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Title: Research news you can use
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Creator: Department of Family, Youth and Community Sciences, Institute of Food and Agricultural Sciences, University of Florida
Publisher: Department of Family, Youth and Community Sciences, Institute of Food and Agricultural Sciences, University of Florida
Place of Publication: Gainesville, Fla.
Publication Date: Fall 2005
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Volume ID: VID00002
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L. UNIVERSITY OF
FLORIDA
IFAS EXTENSION


Department of Family, Youth and Community Sciences

Research News You Can Use


Note from Nayda
Welcome to the Summer 2005 issue of the Department of Family,
Youth and Community Sciences research newsletter: Research News
You Can Use. This helpful series shares up-to-date, reliable research
in Family, Youth and Community Sciences with you for use in your
programs.
Your input and suggestions make this newsletter better. Please let us
know what you think.
Thank you to all faculty members who contributed this issue:
Elizabeth Bolton Jo Turner
Kate Fogarty Glenda Warren
Lisa Guion & Linda Bobroff Carolyn Wilken
Amy Simonne

Nayda Torres, Professor and Chair,
Department of Family, Youth and Community Sciences


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UF/IFAS Department of Fa
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Grassroots Associations versus Larger
Nonprofits: New Evidence from a Community
Case Study in Arts and Culture

Grassroots Associations versus Larger Nonprofits: New
Evidence From a Community Case Study in Arts and Culture.
Author: Stefan Toepler. Publication: Nonprofit and Voluntary
Sector Quarterly, vol 32, no. 2, June 2003, 236-251.
Very small organizations (VSOs) that have not registered with the state to
incorporate or with the Internal Revenue Service for tax exempt status may be
omitted or overlooked. This leads to a portrayal of the nonprofit sector that
may be inaccurate and even misleading. This may be true if one examines the
nonprofit sector primarily in economic terms. Using this theoretical
framework, VSOs are not very important because they do not generate
enough economic activity to merit filing a 990 with the IRS. However if the
focus is on non-economic activity, a very different picture of the significance
of small nonprofit organizations emerges. The contributions of these groups
to a community's social capital are not reflected in the data captured from
large scale nonprofits. The work of these VSOs, or self-help groups, focuses
on altruism as the prime purpose of their activity. These are volunteer driven
grassroots groups that have many diverse purposes. Examples given by the
author of these types of groups include neighborhood associations, choral
societies, epilepsy associations, quilt-making clubs and more.

New thinking is emerging about the importance of nonprofit groups and their
effect on social capital and civil society. These were prominent themes during
the mid to late 1990s. The author cites research by Putnam (1995) and Van Til
(2000) that suggests the growing prominence of nonprofits does not have
much influence on either social capital or civic society. In contrast the
influence of the faith-based and community initiatives since 2000 indicates
that recognition is being given to smaller and less formal community and
grassroots associations and their potential for social change in small but
directed ways. The new argument is that small nonprofits contribute more to
social capital and civic society through voluntary action than the larger
nonprofits.

The case study reported by Toepler examines the influence of arts based
nonprofits in one community with the purpose of determining: (a) If the small
associations do outnumber the large ones, (b) to what degree both large and
small organizations are captured in the data bases derived from IRS filings, (c)
whether small organization volunteering approaches that of the large
organizations, (d) if the revenues and expenditures overall picture would be
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very different if small organizations were included.


The results reported show: (a) The VSOs do significantly outnumber the
larger organizations. In this study that was a ratio of 2:1. (b) Although not all
VSOs were registered with the IRS, about half were even if they had less that
$25,000 per year in revenue which exempts them from having to file. Thus
they were included in the IRS data files. (c) The number of volunteers and
hours volunteered were equal for small and large organizations. (d) The
expenditures and revenues of the small organizations would not greatly alter
the financial and economic picture of the area. Not surprising was the fact
that there were many more small organizations but the large organizations
generated more income and had greater expenditures.

The case study methodology reported in this article deals essentially with the
economic contributions of the arts nonprofits of the community. It does not
deal with any other impact these VSOs might have on the individuals, families
and the community. However, this was not stated as a purpose of the study
but the reader might be lead to believe this would be forthcoming given the
emphasis given to it at the beginning of the article.

Implications for Extension
As a reviewer, the implications for county extension faculty appear to
be as follows:
(a) Very small organizations are overlooked in terms of potential for
programming impact given their emphasis on altruism and its
many forms. These groups may be formal or informal without
any corporate structure, but their connectedness to a specific
purpose, cause or mission may be a vital link for program
outreach as well as networking for future goals.
(b) There are many more of these VSOs than larger nonprofits. Not
all will have been formed with goals and purposes that match
directly to an extension program. However their work
represents great opportunity for building social capital and civic
society (according to the author citing secondary sources).
(c) While the economic picture may not change much by focusing
on VSOs, their significance may lie in forming networks that are
needed when policies are made (or changed) at the local, state or
national level.
This is a topic that will be dealt with in the in-service for Goal 5.5
Working with Nonprofit Organizations in Your Community.
Submitted By: Elizabeth B. Bolton, Ph.D., Professor of Community
Development, ebbolton@ifas.ufl.edu

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Addtina g esource


Children t Adolescents: Dealing with Natural
Disasters

When natural disasters hit, such as tsunamis, hurricanes, earthquakes,
mudslides, floods, and fires, they harm families and their children. Many
natural disaster victims lose their homes, means of support, and become
separated from family members, either temporarily or permanently.

