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A profession has been defined as a calling requiring specialized knowledge and intensive academic preparation. At the University of Missouri-Columbia, specialized knowledge and intensive academic preparation have been the hallmarks of its program since its inception in 1839. The University of Missouri-Columbia (MU) is the flagship and land-grant institution of the four-campus University of Missouri system. This article describes the professionalization of MU's teacher preparation program called Teacher Development Program (TDP) and presents a discussion of the four design principles adopted by the faculty, which serve as the foundation of the program: (1) organizing programs around the problems of practice; (2) creating opportunities for inquiry and reflection; (3) utilizing developmental approaches to performance assessment; and (4) focusing on what educators need to value, know, and be able to do. This article also discusses Teacher Development Program's organization which consists of four phases. These phases provide checkpoints for the major assessments and provide the opportunity to remediate and assist students that have not met phase criteria. Both diversity and use of new learning technologies are overarching themes that are integrated throughout each phase of the program.

Purpose of the Study: I examine whether 5 aspects of a significant other's death quality (pain, decision-making capacity, location, problems with end-of life care, and preparation) affect whether one does advance care planning (ACP). I also identify specific aspects of others' deaths that respondents say triggered their own planning. Design and Methods: Data are from the New Jersey End of Life study, a survey of 305 adults age 55+ seeking care at 2 major New Jersey medical centers. I estimate multivariate logistic regression models for a subsample of 253 participants who recently lost a loved one and provide descriptive findings from an open-ended question regarding the motivation for one's ACP. Results: Multivariate analyses revealed "positive" role model effects; persons who witnessed significant others' deaths that occurred at home, were free of problems associated with end-of-life care, and where advance directives were used are more likely to make end-of-life preparations. Open-ended data showed that 19% cited others' deaths as the main trigger for their own planning, with most citing negative factors (pain, connection to machines, coma) that they hoped to avoid. Implications: Practitioners should encourage patients to use conversations about others' deaths as springboards for discussions about one's own end-of-life care, and to engage in ACP together with family. Implications for health care reform are highlighted.

I use data from the Wisconsin Longitudinal Study (n = 4,971) to evaluate the extent to which socioeconomic status affects three health-related (living will, durable power of attorney for health care, and discussions) and one financial (will) component of end-of-life planning. Net worth is positively associated with all four types of planning, after demographic, health, and psychological characteristics are controlled. Low rates of health-related planning among persons with low or negative assets are largely accounted for by the fact that they are less likely to execute a will, an action that triggers health-related preparations. Rates of health-related planning alone are higher among recently hospitalized persons, whereas financial planning only is more commonly done by homeowners and those with richer assets. The results suggest that economically advantaged persons engage in end-of-life planning as a two-pronged strategy entailing financial and health-related preparations. Implications for health policy, practice, and theory are discussed. (Contains 7 notes and 4 tables.)

We use Wisconsin Longitudinal Study data (n = 2,678) to assess the effects of religious denomination and ideology on end-of-life treatment preferences in two hypothetical terminal illness scenarios: physical pain and severe cognitive impairment. We found no statistically significant differences when comparing traditionally defined religious denominational groups (i.e., conservative, moderate and liberal Protestants; Catholics; other religions; no religion). However, when we considered the intersection of broad denominational group and adherence to Christian fundamentalist beliefs, we found that fundamentalist Catholics and fundamentalist Protestants were significantly more likely than their nonfundamentalist counterparts to desire life-extending treatments in both scenarios. These effects were fully explained by beliefs about quality of life and religious control over medical decisions. We end with a discussion of the study's theoretical and policy implications.

This study examines the potential social diffusion effects of the Respecting Choices advance care planning program administered in La Crosse, Wisconsin, since 1991. The program produces educational materials for patients, trains facilitators to help patients prepare for end of life, and ensures that advance directives are connected to patients' medical records. Using data from a survey of more than 5,000 White Wisconsin high school graduates in their mid-60s, we found that participants who were living in the La Crosse area were significantly less likely than their peers living elsewhere to have executed a living will or appointed a health care power of attorney. This pattern may reflect psychological reactance, where individuals reject a message or lesson when they perceive compliance as a threat to their autonomy. There was no evidence of social diffusion effects; participants who lived in the La Crosse region themselves or who had social network members residing in the area were no more likely than those with no known ties to the region to have engaged in advance care planning. Future studies should explore the processes through which individuals learn and share with others their knowledge of advance care planning. (Contains 2 tables.)

