the perceived benefits and barriers to the participation of students with disabilities in driver’s education including the need for individually tailored accommodations; and (d) whether the goal of driving is appropriate and accessible for students with disabilities. A case-study approach was used in this research to evaluate the innovative practice of school health educators conducting individualized health assessments of current students and some graduates of the study-site university. The school implemented the described innovation during the academic years of 2007-08 and 2008-09. This research was also designed with a mixed-method approach including quantitative data limited to frequencies and percentages and qualitative data collected from student interviews. The findings indicate that the ability of students with disabilities to drive is beneficial to their quality of life. Driving significantly impacts the self-esteem, independence, and personal freedom of this population, as well as their overall freedom to travel.

Indiana University-Purdue University Indianapolis (IUPUI) / Children's and adolescents' capacity to provide valid informed consent is one of the key ethical concerns in pediatric research, and the focus of this project. The original contribution to knowledge is the advancement of both conceptual and empirical bioethical approaches to research with vulnerable populations. First, a review of adolescent vulnerability is presented to highlight the complex interplay between capacity and other forms of vulnerability. This review is offered as an interdisciplinary analysis to better understand why the study of vulnerable populations is critical to the ethical advancement of clinical research. Results from this analysis suggest the need for enhanced screening techniques as well as the utilization of specialized staff to identify and reduce the impact of different forms of vulnerability. The primary tasks of the empirical portion of the dissertation were to: (1) Adapt a validated adult competency assessment tool for clinical research, the MacArthur Competency Assessment Tool for Clinical Research, to assess the capacity of children and adolescents to consent to clinical research; (2) Identify predictors that impact children and adolescents’ capacity to provide consent to clinical research; and (3) assess differences and similarities in capacity between healthy and chronically ill children and adolescents. Overall results suggest adolescent capacity to consent to research was similar to adults, and most strongly associated with their family's socioeconomic status as well as their level of health literacy. These findings contrast starkly with the age-based criterion for providing consent currently utilized in assent and consent determinations. These findings also provide insights into ways to ethically involve youth in complex biomedical research.

Introdução: Estudos têm encontrado uma transição da obesidade da população adulta para crianças e adolescentes, que por sua vez, pode acarretar manifestações clínicas, como: doenças coronarianas, diabetes tipo 2, e complicações psicossociais cada vez mais precocemente. Contudo, métodos para avaliação da composição corporal para essa faixa etária, principalmente envolvendo técnicas de baixo custo como as medidas de dobras cutâneas (DC) apresentam imprecisões em estudos brasileiros. Fator o qual pode levar a uma interpretação equivocada da composição corporal dos avaliados. Objetivo: desenvolver novos modelos matemáticos utilizando medidas de DC, tendo como referência a absorciometria de raios-X de dupla energia (DXA), para estimativa de massa de gordura (G) em adolescentes. Métodos: Trata-se de um estudo exploratório descritivo onde foram avaliados 416 adolescentes do gênero masculino de 12 a 17 anos, sendo 42 destinados para compor a amostra de validação da pesquisa. Foram coletadas medidas de massa corporal total, estatura, circunferência da cintura e quadril, nove pontos anatômicos baseados em DC: bíceps, tríceps, subescapular, peitoral, axilar média, abdominal, supra-ilíaca, coxa e panturrilha, além da G e densidade mineral óssea (DMO) aferida com a tecnologia de DXA. Para o desenvolvimento das equações foi utilizado um modelo de regressão linear múltipla através do método de mínimos quadrados ordinários (OLS). Resultados: O grupo apresentou índice de massa corporal (IMC) médio de 21,25±4,12kg/m² e %G = 20,57±5,80%. A partir do %G, a prevalência de excesso de gordura foi verificada em 38,3% dos adolescentes. O impacto da gordura na DMO dos adolescentes indicou uma associação na ordem de r = -0,358; p<0,005, sendo verificada redução de até 14% da DMO para a região da coluna em adolescentes com obesidade em comparação aos eutróficos. O desenvolvimento de novos modelos matemáticos que atendessem critérios de alto coeficiente de determinação (R²), baixo erro padrão de estimativa (EPE), controle de colinearidade, normalidades dos resíduos, homoscedasticidade e praticidade, possibilitaram a apresentação de três opções com R² = 0,932 e EPE 1,79; R² = 0,912 e EPE = 1,78; R² = 0,850 e EPE = 1,87, respectivamente. Em todas as opções, as variáveis idade e estatura foram empregadas, bem como as DC de tríceps e subescapular. Conclusão: Os resultados obtidos evidenciam a possibilidade de desenvolvimento de novos modelos matemáticos para a avaliação da gordura corporal em adolescentes com resultados superiores aos modelos existentes na literatura. / Introduction: Studies have found a transition from obesity of the adult population to children and adolescents, which in turn, can lead to clinical manifestations, such as: coronary diseases, type 2 diabetes, and psychosocial complications increasingly early. However, methods for evaluating nutritional status for this age group, mainly involving low cost techniques such as skinfold thickness measurements (ST), are imprecise in Brazilian studies. Factor which can lead to a mistaken interpretation of the body composition of the evaluated ones. Objective: To develop new mathematical models, based on DC measurements, based on dual energy X-rays absorptiometry (DXA), to estimate fat mass (G) in adolescents. Methods: This was an exploratory descriptive study in which 416 male adolescents aged 12 to 17 years were evaluated, 42 of whom were separated to compose the study validation sample. Measurements of total body mass, stature, waist and hip circumference were obtained, nine anatomical points based on ST: biceps, triceps, subscapular, pectoral, mid axillary, abdominal, suprailiac, thigh and calf muscles, as well as G and bone mineral density (BMD) measured with DXA technology. For the development of the equations, a multiple linear regression model was used by the ordinary least square (OLS) method. Results: The group had a mean body mass index (BMI) of 21.25± 4.12 kg / m² and %G = 20.57 ± 5.80%. From %G, the prevalence of excess fat was verified in 38.3% of adolescents. The impact of fat on adolescent BMD indicated an association in the order of r = -0.358; P <0.005, with BMD reduction up to 14% for the spine region in adolescents with obesity compared to eutrophic. The development of new mathematical models that meet criteria of high coefficient of determination (R²), low standard error of estimation (SEE), control of colinearity, residue normalities, homoscedasticity and practicality, allowed the presentation of three options with R² = 0.932 and SEE 1.79; R² = 0.912 and SEE = 1.78; R² = 0.850 and SEE = 1.87, respectively. In all the options, the variables age and height were employed, as well as triceps and subscapular ST. Conclusion: The results obtained evidenced the possibility of developing new mathematical models for the evaluation of body fat in adolescents with results superior to the existing models in the literature.