Surviving families and individuals face uncertainties such as:

Threat of physical injury or death

Health problems or disabilities caused by or made worse by the

disaster

Difficulty meeting one's basic needs such as finding food and shelter

Dealing with the death of a loved one

Temporary or permanent separation of parents from their children.

All these stresses families experience add to a child's traumatic
experience during a natural disaster.

Once basic needs are regained such as food, clothing, and shelter, help is
needed for the emotional and psychological well-being of survivors. Children
and adolescents are likely to suffer with post traumatic stress based on the
severe conditions produced by natural disasters. Post traumatic stress
disorder (PTSD) is the development of psychological symptoms after a
catastrophic life event one that is beyond average human experience (Yule &
Canterbury, 1994).

Post traumatic stress disorder (PTSD) takes the following forms and must last
over a month after the disaster in order to be diagnosed (Schonfeld, 2002):

Persistent flashbacks of the event in thoughts and dreams and feelings
of alarm at the presence of event-related stimuli (for example, feeling
intensely anxious at the sight of dark clouds)

Actively avoiding anything that reminds them of the event (for
example, swimming in a lake after a flood or going to a place where
the trauma occurred), including thoughts and feelings.

Becoming numb to one's feelings is one way in which thoughts and


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feelings about an event can be blocked out.


Being easily startled, overly anxious, irritable, angry, and having
difficulty sleeping or concentrating.

More severe forms of PTSD persist longer than three months (Vernberg &
Vogel, 1993) and, in some cases, last a year or longer.

In natural disasters with devastating effects for example, earthquakes,
anywhere from 3% to 33% of adults show symptoms of PTSD, whereas nearly
30% to 70% of children experience PTSD (Hsu, Chong, Yang, & Yen, 2002).

Likelihood of having PTSD symptoms is based on:

Psychological functioning before the event.

o If someone has been through trauma before the event, he or she
becomes more vulnerable to PTSD.

The type of trauma
o Was the event an 'act of God' or caused by people?

Severity of effects from the traumatic event:

o Were deaths witnessed?
o Was there loss of close friends and/or family members?
o Were homes and/or livelihood destroyed?
o Did the person think at any point during the event that he or
she was about to die?

Not only do people vary in their response to natural disasters by the amount,
type, and severity of trauma, but by age, culture, and gender (Scott, Knoth,
Beltran-Quiones, & Gomez, 2003). Of particular concern are the experiences of
children, adolescents, and ethnic minorities as well as severity of
consequences of a natural disaster on youth and families.

Children and Adolescents' Responses to Natural Disasters

Early Childhood
In response to trauma, young children are likely to regress to earlier stages of
development, for example, a four-year-old stops using speech to
communicate. Young children may also become antisocial and act more
aggressively. They are likely to repetitively act out the events they witnessed
through play and artwork. Children under 5 years are strongly influenced by
how they see significant adults react to a disastrous event and are extremely
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fearful of being separated from a parent (National Institutes of Mental Health,
2001). On the positive side, children can provide detailed accounts of an event
and talk about their feelings of upset associated with the event (Yule &
Canterbury, 1994). Research supports that children as young as two years old
were able to describe a traumatic experience they viewed and those three
years and older could convey their feelings about what they witnessed (Misch,
Philips, Evans & Berelowitz, 1993).

Middle Childhood
Elementary school aged children (aged 6-11) may withdraw, become
disruptive or inattentive, act aggressively, and show regressive behaviors (for
example, an eight year-old sucking her thumb). In some cases they are less
likely to demonstrate PTSD and are more likely to be depressed than
adolescents (McDermott & Palmer, 2002). School work is likely to decline.
School-age children may also have some of the same reactions as adults such
as nightmares and sleep problems as well as somatization (feeling physical
pains or symptoms with no medical basis). Other symptoms that school age
children experience that are similar to adults are depression, anxiety,
numbness and guilty feelings.

Adolescence
Adolescents 12-17 years of age may react similarly to adults in their trauma.
They may also, like children, regress socially and act more selfish, be
demanding, and have difficulty getting along with others (Schonfeld, 2002).
Teens may feel anger toward authority figures that should have protected
them, such as the government and parents. They may be likely to seek support
and meaning from their peers as well as parents. At this time, adults need to
be understanding of their teen's behavior and not accuse them of selfishness,
argumentativeness or their insistence on discussing the event alone with their
peers. However, it has been found that teens with higher levels of stress in
response to a hurricane are likely to engage in deviant behavior (Scott et al.,
2003).

In light of adolescents' emerging abilities for higher level thinking; they may
try to rationalize in order to gain a sense of control over an uncontrollable
event. For example, a teen might recall a trivial happening before the disaster
and consider it an omen or sign of what was to happen. Based on the fact that
they 'ignored' this sign, they failed to prevent the disaster or consequences of
the disaster from affecting their friends, family, and self (Schonfeld, 2002). In
such a case, helping a teen to understand the distortion of his or her own
thinking will alleviate feelings of guilt, which are common among adolescents
in this time (NIMH, 2001).