Purpose/Objectives: The objectives of this study were to assess the extent to which school nutrition (SN) programs have implemented food safety programs based on Hazard Analysis and Critical Control Point (HACCP) principles, as well as factors, barriers, and practices related to implementation of these programs. Methods: An online survey was developed and administered using SurveyMonkey. Survey invitation letters were mailed to 14,682 SN directors participating in SN programs, who were asked to distribute an additional invitation letter to SN managers, for a potential sample size of 29,364. Data analyses include descriptive statistics, exploratory factor analysis, and chi-square tests. Results: A total of 2,716 participants (9.2%) responded to the online survey. Although the majority of directors and managers reported that their districts and schools, respectively, had implemented food safety programs based on HACCP principles, further assessment revealed that implementation of programs was often incomplete. Directors who had worked in SN programs for more than 20 years, school districts in the Southwest region, and larger school districts were all more likely to have implemented these programs. The top barriers to implementation were related to time, costs, and negative perceptions of food safety programs based on HACCP principles. The top practices important in implementing these programs were related to restricting ill employees from work with food, positive role modeling regarding food safety, ensuring that role expectations are understood, providing necessary training and materials, ensuring that programs are practical to apply, and gaining employee "buy-in" to programs. Applications to Child Nutrition Professionals: Because the implementation of food safety programs based on HACCP principles is incomplete in many SN programs, there is a continued need for education and training related to this issue. Barriers to implementation and practices supporting implementation identified in this study can be used to guide education and training initiatives designed to support implementation at the local school district level. (Contains 4 tables.)

This article presents a quantitative assessment of the impact of an epilepsy-focused training program on school nurses. The Epilepsy Foundation and the National Association of School Nurses (NASN) created a training program titled "Managing Students with Seizures" to educate school nurses on strategies and resources that they can use to handle emergency situations effectively and to create a safe and supportive school environment for children with epilepsy and seizures. Before and after the training sessions, nurses answered questionnaires that measured their confidence levels in providing care for students with epilepsy and seizures; these questionnaires showed an improvement in nurses' confidence levels across all measures. Analysis was also carried out to identify program components and nurse subgroups associated with statistically significant improvements. An evaluation of satisfaction indicated overall satisfaction with the program. This article presents results from 1,080 complete surveys associated with the training in 2007. (Contains 7 figures.)

We review research on families and health published between 2000 and 2009 and highlight key themes and findings from innovative, methodologically rigorous studies. Whereas research in prior decades focused primarily on whether family structure affects child and adult health, contemporary research examines the contextual and processual factors that shape for whom, for which outcomes, and under what conditions families affect mental and physical health. We discuss how family structure, transitions, and processes within families of origin affect children's health over the life course. We then examine the effects of marital status, transitions, and quality for adult health. We point out limitations in current research, discuss implications of recent findings for policy, and highlight theoretical and methodological directions for future research.

Purpose/Objectives: The purpose of this research project was to identify goals and establish best practices for school nutrition (SN) programs that serve students with special food and/or nutrition needs based on the four practice categories identified in previous National Food Service Management Institute, Applied Research Division (NFSMI, ARD) research. Methods: Researchers followed a best practices research model methodology to identify and establish best practices and goals. In Phase I, an expert panel of SN professionals and a school nurse identified goal themes and best practice statements, grouped similar statements within the four practice categories, and provided formatting suggestions for the best practice resource. In Phase II, a national review panel evaluated the best practice statements, goal statements, and draft resource. Panel members provided feedback on the content, scales, format, and usefulness of the resource as a self-assessment tool for SN professionals. Results: Using recommendations from two expert panels, the practice categories, goal statements, and best practice statements were formatted into a Web-based self-assessment tool for SN professionals. The final resource consists of eight goals and 137 best practice statements within four practice categories. Applications to Child Nutrition Professionals: The "NFSMI Best Practices for Serving Students with Special Food and/or Nutrition Needs in School Nutrition Programs" is a self-assessment tool for SN professionals to assess their operation based on the identified best practices. Upon assessing the current status and priority level of the best practices, a plan of action can be established for addressing and prioritizing those best practices identified as needing attention. (Contains 3 tables and 1 figure.)

Purpose/Objectives: Nutrition information can be an important component of local wellness policies. There are very few studies regarding nutrition information at the point of selection (POS) in high schools. The purpose of this study was to investigate the effects of posting entree nutrition information at the POS in high schools nationwide. Methods: This research study was conducted in three phases. In Phase I, focus groups were conducted with high school students from three high schools in the Midwest, Southeast, and Southwest USDA regions. In Phase II, the intervention school nutrition (SN) directors (n = 9) posted nutrition labels for entrees in the high school while the control SN directors (n = 11) did not. In Phase III, the intervention SN directors were interviewed via telephone to determine satisfaction with and barriers to posting nutrition information at the POS. Results: A total of 38 female and 35 male high school students participated in the focus groups. Male and female students thought nutrition information might affect their food choices. Data from the POS were analyzed using ANOVA and stepwise regression. The nutrition labels did not seem to influence students' choices. The SN directors' experiences with the intervention were positive, and they reported providing nutrition labels was a service to students. Applications to Child Nutrition Professionals: The lack of impact of entree nutrition labels in the intervention schools suggests that simply providing passive nutrition information is insufficient for changing lunch purchases in high schools. The findings indicated that attention to the levels of calories and fat in the menu offerings influenced student purchases. If schools provide healthy options, students will eat better. While this conclusion appears simple, it is consistent with the principle of having professionally trained SN directors and registered dietitians associated with SN programs. (Contains 3 tables.)