Introdução: Estudos têm encontrado uma transição da obesidade da população adulta para crianças e adolescentes, que por sua vez, pode acarretar manifestações clínicas, como: doenças coronarianas, diabetes tipo 2, e complicações psicossociais cada vez mais precocemente. Contudo, métodos para avaliação da composição corporal para essa faixa etária, principalmente envolvendo técnicas de baixo custo como as medidas de dobras cutâneas (DC) apresentam imprecisões em estudos brasileiros. Fator o qual pode levar a uma interpretação equivocada da composição corporal dos avaliados. Objetivo: desenvolver novos modelos matemáticos utilizando medidas de DC, tendo como referência a absorciometria de raios-X de dupla energia (DXA), para estimativa de massa de gordura (G) em adolescentes. Métodos: Trata-se de um estudo exploratório descritivo onde foram avaliados 416 adolescentes do gênero masculino de 12 a 17 anos, sendo 42 destinados para compor a amostra de validação da pesquisa. Foram coletadas medidas de massa corporal total, estatura, circunferência da cintura e quadril, nove pontos anatômicos baseados em DC: bíceps, tríceps, subescapular, peitoral, axilar média, abdominal, supra-ilíaca, coxa e panturrilha, além da G e densidade mineral óssea (DMO) aferida com a tecnologia de DXA. Para o desenvolvimento das equações foi utilizado um modelo de regressão linear múltipla através do método de mínimos quadrados ordinários (OLS). Resultados: O grupo apresentou índice de massa corporal (IMC) médio de 21,25±4,12kg/m² e %G = 20,57±5,80%. A partir do %G, a prevalência de excesso de gordura foi verificada em 38,3% dos adolescentes. O impacto da gordura na DMO dos adolescentes indicou uma associação na ordem de r = -0,358; p<0,005, sendo verificada redução de até 14% da DMO para a região da coluna em adolescentes com obesidade em comparação aos eutróficos. O desenvolvimento de novos modelos matemáticos que atendessem critérios de alto coeficiente de determinação (R²), baixo erro padrão de estimativa (EPE), controle de colinearidade, normalidades dos resíduos, homoscedasticidade e praticidade, possibilitaram a apresentação de três opções com R² = 0,932 e EPE 1,79; R² = 0,912 e EPE = 1,78; R² = 0,850 e EPE = 1,87, respectivamente. Em todas as opções, as variáveis idade e estatura foram empregadas, bem como as DC de tríceps e subescapular. Conclusão: Os resultados obtidos evidenciam a possibilidade de desenvolvimento de novos modelos matemáticos para a avaliação da gordura corporal em adolescentes com resultados superiores aos modelos existentes na literatura. / Introduction: Studies have found a transition from obesity of the adult population to children and adolescents, which in turn, can lead to clinical manifestations, such as: coronary diseases, type 2 diabetes, and psychosocial complications increasingly early. However, methods for evaluating nutritional status for this age group, mainly involving low cost techniques such as skinfold thickness measurements (ST), are imprecise in Brazilian studies. Factor which can lead to a mistaken interpretation of the body composition of the evaluated ones. Objective: To develop new mathematical models, based on DC measurements, based on dual energy X-rays absorptiometry (DXA), to estimate fat mass (G) in adolescents. Methods: This was an exploratory descriptive study in which 416 male adolescents aged 12 to 17 years were evaluated, 42 of whom were separated to compose the study validation sample. Measurements of total body mass, stature, waist and hip circumference were obtained, nine anatomical points based on ST: biceps, triceps, subscapular, pectoral, mid axillary, abdominal, suprailiac, thigh and calf muscles, as well as G and bone mineral density (BMD) measured with DXA technology. For the development of the equations, a multiple linear regression model was used by the ordinary least square (OLS) method. Results: The group had a mean body mass index (BMI) of 21.25± 4.12 kg / m² and %G = 20.57 ± 5.80%. From %G, the prevalence of excess fat was verified in 38.3% of adolescents. The impact of fat on adolescent BMD indicated an association in the order of r = -0.358; P <0.005, with BMD reduction up to 14% for the spine region in adolescents with obesity compared to eutrophic. The development of new mathematical models that meet criteria of high coefficient of determination (R²), low standard error of estimation (SEE), control of colinearity, residue normalities, homoscedasticity and practicality, allowed the presentation of three options with R² = 0.932 and SEE 1.79; R² = 0.912 and SEE = 1.78; R² = 0.850 and SEE = 1.87, respectively. In all the options, the variables age and height were employed, as well as triceps and subscapular ST. Conclusion: The results obtained evidenced the possibility of developing new mathematical models for the evaluation of body fat in adolescents with results superior to the existing models in the literature.