How Do Children Compare to Adolescents in their Reactions to

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Natural Disasters? Developmental Concerns
Research findings, comparing children and adolescents' reactions to natural
disasters, vary. Studies of wildfire disasters found that high schoolers
experience lower levels of distress than elementary school children
(McDermott, Lee, Judd, & Gibbon, 2005) and that posttraumatic symptoms
were the strongest in early adolescence, peaking in 8th grade (McDermott &
Palmer, 2002). Another study of 9th grade adolescents found that witnessing a
disaster increased their expectations of susceptibility to death (Halpern-
Felsher & Millstein, 2002). However, regardless of the age of a youth, those
who are most vulnerable to the effects of post traumatic stress are ones who
have prior experience with trauma such as abuse or exposure to violence or
who have mental health problems before the traumatic event happens.

PTSD and Diversity: Ethnic Minorities and Cultural Beliefs
Research evidence overwhelmingly supports the increased vulnerability of
ethnic minorities to long-term distress after a natural disaster. For example, in
a 6-month follow-up of the effects of Hurricane Andrew that decimated much
of southern Florida in 1992, it was found that PTSD rates were the highest
among African-Americans and Hispanics, as compared to Caucasians (Scott,
et al., 2003). In fact, race, namely being African-American, is a close second to
severity of the natural disaster experience in increasing the likelihood of post
traumatic stress (March et al., 1997). It was found that African-American
youth were more likely than their Caucasian peers and among, Caucasians,
females were more likely than males to show PTSD symptoms (March et al.,
1997; Scott, et al., 2003; Yule & Canterbury, 1994). These findings may perhaps
be explained by a greater number of prior traumas experienced by minority
youth (e.g., higher incidence of child abuse, see Schuck, 2005) before the
natural disaster and that males are less likely than female youth to perceive
themselves or close friends and family as likely to die in such situations
(McDermott, Lee, & Gibbon, 2005).

However, ethnic minorities also demonstrate resilience in comparison to
Caucasians. The presence of social support networks among Latin American
communities helped to reduce stress symptoms among its members after a
natural disaster and tend to normalize, rather than stigmatize, stress (Scott et
al., 2003). Moreover, Latin American youth who demonstrate resilience tend to
have stronger confidence in their cognitive abilities than their less resilient
peers. Overall, with respect to multicultural differences in responses to natural
disasters it is perhaps best to focus on the dimensions of socioeconomic status
and social support as they vary across cultures (Rabalais, Ruggiero, & Scotti,
2002), rather than race or ethnicity per se.

Cultural beliefs also contribute to the ways in which individuals and families
respond to a natural disaster. In a study of an industrialized, recently capitalist
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country, it was found that those who demonstrate an avoidant coping style in
the face of a traumatic event (in other words who are likely to be in denial or
socially withdraw from a threat) are more likely to experience distress after a
natural disaster than individuals who use active coping strategies such as
problem solving and seeking support (Bokszczanin, 2003). In Eastern cultures
where suppression of strong emotions is emphasized, victims of natural
disasters may be more likely to have somatic complaints in response to their
distress (Hsu et al., 2002). Individuals from some cultures are likely to reject
psychological help, which needs to be appropriately dealt with by mental
health providers. For example, Red Cross mental health providers are called
"disaster stress relief workers", to reduce the stigma associated with receiving
psychological help (Vernberg & Vogel, 1993). Research finds that cultures in
which members experience psychological recovery or resilience from a natural
disaster are those that encourage (Scott et al., 2003):
Open dialogue about the traumatic event
Celebration of survival
Refusal to blame the victims
Posttraumatic symptoms viewed as normative
Making meaning of the experience

Circumstances and Severity of Post-Traumatic Stress
Research shows that families (mothers and children) who are displaced from
their homes due to destruction by a natural disaster show the highest amount
of PTSD symptoms, as compared to those indirectly affected or those who did
not lose their homes by natural disaster (Najarian, Goenjian, Pelcovitz,
Mandel, & Najarian, 2001). The more exposure children and adolescents have
to a natural disaster (for example, witnessing the deaths of others) the more at
risk they are for PTSD (March, Amaya-Jackson, Terry, & Costanzo, 1997).
Research shows that children with most severe exposure to an event have
moderate to severe levels of PTSD even a year after the event (Yule &
Canterbury, 1994). The more a natural disaster poses a threat to someone's life
and those close to him or her, the higher the risk for PTSD (Najarian, et al.,
2001).

Conclusions and Suggestions from the Research
Unfortunately, when physical needs are at the forefront in a family's recovery,
few are likely to have the resources to seek psychological help for post
traumatic stress that children and adolescents in families may be dealing with.
Although psychological intervention is most necessary after a natural disaster,
mental health services are not a top priority, nor do providers have the
resources to work with many children and adolescents at one given time
(McDermott, Lee, Judd, & Gibbon, 2005). Moreover, mental health providers'
motivation to help disaster victims may be dismissed by emergency planners
and downplayed as less important than meeting basic physical needs
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(Vernberg & Vogel, 1993).


In conclusion, the following suggestions are made to deal with reducing the
risk of long-term post-traumatic stress among children, adolescents, ethnic
minorities, and their families:
Consider a youth's cultural and familial background when it comes to
suggesting treatment and mental health services, age and stage of
development, degree of trauma in the experience.

Be aware of local cultural norms for how grief and loss are handled
(Vernberg & Vogel, 1993)

Encourage adults in families to discuss their emotional reactions to an
event in order to help their children do the same. When families fail to
process the event, children are increasingly likely to display PTSD
(Yule & Canterbury, 1994).

Decrease the amount of time that children watch televised or other
media forms of reporting on a natural disaster they have experienced
directly (or indirectly). And, when children are exposed to media
coverage, make sure referential adults are present. (Schonfeld, 2002).