Purpose/Objectives: The purpose of this national study was to describe nutrition literacy levels and nutrition knowledge among school nutrition (SN) managers, and explore if barriers to seeking SN information, perceived role in school wellness, and confidence in SN decision making varied by nutrition literacy and knowledge scores. Methods: An expert panel consisting of seven SN professionals contributed to the development of the survey instruments for the national study. A random sample totaling 700 SN directors, equally stratified by USDA region, was selected for this study. A total of 199 SN directors responded to the request for participation and subsequently administered 728 SN managers' surveys. Chi-square, one-way ANOVA, MANCOVA and Pearson Correlation tests were used to examine survey data. Results: The majority of SN managers (72.2%) had adequate nutrition literacy skills as measured by an adapted version of a previously validated instrument based on interpreting a food label. For the 10 nutrition knowledge statements, results indicate that knowledge was more compromised including 22.7% with low nutrition knowledge (0-5 questions correct), 45.0% with limited nutrition knowledge (6-7 questions correct), and 32.3% with adequate nutrition knowledge (8-10 questions correct). Nutrition literacy/knowledge scores varied significantly by the type of school and years worked in current position. No meaningful significant relationships were identified among knowledge and literacy scores and the barriers, roles, confidence scales. Applications to Child Nutrition Professionals: This study provides a foundation to explore the causes and consequences associated with nutrition literacy within the context of child nutrition programs. Since SN managers make daily decisions regarding the provision of food to young children, it is critical to assure training agencies are providing opportunities for these managers to develop the skills necessary to locate, comprehend, and apply complex nutrition information for the children they serve. (Contains 4 tables.)

Purpose/Objectives: The purpose of this project was to develop and validate a survey that will enable school nutrition (SN) directors and managers to identify and address issues affecting the non-participation of high school students in the National School Lunch Program (NSLP). Methods: The research was conducted in two phases. Qualitative data from Phase I focus groups explored the perceptions and barriers to participation as identified by high school students and school nutrition (SN) professionals. Responses were transcribed, summarized, and classified into common themes used in Phase II survey development. A series of pilot tests were conducted to refine and validate the instrument. Factor analyses were used to statistically collapse responses into meaningful categories reflecting factors affecting non-participation. Results: Focus group discussions revealed that students who eat school lunch three or more times per week have different concerns than students who eat two or less times per week. Survey development in Phase II focused on measuring factors that affect the non-participation of students who ate two or less times per week. Factor analyses showed that low participation can be attributed to six key issues. Operationally controllable issues included food quality, staff, and access to food. Issues external to the SN program included seating capacity of facilities, food brought from home, and schoolwork. Additionally, students stated that they would be most likely to participate if they saw improvements in the following attributes: overall quality of the food, variety of menu items from day to day, and time spent waiting in line. Applications to Child Nutrition Professionals: The survey developed specifically targets students who eat in the school cafeteria two or less times a week. Results will be useful in helping SN professionals identify the specific issues that can be improved to increase participation. In addition, results will provide researchers a foundation for developing a best practice guide for addressing participation issues in the high school setting. (Contains 2 tables and 1 figure.)

Purpose/Objectives: This study identifies issues associated with creating and maintaining a wellness environment in child care centers (CCCs) participating in the Child and Adult Care Food Program (CACFP). Methods: Structured interviews and focus groups were conducted with CCC professionals and state agency personnel to develop a survey to assess perceptions, practices, and training needs of child care professionals creating and maintaining a wellness environment in CCCs. The surveys were mailed to a national sample of 700 CCC directors stratified by seven USDA regions. Results: A total of 363 surveys were returned (52%) and proportional representation was achieved from CCC directors in all seven USDA regions. The majority of respondents were women (99%) operating CCCs eight hours or more per day (99%), preparing meals and snacks onsite (86%), serving mostly children ages 3 to 5 years (98%). Findings from the data indicate that CCC professionals perceived wellness in CCCs as a comprehensive approach that includes nutrition, safety, and physical activity for children. Exploratory factor analysis produced two factors from the practice statements accounting for 50.0% of the variance: Resources and Partnerships (13 items, alpha = 0.94) and Healthy Environment (13 items, alpha = 0.90). Respondents indicated that "I need" and "my staff" need training to secure resources to support wellness practices. CCC staff need additional training to address issues related to teaching and modeling wellness practices to children and addressing communication issues with parents about their children's wellness needs. Applications to Child Nutrition Professionals: The child care wellness perceptions, practices, and training needs identified in this study could be used to develop best practices or quality indicators for CCC professionals creating and maintaining a wellness environment in CCCs participating in the CACFP. (Contains 4 tables.)