Stakeholder involvement in strategic planning: a strategy to mitigate the effects of HIV and AIDS on secondary education in Botswana. This study explores the involvement of stakeholders in strategic planning to mitigate the effect of HIV and AIDS in secondary education in Botswana. The prevalence of HIV and AIDS-related illness and deaths is high in Botswana and affects both teachers and learners. Education provision has been affected through increased mortality and morbidity and increased absenteeism which affect education-related personnel and the demand for education has been reduced due to growing numbers of orphaned and vulnerable children as a consequence of parent/guardian mortality and morbidity related to HIV and AIDS. The problem was investigated by means of a literature review and an empirical inquiry which combined quantitative and qualitative data collection. Based on the findings, in addition to medical and other interventions, an education management approach is required to mitigate the effects of HIV and AIDS on secondary education in Botswana. The strategies of coping, caring and preventing have been effective in this regard. Some internal stakeholders of the Department of Secondary Education (DSE) are not meaningfully involved in strategic planning. Similarly, most of the selected external stakeholders were not involved in the DSE HIV and AIDS strategic plan. Both external and internal stakeholders should be involved at all stages of planning. Furthermore, inducement-contribution exchanges and teacher credibility should be considered in a strategic plan. To improve the current DSE strategic plan, a stakeholder involvement model to involve internal and external stakeholders was designed. Based on this model and the above findings, recommendations for practice and suggestions for future research are made. / Educational Studies / D.Ed.(Educational Management)

Stakeholder involvement in strategic planning: a strategy to mitigate the effects of HIV and AIDS on secondary education in Botswana. This study explores the involvement of stakeholders in strategic planning to mitigate the effect of HIV and AIDS in secondary education in Botswana. The prevalence of HIV and AIDS-related illness and deaths is high in Botswana and affects both teachers and learners. Education provision has been affected through increased mortality and morbidity and increased absenteeism which affect education-related personnel and the demand for education has been reduced due to growing numbers of orphaned and vulnerable children as a consequence of parent/guardian mortality and morbidity related to HIV and AIDS. The problem was investigated by means of a literature review and an empirical inquiry which combined quantitative and qualitative data collection. Based on the findings, in addition to medical and other interventions, an education management approach is required to mitigate the effects of HIV and AIDS on secondary education in Botswana. The strategies of coping, caring and preventing have been effective in this regard. Some internal stakeholders of the Department of Secondary Education (DSE) are not meaningfully involved in strategic planning. Similarly, most of the selected external stakeholders were not involved in the DSE HIV and AIDS strategic plan. Both external and internal stakeholders should be involved at all stages of planning. Furthermore, inducement-contribution exchanges and teacher credibility should be considered in a strategic plan. To improve the current DSE strategic plan, a stakeholder involvement model to involve internal and external stakeholders was designed. Based on this model and the above findings, recommendations for practice and suggestions for future research are made. / Educational Studies / D.Ed.(Educational Management)