Develop primary prevention programs (e.g., disaster preparation) that
bolster the coping skills of youth and their families in the event of a
natural disaster (Vernberg & Vogel, 1993).

Rather than rush back into a regular school routine, develop
intervention programs in the schools that allow children and
adolescents to process the event (NIMH, 2001). Teachers or child care
professionals can lead sessions for lower risk children and mental
health professionals should work with youth at higher risk for post
traumatic stress (Vernberg & Vogel, 1993).

Youth should be grouped by age and severity of event exposure
during intervention programs (Vernberg & Vogel, 1993).

Help provide ongoing information to victims as to rescue efforts and
whereabouts of family members (Vernberg & Vogel, 1993).

Rather than shelter a child from learning about the death of a parent or
family member, allow a significant adult to be available for comfort
and to deliver the news (Vernberg & Vogel, 1993).

Encourage family togetherness and reassure children through

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maintaining emotional support and regular routines (NIMH, 2001).


Hold community meetings for families where parents can talk about
the event and how their children are coping with it. Whenever
possible, involve professional counselors as facilitators of these
meetings (NIMH, 2001).

References:

Bokszczanin, A. (2003). The role of coping strategies and social support in
adolescent's well-being after a flood. Polish Psychological Bulletin, 34, 67-72.

Halpern-Felsher, B.L., & Millstein, S.G. (2002). The effects of terrorism on
teens' perceptions of dying: The new world is riskier than ever. Journal of
Adolescent Health, 30, 308-311.

Hsu, C.C., Chong, M.Y., Yang, P., & Yen, C.F. (2002). Posttraumatic stress
disorder among adolescent earthquake victims in Taiwan. Journal of the
American Academy of Child and Adolescent Psychiatry, 41, 875-881.

March, J.S., Amaya-Jackson, L., Terry, R., & Costanzo, P. (1997). Posttraumatic
symptomatology in children and adolescents after an industrial fire. Journal of
the American Academy of Child and Adolescent Psychiatry, 36, 1080-1088.

McDermott, B.M., Lee, E.M., Judd, M., & Gibbon, P. (2005). Posttraumatic
stress disorder and general psychopathology in children and adolescents
following a wildfire disaster. Canadian Journal of Psychiatry, 50, 137-143.

McDermott, B.M., & Palmer, L.J. (2002). Postdisaster emotional distress,
depression and event-related variables: findings across child and adolescent
developmental stages. Australian and New Zealand Journal of Psychiatry, 36, 754-
761.

National Institute of Mental Health. (2001). Helping children and adolescents
cope with violence and disasters. NIH Publication No. 01-3518. Department of
Health and Human Services.

Najarian, L.M., Goenjian, A.K., Pelcovitz, D., Mandel, F., & Najarian, B. (2001).
The effect of relocation after a natural disaster. Journal of Traumatic Stress, 14,
511-526.

Rabalias, A.E., Ruggiero, K.J., & Scotti, J.R. (2002). Multicultural issues in the
response of children to disasters. In A.M. La Greca and W.K. Silverman (Eds.),
Helping children cope with disasters and terrorism. Pp. 73-99. Washington, DC:

UF/IFAS Department of Family, Youth and Community Sciences
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American Psychological Association.


Schonfeld, D.J. (2002). Supporting adolescents in times of national crisis:
Potential roles for adolescent health care providers. Journal of Adolescent Health,
30, 302-307.

Schuck, A.M. (2005). Explaining black-white disparity in maltreatment:
Poverty, female-headed families, and urbanization. Journal of Marriage and the
Family, 67, 543-551.

Scott, R.L., Knoth, R.L., Beltran-Quiones, M., & Gomez, N. (2003). Assessment
of psychological functioning in adolescent earthquake victims in Colombia
using the MMPIA-A. Journal of Traumatic Stress, 16, 49-57.

Vernberg, E.M., & Vogel, J.M. (1993). Interventions with children after
disasters. Journal of Clinical Child Psychology, 22, 485-498.

Yule, W., & Canterbury, R. (1994). The treatment of post traumatic stress
disorder in children and adolescents. International Review of Psychiatry, 6, 12 p.
Submitted by: Kate Fogarty, Ph.D., Assistant Professor, Youth
Development, kfogartvy@ifas.ufl.edu


Effects of a Nutrition Education Program on
the Dietary Behavior and Nutrition Knowledge
of Second-Grade and Third-Grade Students

Effects of a Nutrition Education Program on the Dietary
Behavior and Nutrition Knowledge of Second-Grade and Third-
Grade Students, Alicia Raby Powers, Barbara J. Struempler,
Anthony Guarino, Sondra M. Parmer Journal of School Health,
April 2005 Vol. 75, No. 4 129

Nutrition-related problems in elementary school-aged children include dental
caries and overweight. Poor nutrition and overweight increases the risk of long-
term health problems such as heart disease, cancer, and diabetes. By increasing
consumption of low-fat dairy products, fruits, and vegetables; decreasing
consumption of soft drinks; and increasing participation in regular physical
activities within the elementary school-aged population, prevalence of these
nutrition-related problems may be reduced.