We use prospective couple-level data from the Changing Lives of Older Couples to assess the extent to which spouses concur in their assessments of marital quality (N = 844) and whether discrepancies in spouses' marital assessments affect the bereaved spouse's psychological adjustment 6 months after loss (n = 105). Spouses' assessments of marital quality are correlated modestly (r = 0.45), with women offering less positive assessments. Bereaved persons who had rated their marriages more positively than their spouse at the preloss interview reported higher levels of anger 6 months postloss. We conclude that persons who offer more positive appraisals of their marriages than their spouse may view spousal loss as a particularly unjust event. We discuss implications for understanding late life marriage and spousal bereavement.

Purpose/Objectives: The purpose of this study was to determine the best practices (quality indicators) related to recess placement before lunch in elementary schools; compile a best practices checklist that can be used as an assessment tool for school nutrition programs; and validate and evaluate the usefulness of the best practices checklist. Methods: This study was conducted in two phases. In phase I, researchers drafted 107 best practice statements from previous research, research literature, and standards of practice for the National School Lunch Program. These statements were evaluated in a two-day workgroup meeting with an expert panel of school nutrition directors, principals, and state agency personnel representing four USDA regions. Three of the five research-based practice categories identified in previous research (personnel support/workload, logistics, and scheduling) were confirmed by the work group, as well as 3 goals, 15 best practice statements, and 18 considerations and professional reminder practice statements. In phase II, the draft checklist was further evaluated and pilot tested via electronic mail by a national review panel of school nutrition directors and state agency personnel from six USDA regions. Results: Based on the review panel's comments and suggestions, the recess before lunch (RBL) best practice checklist was revised and formatted as a Web-based, self-assessment tool. The "NFSMI Best Practice Checklist for School Nutrition Professionals Implementing or Assessing Recess Before Lunch in Elementary Schools" has a user-friendly format designed around three practice categories, four goals, and 39 best practices and standard supporting practices. Applications to Child Nutrition Professionals: The "RBL Best Practice Checklist" will assist school nutrition professionals and stakeholders in implementing services for a new RBL program or serve as an assessment tool for evaluating an existing RBL program in elementary schools. (Contains 3 tables and 1 figure.)

Purpose/Objective: The purpose of this study was to investigate school nutrition directors' (SNDs) previous experience with web-based training (WBT), interest in utilizing WBT within 14 functional areas, and logistical issues (time, price, educational credits, etc.) of developing and delivering WBT learning modules. Methods: A survey was developed based on a previous qualitative study exploring SNDs opinions and perceived benefits and barriers regarding WBT. A random sample of 700 SNDs equally stratified by United States Department of Agriculture regions was used. Survey responses were analyzed using descriptive statistics, Chi-square and one-way ANOVA tests. Results: A total of 210 (30%) usable surveys were returned with adequate representation of SNDs with varying educational achievement, certified/credentialed status, and geographical location. Although the majority (57%) of SNDs reported previous experience with WBT, experiences were mostly limited to basic tasks and relatively few SNDs had interacted with an instructor or earned education credits through WBT. Benefits of WBT outnumbered barriers. The most frequently identified benefits included completing the training at anytime, self-directed learning, not traveling, and financial savings. Barriers included technology issues or computer problems and lack of interaction with an instructor. In total, 95% of SNDs indicated they would participate in WBT. Forty-eight percent of SNDs indicated the importance of earning credits for WBT, while 45% of SNDs would complete WBT regardless of earning any type of credit. On a 5-point scale ("1=very disinterested", "5=very interested"), WBT interest ratings were above 3.4 for all functional areas. Although 83% of SNDs would complete WBT at work, there was uncertainty whether their organizations would provide workday release time to participate. Applications to Child Nutrition Professionals: Overall interest and support for WBT is high among SNDs. If barriers and logistical concerns are properly considered, SNDs would participate in WBT to meet their individualized learning needs and to enhance their professional development. (Contains 4 tables.)

Purpose: This study identifies best practices for school nutrition professionals serving the nutritional needs of Pre-Kindergarten (PreK) children in public schools. Methods: The two-phased study followed a best practices research model (BPRM) utilizing the seven practice categories identified from previous PreK research. In Phase I, an expert panel of school professionals (n = 7) identified and confirmed goals and best practice statements under the practice categories: Communication and Training, Nutritious Menus and Meal Experiences, Administrative Support, Encouragement, Mealtime Opportunities, Dining Environment, and Healthy Wellness Practices. The panel provided feedback on the content, wording of goals and best practices, and formatting suggestions to develop a best practice guide. The panel members' comments were then used to revise and pilot the guide. In Phase II, members of a review panel, composed of school professionals (n = 14), were provided the draft guide, evaluation form, and demographic survey to complete a directed review. The panel assessed the efficacy of the guide as a self-assessment tool, and confirmed the placement of best practice statements under related goals and practice categories. Descriptive statistics included means, standard deviations, and frequencies of total responses. Researchers reviewed the data and incorporated suggestions from the review panel to revise and format the guide. Results: The review panel's evaluation indicated a high level of agreement that the goals and best practices were clearly stated, were measurable and achievable, and were similar to performance standards necessary for serving PreK children. The final version of the best practice guide consisted of seven practice categories, 17 goals, and 97 best practice statements. Application to Child Nutrition Professionals: The NFSMI best practice guide was formatted into a Web-based, checklist which can be used either as a self-assessment tool to evaluate and monitor the quality of nutrition services in PreK programs or as a guide to plan new PreK programs. (Contains 2 tables.)

Purpose/Objectives: Study objectives were to identify the functional areas, competencies, knowledge, and skills needed by effective school nutrition (SN) assistants in the current SN environment, and determine at what point the SN assistant should be able to know/perform the knowledge/skill statement, at time of hire or after training. Methods: In Phase I, an expert panel of state agency staff, SN directors, and SN managers identified functional areas for job duties performed by SN assistants using a modified Delphi technique. The expert panel also agreed upon the knowledge and skill statements needed in each functional area. Researchers categorized the knowledge and skill statements for each functional area and drafted competency statements. The Phase II review panel was mailed a survey to verify whether the knowledge and skill statements are important to job responsibilities of SN assistants, determine at what point SN assistants should be able to know or perform the knowledge or skill statement, and confirm whether the competency statements are consistent with the supporting knowledge and skill statements. Results: Six functional areas were identified that encompass the job duties of the SN assistant: food production; sanitation, safety, and security; customer service; program regulations and accountability; equipment use and care; and professional excellence. In addition, 12 competencies, 45 knowledge statements, and 105 skill statements were confirmed by the Phase II review panel. Thirty-seven statements were identified as being necessary when SN assistants are hired. Applications to Child Nutrition Professionals: SN administrators can use the knowledge and skill statements in preparing job descriptions for SN assistants. Although job requirements for SN assistants may differ, these findings provide needed information for defining the role of an effective SN assistant. (Contains 2 tables.)

Purpose: We document the extent to which older adults accurately report their spouses' end-of-life treatment preferences, in the hypothetical scenarios of terminal illness with severe physical pain and terminal illness with severe cognitive impairment. We investigate the extent to which accurate reports, inaccurate reports (i.e., errors of undertreatment or overtreatment), and uncertain reports (responses of "do not know") are associated with spouses' advance care planning and surrogates' involvement in the planning. Design and Methods: We used data from married couples who participated in the Wisconsin Longitudinal Study in 2004. These 2,750 couples were in their mid-60s and in relatively good health. We conducted multinomial logistic regressions. Results: Surrogates were accurate in the majority of cases, made errors in 12% to 22% of cases, and were uncertain in 11% to 16% of cases. Errors of overtreatment and undertreatment were equally prevalent. For both scenarios, discussing preferences was associated with lower odds of an uncertain surrogate response. Implications: We suggest ways that health care practitioners could facilitate family-level conversations in order to ensure that patients' preferences are accurately represented in end-of-life care settings.

Background: In the UK, Early Intensive Behavioural Intervention [EIBI] programmes typically are conducted within the homes of children with autism. Despite evidence for their effectiveness in producing appreciable developmental gains in children with autism, a concern expressed about EIBI programmes is that stressful effects from the high levels of demand they place on family resources could undermine their effectiveness [The Effectiveness of Early Interventions for Children with Autistic Spectrum Disorders (ASD). A report for the DfES South East Regional Special Educational Needs Partnership. SERSEN Website, 2004]. This study investigates the positive impacts and the stressors experienced by families running EIBI programmes. Method: Sixteen parents from nine different families participated in semi-structured qualitative interviews on their experiences of running a home-based EIBI programme. Data were analysed using the Grounded Theory process. Results: Positive and negative impacts of the programmes were reported. Analysis indicated that sources of support obtained through the programmes' benefits offset sources of stress through the programmes' demands. Conclusions: The interaction between programme demands and benefits and the resources available to each family strongly influences the impact of running a home-based EIBI programme.

Dying persons are encouraged to name as durable power of attorney for health care (DPAHC) someone who will thus be empowered to make end-of-life treatment decisions for them in the event that they become incapacitated. We use data from the Wisconsin Longitudinal Study to investigate whether and whom older adults designate as their DPAHC. DPAHC appointments are affected by recent hospitalizations, personal beliefs (including religion, fear of death, and the belief that doctors rather than patients should control health care decisions), and personal experience with the recent painful death of a loved one. The selections of DPAHC designees are generally consistent with the hierarchical compensatory model: Married persons overwhelmingly name their spouses, while unmarried parents appoint their children. Women are more likely than men to rely on children. Parents of one or two children tend to bypass their children for another relative. Unmarried, childless persons show considerable heterogeneity in their choices. We discuss implications of these findings for health care policy and practice. (Contains 4 notes and 4 tables.)