The purpose of this study by Powers et. al was to evaluate the effects of a six-
session nutrition education program on dietary behavior and nutrition
knowledge among second-grade and third-grade students. This article will
share a general overview of the evaluation methods and findings of this study.
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Methods


Subjects
The researchers used a convenience sample of 1100 (550 girls and 550
boys) second-grade and third-grade students from 64 schools in two-thirds of
the counties of Alabama. Schools selected for the study were those wherein at
least 51% of students received free or reduced-price meal plans. There were
398 children who received the program (treatment group) and 702 children
completed the preassessment and post assessment only (control group).

Intervention
Children in the treatment group participated in six weekly nutrition classes that
covered concepts assessed in the questionnaire. Nutrition educators were
provided a curriculum guide with specific curricula and materials in order to
increase consistency across the classes. Children in the control group did not
receive nutrition classes.

Evaluation Methods:
Pizza Please Game. The Pizza Please game component included an
interactive game board and 12 mealtime game questions. The game board
consisted of a life-size pizza with detachable toppings and four place mats
depicting a table setting with an outline of a pizza slice on the plate. The
object of the game was to correctly answer the most nutrition-related questions.
A pizza topping was awarded and placed on the pizza slice on the team's place
mat for a correct response. This game served to assess and reinforce learning
among children in the treatment group.
Pizza Please Questionnaire. The questionnaire included 24 dietary behavior
and 16 nutrition knowledge questions primarily based on nutrition-related
problems often associated with elementary school-age children. This
questionnaire served as a preassessment and postassessment for both the
treatment and control groups. The dietary behavior questions used "yes/no"
response categories to determine whether a particular food was consumed at a
particular meal or snack. For example, "On most school days do you drink
milk at breakfast?" This frequency question was used for breakfast, lunch,
dinner, and snack as well as individually for consumption of milk, cheese,
yogurt, juice, fruit, and vegetable. Food consumption questions only detected
frequency; amounts were not assessed. Nutrition knowledge (pre/post) was
assessed using an actual test, which provides a more precise measurement of
knowledge gain. For example, there were questions whereby children had to
eliminate food that were incorrectly placed in a Food Guide Pyramid food
group. Children were asked matching questions as well. For example, children
had to match a certain food to the nutrient it provides, or a particular nutrient to
the correct benefit that the nutrient provides.
Readability was assessed by the researchers and it was determined that the
reading level for the questionnaire was second grade (Flesch-Kincaid
Readability score = 2.3). In addition, the educators read aloud each question

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and answer choice to help children who read below this level.


Overall Results

Dietary Behavior Changes
The researchers reported that children who received the program
experienced significantly greater improvements in overall dietary behavior than
children in the control group. In fact, children who did not receive the six
nutrition classes experienced a decline in overall dietary behavior.
More specifically, those children receiving the program: increased
consumption of juice at breakfast, increased consumption of vegetables and
cheese at lunch, increased consumption of fruit at supper, and increased
consumption of fruit at snack.

Nutrition Knowledge Changes
The researchers reported that children in the treatment group exhibited
significantly greater improvements in overall nutrition knowledge than children
in the control group. To determine specific nutrition knowledge changes,
researchers analyzed the sixteen nutrition knowledge questions individually by
comparing each question's preassessment and postassessment answers. They
reported that students in the treatment group had significant positive changes
for all sixteen nutrition knowledge questions, whereas those in the control
group demonstrated a significant increase in correctly answering only one
question.


Discussion and Implications for Extension
The School Health Education Evaluation, a hallmark study that guides practice
in the school health field, found that a minimum of 50 hours were needed to
impact behavior and ten to fifteen hours of education were needed to expect
"large" effects in program-specific knowledge. However, students in this study
only participated in six hours of nutrition education with significant changes in
both behavior and knowledge observed by the researchers. Ideally, more
instruction hours might yield an even greater impact on behavior. But, this
study supports and lends credibility to Florida Extension's stance that it takes
as little as six hours of education on a topic delivered to the same participants
to be deemed a program. After all, the purpose of a program is to effect
positive changes in the lives of its participants, and this study demonstrated
improvements in dietary behavior among young people using a six-hour
intervention.

Submitted by Dr. Lisa A. Guion, Assistant Professor, Program
Planning and Evaluation, laguion@ifas.ufl.edu and Dr. Linda Bobroff,
Professor, Foods and Nutrition, lbbobroff@ifas.ufl.edu


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Addtina g esource


Understanding Your Risk for Listeriosis

This article is prepared based on "Achieving Continuous Improvement in
Reductions in Foodborne Listeriosis- A Risk-Based Approach" a
comprehensive risk based approach for the reduction of foodborne Listeriosis
document by the International Life Science Institute (ILSI) Risk Science
Institute Expert Panel. The comprehensive review contains 310 referred
publications and was published in the Journal of Food Protection, Supplement,
2005, 68(9):1932-1994.

Listeriosis is a foodborne illness caused by a bacterium called Listeria
monocytogenes. According to the CDC FoodNet, the current listeriosis
disease rate in the US is 3.3 cases per 1,000,000 individuals per year, and the
consumption of contaminated foods is the primary means of human infection.
The estimated incidence of listeriosis cases is highly variable from year to year.
Although the number of cases, 1900-2500 cases/year, of this illness is low
compared to other foodborne bacterial illnesses, the fatality rate is very high,
especially for the population's susceptible groups.

For the susceptible individuals, L. monocytogenes is invasive; these individuals
already have one or more underlying conditions that predispose them to the
illness. Listeria monocytogenes can cause a severe disease with symptoms
including septicemia (blood infection), meningitis (inflammation of brain or
spinal cord), and spontaneous abortion. Listeria monocytogenes is widespread
in the environment. It is also presents at low levels in many ready-to-eat food
products. Furthermore, it can grow at refrigerated temperatures.

Who is at risk?
The susceptible populations for this illness include: patients with cancer or
undergoing treatment with steroids or cytotoxic drugs, pregnant women,
newborn infants, transplant recipients, patients with AIDS, diabetics, and the
elderly. Most cases of listeriosis occur among the elderly, pregnant women,
and people who have impaired immunity. Within these groups of the
population, the relative susceptibilities are different. Pregnant Latina women
are at higher risk of listeriosis than pregnant women from other ethnic groups.
This may be due to the possible consumption of contaminated soft cheeses,
such as queso fresco, made from noncommercial facilities. Based on current
knowledge and outbreak data, Tables 1 and 2 provide relative susceptibility
within different subpopulations.

Table 1. Relative susceptibilities for non-pregnant subpopulations


Condition
Transplant
Cancer, blood


Relative susceptibility
2,584
1,364


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AIDS 865
Dialysis 476
Cancer, pulmonary (lung) 229
Cancer, gastrointestinal and liver 211
Noncancer liver disease 143
Cancer, bladder and prostate 112
Cancer, gynecological 66
Diabetes, insulin dependent 30
Diabetes, non-insulin dependent 25
Alcoholism 19
Older than 65 years old 7.5
Younger than 65, no other condition 1
Source: JFP, 2005, 68(9):1932-1994

Note: Based on the incidences of Listeriosis cases in these groups in 1992. This
table is an excerpt from the article with slight modification to simplify the
subj ect:

Table 2. Relative susceptibility for different subpopulations based on the
incidences of Listeriosis cases in these groups.

Condition Relative susceptibility
Perinatal (five months before birth or 14
one month after birth)
Elderly (60 years and older) 2.6
General population (all of those who 1
are not perinatal or elderly and
therefore includes
immunocompromised individuals)
Source: JFP, 2005, 68(9):1932-1994
Note: This table is an excerpt from the article with slight modification to
simplify the subject

What are high risk foods?
Certain foods may have an increased risk of being associated with listeriosis.
Foods that are considered high risk for listeriosis are foods that have the
potential for contamination with L. monocytogenes, foods that can support
growth of L. monocytogenes to a high number, foods that are ready-to-eat
without further cooking, foods that require refrigeration, and foods that are
stored for an extended period of time.


Table 3. Examples of high and low risk foods


S Examples of foods with increased Examples of lower risk foods
risk
Pdte and meat spreads Canned product until opened (e.g.,
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deviled ham) once opened and
refrigerated the risk become high)
Smoked seafood (in the refrigerated Retorted, shelf-stable product, frozen
section) smoked products
Precut melon Whole melon, whole fruits (e.g.,
citrus, apple, pear)
Cooked ready-to-eat shrimp Cook-in-bag imitation shrimp that is
(shellfish) frozen until open
Seafood salad (shrimp, crab, Freshly prepared tuna salad prepared
imitation crab) from canned tuna
Unpasteurized milk and milk Pasteurized milk and milk products
products or fermented milk, yogurt, ice cream
Queso fresco, brie, and Camembert Aged hard cheese, processed cheese
cheese blue-veined cheese
Uncured poultry, ham, bologna Summer sausage, dry fermented
sausage
Franks (not reheated) Franks stored frozen, franks
consumed after through reheating
Refrigerated leftovers Frozen leftovers


Source: This table adapted from the article: JFP, 2005, 68(9):1932-1994)

Key recommendations for consumers and educators for
reducing the incidence of listeriosis:

1) There are two risk factors for listeriosis: (a) being in a high-risk
consumer group and (b) consuming a high-risk food. It is important
for consumers to be aware of these risk factors.

2) Consumers in high-risk groups should consume medically restricted
foods that have been treated to destroy L. monocytogenes

3) High-risk individuals should be provided with guidance on healthy
eating, including specific information on high-risk foods and
strategies for reducing their risk by avoiding high-risk foods,
avoiding cross-contamination, using proper methods of cooking,
cleaning, and methods for storing of perishable foods

4) Certain foods pose a higher risk of contributing to listeriosis and
understanding the common properties of these foods is important.
High-risk foods have all of the following properties: (1) have
potential to be contaminated with L. monocytogenes; (2) support the
growth of L. monocytogenes; (3) are ready-to-eat; (4) require
refrigeration; and (5) are stored for an extended period of time.

5) Resource materials should focus on reducing the risk associated with
the high-risk foods rather than treating all foods as equally risky.
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Addtina g esource


6) Effective educational strategies should focus on high-risk ready-to-eat
foods known to be sources ofL. monocytogenes, cleaning and
sanitizing, storage and shelf life, and practical information to aid the
end user in selection, purchase, and preparation of foods for home use
or to be eaten away from home.

7) Increased educational efforts are needed to ensure that refrigerators
are held at the appropriate temperature and used correctly in the
home. Refrigerated products that support growth of pathogen should
be maintained at 4.40C (40F) or less. Encourage consumers to use
thermometers to verify home refrigerator temperature.

8) Food handlers serving at-risk individuals should have sufficient
knowledge and understanding as well as the appropriate facilities to
ensure the safety of the food they prepare and serve.
Submitted by: Amy Simonne, Ph.D. Assistant Professor, Food Safety and
Quality, asimonne@ifas.ufl.edu


Household Debt and IRAs: Evidence from the
Survey of Consumer Finances

Bernstein, D. (2004). Household debt and IRAs: Evidence from
the survey of consumer finances. Financial Counseling and
Planning, 15(1), 63-72.