The study investigated the impact of mastery of the Picture Exchange Communication System (PECS) to Phase III, on the communications of children with autism. Children aged between 3 and 7 years, formed a PECS intervention group and a non-intervention control group. The intervention group received 15 h of PECS teaching over 5 weeks. Three 2-h classroom observations recorded communications between the children and their teachers. These occurred: 6 weeks before teaching; during the week immediately prior to teaching; during the week immediately following teaching. For the control group, two 2-h observations were separated by a 5-week interval without PECS teaching. Communicative initiations and dyadic interactions increased significantly between the children and teachers in the PECS group but not for the control group.

The context for this work was an evaluation study [Carr, D., & Felce, J. A. (in press)] of the early phases of the Picture Exchange Communication System (PECS) [Frost, L. A., & Bondy, A. S. (1994). "The picture exchange communication system training manual." Cherry Hill, NJ: Pyramid Educational Consultants, Inc.; Frost, L. A., & Bondy, A. S. (2004). "The picture exchange communication system training manual," 2nd edn. Newark, DE: Pyramid Educational Consultants, Inc.]. This paper reports that five of 24 children who received 15 h of PECS teaching towards Phase III over a period of 4-5 weeks, showed concomitant increases in speech production, either in initiating communication with staff or in responding, or both. No children in the PECS group demonstrated a decrease in spoken words after receiving PECS teaching. In the control group, only one of 17 children demonstrated a minimal increase and four of 17 children demonstrated a decrease in use of spoken words after a similar period without PECS teaching.

We investigate whether underweight, normal-weight, overweight, and obese Americans differ in their evaluations of positive and negative aspects of their interpersonal relationships. Analyses are based on data from the Midlife Development in the United States (MIDUS) study, a survey of more than 3,000 adults ages 25 to 74 in 1995. We find no significant differences across the body mass index (BMI) categories in the quality of relationships with friends, coworkers, and spouses. Severely obese persons report significantly higher levels of strain and lower levels of support in their family relationships. This pattern, however, is contingent upon one's adolescent body weight. Among persons who were of "normal" weight at age 21, current BMI is not associated with relationship quality. For persons who were overweight at age 21, the level of social support received from family during adulthood declines as adult BMI increases. Implications for stigma theory are discussed. (Contains 2 figures, 4 tables and 8 footnotes.)

This study examines the ways that widowhood affects older adults' perceived exchange of support with their children, and whether exchange patterns differ by gender. Data are from the Changing Lives of Older Couples (CLOC), a prospective study of 1,532 married individuals age 65 years and older. Spousal loss increases older adults' dependence on their children 6 months after the loss yet decreases children's dependence on their surviving parents. Patterns of postloss parent-child exchanges differ by gender of parent. Compared to widowers, widows are more dependent on their children for financial and/or legal advice yet provide more emotional and instrumental support. However, these gender differences are contingent on educational attainment. Education decreases widows' dependence on children for financial and legal advice yet increases widowers' provision of emotional support to their children. The findings suggest that adherence to traditional gender roles among married couples may influence older adults' adaptation to spousal loss.

We investigate the frequency and psychological correlates of institutional and interpersonal discrimination reported by underweight, normal weight, overweight, obese I, and obese II/III Americans. Analyses use data from the Midlife Development in the United States study, a national survey of more than 3,000 adults ages 25 to 74 in 1995. Compared to normal weight persons, obese II/III persons (body mass index of 35 or higher) are more likely to report institutional and day-to-day interpersonal discrimination. Among obese II/III persons, professional workers are more likely than nonprofessionals to report employment discrimination and interpersonal mistreatment. Obese II/III persons report lower levels of self-acceptance than normal weight persons, yet this relationship is fully mediated by the perception that one has been discriminated against due to body weight or physical appearance. Our findings offer further support for the pervasive stigma of obesity and the negative implications of stigmatized identities for life chances. (Contains 10 notes, 3 tables and 1 figure.)

I examine how midlife men (N=542) compare their work and family lives with those of their young adult sons, and how these comparisons affect the fathers self-evaluations. Analyses are based on quantitative and qualitative data from the Wisconsin Longitudinal Study. Fathers who rate their work lives as more successful than their sons have elevated self-esteem only when they also report being very close with their children. Open-ended interviews reveal that men derive pride from financially supporting their families, yet normative and economic constraints of the good provider role prevented them from pursuing their own career aspirations and from maintaining close parent-child ties. Intergenerational social comparisons highlight the distinctive work and family constraints felt by the midlife fathers.

This study explores gender differences in older widowed persons' interest in dating and remarriage, and the implications of these desires for psychological adjustment to loss. Analyses are based on the Changing Lives of Older Couples study (N = 210). Men's interest in dating and remarriage is conditional upon the amount of social support received from friends. Six months after spousal loss, only those men with low or average levels of social support from friends are more likely than women to report interest in remarrying someday. Similar patterns emerge for interest in dating 18 months after loss. Persons who both want and have a romantic relationship report significantly fewer depressive symptoms 18 months after loss, yet this relationship is attributable to their greater socio-economic resources.

This study examines (a) whether widowhood affects the performance of daily household activities, (b) the extent to which dependence on children mediates the effect of widowhood on subsequent housework performance, and (c) the extent to which these patterns vary by gender. Using the Changing Lives of Older Couples study, a prospective survey of married persons age 65 and older, we find that late-life widowhood is associated with an increase in men's housework, yet does not produce a change in women's subsequent housework performance. Dependency on children mediates the effect of widowhood on housework, suggesting that adult children assist their grieving parents with errands and other household chores. Finding simply that the daily consequences of late-life widowhood are dependent on the individual, dyadic, and intergenerational characteristics of the older adult.

I examine how midlife women, who came of age in the 1950s, compare their career accomplishments with those of their young adult daughters who came of age in the 1970s. Analyses are based on quantitative and qualitative data from the Wisconsin Longitudinal Study, which has tracked a sample of adults since their high school graduation in 1957. Nearly two-thirds of the mothers report that they have been less successful than their daughters; yet these unfavorable comparisons are linked only weakly to self-esteem. The open-ended interviews suggest that the mothers who rate themselves as "less successful" than their daughters maintain positive self-evaluations by characterizing their own decision to give family responsibilities priority over career pursuits as "in step" with their cohort peers; by attributing their less successful careers to cohort differences in the freedom to choose one's career; and by focusing on their daughters' difficulties in balancing work and family demands. (Contains 1 figure, 9 footnotes, and 5 tables.)

I examine how pre-loss emotional and instrumental dependence on one's spouse affects older adults psychological adjustment to widowhood. Analyses are based on 297 persons from the Changing Lives of Older Couples CLOC study, a prospective study of widowhood among adults aged 65 and older. Women who were most emotionally dependent on their spouses had the poorest self-esteem while still married, yet evidence the highest levels of self-esteem following loss. Men who were most dependent on their wives for home maintenance and financial management tasks experience the greatest personal growth following loss. These results suggest that widowed persons who were once highly dependent upon their spouses reap psychological rewards from the recognition that they are capable of managing on their own.

A longitudinal matched-groups design was used to examine the quality and costs of community-based residential supports to people with mental retardation and challenging behavior. Two forms of provision were investigated: noncongregate settings, where the minority of residents had challenging behavior, and congregate settings, where the majority of residents had challenging behavior. Data were collected for 25 people in each setting. We collected information through interviewing service personnel in each type of setting on the costs of service provision, the nature of support provided, and the quality of life of residents. We also conducted observations in each setting. Results suggest that noncongregate residential supports may be more cost effective than congregate residential supports.

This empirical study is intended to assess whether a standards-based integrated teacher preparation curriculum is more beneficial in developing professional competencies than a traditional course-oriented curriculum at a college of education in a state university. Using multivariate analysis of variance, we found that students who went through the new integrated curriculum reported higher levels of professional preparation in all 13 standards and competency areas than those who went through the traditional course-oriented curriculum. This finding remained strong even when the teaching majors were included and controlled as another factor variable. Students in the integrated curriculum and those in the traditional curriculum had comparable characteristics, high school grade point averages (Gaps), and college GPAs. Additional related findings and suggestions for future studies also emerged.

Describes qualifications and responsibilities for the position of school nutrition director. Based on guide published by the National Food Service Management Institute called "Competencies, Knowledge and Skill Statements for District School Nutrition Directors/Supervisors." Guide is available at www.nfsmi.org. (PKP)

Discusses several real-world cases of teachers who took the lead in working cooperatively with others to create learning opportunities. Describes changes needed in administration and teacher education. (RS)

Objectives: Web-based training (WBT) has the potential to meet the diverse learning needs of school nutrition directors (SNDs). The overall objective of this needs assessment targeting SNDs was to explore their needs and interests in utilizing WBT. Methods: Researchers developed and administered two instruments: 1) a qualitative structured-interview questionnaire to assess SNDs' use of computers, experiences in Web-based education, and perceived acceptance to WBT, and 2) a quantitative survey to assess perceived knowledge, skill, training, and interests in utilizing WBT within 14 established functional areas. The sampling plan accounted for SNDs who had attended a 5-day Orientation to Child Nutrition Management Seminar (attendees) and those who had not attended (non-attendees). Results: Participants included 42 SNDs (21 attendees and 21 non-attendees) with an average of 3.1 (SD+4.6) years of director experience. There were no discernable response differences between attendees and non-attendees. The majority of SNDs have the technology infrastructure needed to support WBT at work and at home. Thirty-eight (90%) reported interest in utilizing WBT to acquire knowledge, and 40 (95%) reported interest in WBT for practice activities to further improve skills. Benefits of WBT included convenience, opportunities to study unfamiliar areas in more detail and practice skills, ability to gain knowledge, and accessibility of information. Barriers included lack of instructor/student interaction or feedback to questions, on-site interruptions or time, technology problems, and the motivation or discipline needed to complete assignments. Functional areas with the highest ranking for WBT format included "Financial Management and Record Keeping and Nutrition and Menu Planning." Application to Child Nutrition Professionals: As the potential to integrate WBT into current educational offerings is further investigated, it is important to begin WBT module development with competency-based functional areas as prioritized by SNDs and to address perceived benefits and barriers during development, field testing, and marketing of WBT modules.