Recently I talked with a woman who had been retired for 45 years. Funding so
many years of retirement is a personal as well as a societal problem. Pension
funds have gone broke; companies have declared bankruptcy and employees
have lost a part of their retirement fund. Employers have phased out the
defined benefit plan for new employees and in its place promoted a defined
contribution plan [401(k), 403(b)] where employees assume the risk of
investing their retirement funds. The 401(k) plans have been successful
because most employers have matched a portion of the employee contribution
to the plan and once an employee is enrolled in such a plan they tend to remain
in the plan.

Individual Retirement Accounts (IRAs) were first set up to help the employee
who had no retirement plan. Then it was extended to all employees who met
the criteria.

IRAs were created in 1974.
In 1981 IRAs were available to all workers.
In 1997 ROTH IRAs were created. Purchase price is not tax deferred
but interest accrues tax-free.


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By 2008 contributions to IRAs are scheduled to rise to $5,000 per year and the
catch up provision for workers 50 and over will rise from $500 to $1000 in
2006.

Numerous research studies show that only about half of U.S. households are
adequately preparing for retirement. This study confirms that result. Thaler,
1994, suggests the problem is that families have trouble exercising self-control
over consumption and they lack opportunity to learn from mistakes.

Households who have a substantial propensity to consume as measured in part
by consumer debt and credit card debt are less likely to own an IRA. Also low
income and divorce reduces the likelihood that the household will own an IRA
even though low-income households are eligible for a retirement savings
contribution credit on their income tax returns. Home ownership and median
to high income are positively related to owning an IRA.


Implications for Extension Programming

Given the critical nature of retirement planning, conducting programs that will
help clients determine how much money should be saved for retirement and
where that money should be invested would be a starting place. Examining the
tax benefits of an IRA and the matching benefits of a 401(k) will enhance the
likelihood of families increasing their retirement fund.

There are a number of publications and computer programs that can help.
Homeownership, a pension plan including IRAs and 401(k) s, and Social
Security are important as a base of retirement planning.

References
Bernstein, D. (2004). Household debt and IRA's: Evidence from the
survey of consumer finances. Financial Counseling and Planning, 15(1),
63-72.
Thaler, R. (1994). Psychology and savings policies. American Economic
Review Papers and Proceedings. 84, 186-192.

Submitted by: Jo Turner, Ph.D., CFP, Professor, Family and Consumer
Economics










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Addtina g esource


Parents Roles Are Emphasized For Dealing With
Competitive Foods In Schools

Probart, Claudia, Elaine McDonnell, J. Elaine Weirich, Terryl
Hartman, Lisa Bailey-Davis, and Vaheedha
Prabhakher. "Competitive foods available in Pennsylvania
public high schools.(Current Research)." Journal of the
American Dietetic Association 105.8 (August 2005): 1243(7).

Probart and colleagues collected data from school food service directors from a
random sample of 271 Pennsylvania public high schools. They wanted to
examine the availability of competitive foods, which includes foods offered
outside of the school meals programs.

They determined that this would include those foods available in schools
through a la carte sales, vending machine sales, school stores and club
fundraisers. They cited studies that suggest that the availability of competitive
foods may have negative influence on the quality of the students' diets.

In the discussion Probart and colleagues pointed out that the media and others
have tended to suggest that the school meals have a potential role in the
problem of "the alarming increases in the rates of childhood overweight and
obesity."

On the positive side, one study was cited that "suggested an association
between participation in school meals and lower rates of overweight."

Foods that are offered in the school meals programs must meet federal
standards as regulated by the USDA. In addition, schools are encouraged to
maintain a "healthy school environment" as described in the USDA Healthy
School Nutrition Environments Initiative.

School food service programs must be financially self-supportive and part of
being able to do this means they must provide foods that the students will
accept. At the same time, these meal programs must also meet nutrient
standards and follow the Dietary Guidelines as established at the Federal level.
The Dietary Guidelines focus on health promotion and risk reduction and form
the basis of Federal food, nutrition education, and information programs.
Competitive foods are only minimally regulated. The authors stated that:
"Competitive food sales appear to be providing needed funding for schools and
school foodservice programs, as other funding sources are decreasing."

Parents can become involved by providing a healthy nutrition environment in
the home and helping children learn healthy eating patterns.


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Implications for Extension: County Extension faculty can form
partnerships with local dietetics professionals, county school food service
programs, parent-teacher organizations and other parent groups to help parents
"learn about the food choices their children are making." The authors
presented information that can serve as action items for parents and many
others. These action items also serve as implications for how Extension can
work with the parents.

Parents may need to:
Become involved in their children's schools.
Inquire about foods available in the school environment.
Learn about the food choices their children are making,
Become involved in the decision-making process to determine the
foods that will be offered in their children's schools

The authors further stated in the conclusions that "Parents can ensure their
children will be provided a nourishing meal by supporting the school meals
programs and encouraging their children to purchase the reimbursable school
lunch."

Extension faculty members are also encouraged to peruse in its entirety the
report of this study that was conducted by Probart and colleagues.

References:

Dietary Guidelines Advisory Committee. 2005. Report of the Dietary
Guidelines Advisory Committee on the Dietary Guidelines for
Americans, 2005. U.S. Department of Agriculture, Agricultural
Research Service.