Purpose/Objectives: The purpose of this research was to explore the attitudes and barriers related to the implementation of the local wellness policy (LWP) in the elementary school setting. Methods: Researchers used a two-phase approach. Phase I included focus group interviews with school nutrition directors, principals, teachers, parents, and other individuals involved with implementation of the LWP to identify issues surrounding policy implementation. In phase II, 2,800 questionnaires were distributed to school nutrition directors, principals, teachers, and parents from all seven USDA regions. Results: A total of 575 surveys were used in the final data analysis, with nearly equal numbers of participants in each group. Slightly more than half reported playing a role in implementing the wellness policy. Participants ranked meeting the USDA requirements for school meals as the most important component in implementing an LWP. Respondents considered encouraging students to eat healthy was their primary responsibility in implementing the policy and believed the wellness policy would improve physical fitness among elementary students. Having a clean and sanitary cafeteria and a safe and secure campus were most commonly agreed upon as important for a healthy school environment. In addition, respondents strongly agreed they needed training on strategies to implement the school wellness policy. Application to Child Nutrition Professionals: Support from administration, teachers, and parents is necessary to implement, manage, and evaluate an LWP. Additionally, adequate training and credible resources can lay a foundation for achieving the LWP goals, providing strategies for effective LWP implementation, and fostering the need for a collaborative LWP team.

Purpose/Objectives: The purpose was to explore issues associated with school nutrition (SN) programs in large school districts. Specific objectives were to identify operational issues and practices SN directors encounter and describe characteristics of SN directors and their programs. Methods: A panel of seven SN professionals from large school districts was assembled to ascertain their opinions regarding operational issues and challenges in SN programs. This information was used to develop a survey that was mailed to all SN directors in districts with 30,000 or more student enrollment (N = 232). The survey asked SN directors to indicate their agreement with 52 operational issues/practices related to SN operations in large school districts and provide information about themselves and their SN operations. Results: Ninety-eight surveys (42%) were returned. Most respondents have worked in SN programs for 15 years or more and in their current position for less than ten years. Prior to taking the SN director position, over one-third had worked on their district's SN management team. Operational issues receiving the highest mean agreement ratings were: "putting together an effective management team is critical to the operational success of the SN department," "I serve as the SN representative with district administration," and "the SN department employs district-level professional staff to oversee site-level operations." Regardless of district size, there was strong agreement with the operational issues and practices encountered by the SN directors. Applications to Child Nutrition Professionals: Findings suggest that education and training programs are needed to assist in preparing SN professionals to operate SN programs in large school districts. These programs should target SN professionals who work on SN management teams in large districts and SN directors from smaller school districts. The operational issues and practices identified in this study could provide the foundation for educational and training programs.

Objectives: The objectives were to investigate the operational requirements for offering healthful vended reimbursable lunches to students and to identify barriers to implementation. Methods: A descriptive case study method was utilized to explore the operations of two school nutrition programs offering vended reimbursable lunches. Two school districts were selected based on availability and willingness to participate. A multiple case design followed a replication format, thus conclusions from each study site contributed to the whole. Structured and informal interviews, examination of documents and direct observations were used to gather data during a one-day site visit. Results: Two vending machines in a school in each participating district successfully vended reimbursable lunches to high school students. Three considerations were critical to this outcome: regulations, technology, and support. The ability to integrate point-of-sale software, cashless and vending machine technology, and school district electronic record keeping applications was the key element in implementing electronic compliance with USDA National School Lunch Program (NSLP) regulations. This interface of technology with regulations facilitated identification of legitimate reimbursable lunches, accurate provision of free and reduced price meals to eligible students, correct charges for full-pay meals, second meals and à la carte items, and maintaining confidentiality of meal eligibility category. The process entailed overcoming barriers and developing solutions to novel obstacles. All involved in the project stressed that it was possible only with the enthusiastic support of school nutrition program (SNP) and school district administrators, principals, and state agency administration overseeing the NSLP. Application to Child Nutrition Professionals: This qualitative study provided useful information for school nutrition program and school personnel, administrators, district financial personnel, and state agency professionals when considering innovative vending practices. The results offer guidance in implementing a vended reimbursable lunch that provides an additional menu option and the potential for increasing participation and revenue.