Probart C, McDonnell E, Weirich JE, Hartman T, Bailey-Davis L, Prabhakher
V. Competitive Foods available in Pennsylvania public high
schools. J Am Diet Assoc. 2005; 105:1243-1249.

US Department of Agriculture, Food and Nutrition Service. Changing the
scene: Improving the school nutrition environment-A guide
to local action, 2000. Available at:
http://www.fns.usda.gov/tn/Resources/guide.pdf. Accessed
September 22, 2005.

Submitted by: Glenda Warren, Associate Professor, Extension
Nutritionist Expanded Food and Nutrition Education Program (EFNEP),
glwarren@ifas.ufl.edu


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Disaster Preparedness Programs For the Elderly and
Members of Their Families

Hernandez, L. S., Byard, D., Lin, C., Benson, S. & Barbera, J.
(2002). Frail elderly as disaster victims: Emergency
management strategies. Prehospital and Disaster Medicine, 17(2),
67-74.

The ability of anyone to prepare, respond to and recover from a disaster
depends on a number of issues that are beyond their immediate control.
Although age in and of itself is not related to the ability to respond to a
disaster, the concomitant factors of frailty and disability influence an older
adult's ability to respond to disaster. Furthermore, the severity of the event,
the efficiency of early warning systems and the person's health status impact
the ability to cope with disaster. Older adults who are house bound, isolated
socially or have impaired mobility may have additional difficulty responding
to disaster issues.

The authors recommend a responsibility paradigm for individuals and their
families and service providers of Personal- Agency/Service Provider -
Community that mirrors the emergency management progression of
responsibility for disaster assistance defined as City State Federal.

The personal level represents the elderly individual and their family. At this
level professionals can promote self-reliance, self-preparation, and the
expectation of family (and/or legal guardian) responsibility.


Recommendations help families prepare include:
Information about how to prepare for a disaster (i.e. checklists)
Media based public service information targeting the elderly before,
during and after the disaster
Individual information to assist elderly persons in obtaining resources
throughout the recovery phase
Target information to the elderly person and the family members

For those who can not manage independently, even with the assistance of
family, the next level of assistance is expected to come at the agency or service
provider. Because many services are provided within the home by myriad
home care professionals, the authors suggest that it is the responsibility of
those agencies and service providers to have a plan of warning, protection,
and recovery for their most vulnerable patients/consumers.

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Recommendations at the agency level include:
Incorporate disaster issues and planning into the general operations
Strengthen the ability to continue providing service during and
especially as soon as possible following a disaster
Provide pre-disaster services to clients (i.e. extra meals, medications,
batteries, etc.).
Educate staff regarding professional responsibilities to patients,
customers, etc.
Assist community leaders in identifying vulnerable older adults

The authors suggest that the community bears responsibility for items such as
transportation, healthcare access, aid distribution and warning system.

Additionally, the community must bear responsibility for:
Coordinating service agencies in preparation for disaster response
Clarify the roles and responsibilities of agencies and organizations
within the community
Develop memoranda of understanding which insure that agencies,
service providers and other organizations (both for profit and not for
profit)
Provide transportation for the delivery of services to the elderly at
home as well as transportation for evacuating the elderly
Protect the elderly at distribution stations when obtaining supplies (i.e.
food and water) can become a physical competition
Recognize and address the unique recovery needs of older adults who
routinely do not apply for assistance yet are known to be most
economically impacted by disaster

Implications for County Extension Faculty

This article points out a variety of intervention points for county faculty at
each level of the model.

At the personal level, Extension can be critical in the development and
delivery of educational programs related to disaster preparedness for
individuals and their families. Extension programs are also critical during the
recovery phase, whether the topic is stress, depression, insurance, mold, food
safety, or resource management.

At the agency level Extension has an important place at the table as a provider
of information with a wide-spread and loyal following, particularly among the
elderly.


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At the community level Extension, as employees of the county bear a
responsibility to contribute to the planning, implementation and evaluation of
community/county programs. Extension faculty provide expertise in
collaboration, education and outreach. While service providers reach specific
populations (i.e. those with health and daily living needs), Extension reaches
across the elderly population in providing information and guidance to older
adults from all economic and cultural backgrounds.

Additional Resources:

Wilken, C. After the Hurricanes Have Gone: Stress and Decision Making
When Living Alone. http://edis.ifas.ufl.edu/FY774

Wilken, C. Disaster Planning Tips for Senior Adults.
http://edis.ifas.ufl.edu/FY620

Wilken, C. Preparing for a Disaster: Planning Strategies for Older Adults.
http://edis.ifas.ufl.edu/FY750

Wilken, C. Disaster Planning for Caregivers of the Elderly and People i, iih
Disabilities. http://edis.ifas.ufl.edu/FY751

State of Florida. Disaster Planning and Response for Persons i ith Disabilities.
http://apd.myflorida.com/hurricane/disaster preparation.htm

ReadyAmerica.gov Get a Kit: Items for Special Needs.
http://www.ready.gov/special needs items.html

Federal Emergency Management Agency. Disaster Preparedness for People
i iih Disabilities. (http://www.fema.gov/library/disprepf.shtm

American Red Cross. http://www.redcross.org

Submitted by: Carolyn S. Wilken, Ph.D., M.P.H., Associate Professor,
Family Life, Extension Specialist, Gerontology, cswilken@ifas.ufl.edu














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