Characterization of Pregnancy Induced Changes in Glucose Metabolism

Many reports indicate that pregnancy is a diabetogenic state in which there is both insulin resistance and an exaggerated maternal glucose and insulin response to food ingestion. However, the magnitude of these aberrations and their temporal relationship have not been adequately characterized. This study utilizes the hyperglycemic clamp technique to investigate the insulin secretory response and tissue sensitivity to insulin under hyperglycemic conditions in normal and gestational diabetic pregnancies. Our results indicate that third trimester normal pregnancy is characterized by an increased first phase (108.81+/-13.03 uU/ml) and second phase (228.57+/-43.40 microunits/ml) insulin secretory response as compared to non-pregnant controls (72.93+/-15.76, 103.02+8/-12.43 ) (p\u3c0.05). However, C-peptide values did not mirror those of insulin in that normal pregnant women during the third trimester of pregnancy demonstrated a significantly lower C-peptide to insulin ratio than either non-pregnant controls or gestational diabetic women in their third trimester (p\u3c0.05). In contrast to normal pregnant women, gestational diabetic women in their third trimester of pregnancy showed no increase in insulin secretion. Glucose uptake under hyperglycemic conditions tended to decrease progressively through pregnancy and was significantly lower than non-pregnant controls (10. 60+/-1. 19 mg/kg/min) in the third trimester of normal pregnancy (7.20+/-0.79 mg/kg/min) and gestational diabetic pregnancy (5.87+/-0.27 mg/kg/min) (p\u3c0.05). Furthermore, there was a significantly lower tissue sensitivity to insulin (defined by the ratio of the glucose uptake to the circulating insulin level during the final sixty minutes of the study) in normal third trimester pregnancies (0.03+/-0.01 mg/kg/min per uU/ml) and gestational diabetic pregnancies (0. 04+/-0. 01 mg/kg/min per uU/ml) as compared to non-pregnant controls (0.11+/-0.02 mg/kg/min per uU/ml) (p\u3c0.05). Neither glucagon nor growth hormone were found to be significantly different between the normal pregnant or gestational diabetic groups. These studies suggest that normal pregnancy is indeed characterized by a tissue insensitivity to insulin and that glucose tolerance (defined in this study as the rate of glucose uptake) in normal pregnancy is primarily related to the degree of compensatory hyperinsulinism. However, this increased compensatory insulin secretion appears to be absent in gestational diabetic women, thereby contributing to the deterioration of glucose tolerance observed in these women

Dignity at Work for Low Wage, Low Skill Service Workers

Using responses from a telephone survey of 589 low wage, low skill workers in US hospitals, the authors investigate the workplace features that influence workers’ perceptions of dignity at work. Both work organization variables and union representation are investigated as potential factors affecting workers’ perceptions of fair treatment by their employer, intrinsically satisfying work, and economic security. Work organization and union representation have little effect on dignity at work with the exception of their association with higher wages and therefore a greater degree of economic security. Results indicate that higher pay, adequate levels of staffing and resources, and access to training are the variables that are most closely associated with dignity on the job.On a récemment accordé beaucoup d’attention à l’inégalité croissante des gains et aux conditions économiques qui se détériorent chez les travailleurs à faibles revenus (Levy et Murnane, 1992; Johnson et Kuhn, 2004). En plus de faibles revenus, ces travailleurs doivent aussi affronter de mauvaises conditions de travail : insécurité d’emploi, traitement arbitraire et absence de représentation. De plus en plus, en relations industrielles, on cherche comment améliorer la vie au travail de ces travailleurs. La dignité au travail est devenue un sujet de ralliement, non seulement pour les syndicats, comme ce fut traditionnellement le cas, mais aussi pour les décideurs politiques et les intellectuels.Dans cet article, nous avons voulu évaluer les effets de certaines caractéristiques des lieux de travail sur les perceptions que les travailleurs se font de la dignité au travail, en recourant à une enquête auprès des personnes occupant des postes peu qualifiés et peu rémunérés dans le secteur des services. De plus, nous nous sommes demandés si la représentation syndicale ou des changements dans l’organisation du travail associés à des pratiques de haut rendement au travail affectent ou non la perception de ces travailleurs de la dignité en emploi.Les données proviennent d’une enquête effectuée dans quinze hôpitaux communautaires américains. Ce type d’hôpitaux constitue la majeure partie des hôpitaux aux États-Unis, et nous avons retenu le groupe le plus représentatif, c’est-à-dire ceux qui comptent entre 200 et 400 lits. Les hôpitaux sont répartis dans presque toutes les régions du pays. L’étude a débuté à l’été de l’année 2000 et elle s’est terminée au printemps de 2002.Notre analyse s’appuie sur une enquête téléphonique auprès de 589 travailleurs, dans les quinze hôpitaux retenus, et comprend des questions sur tous les aspects du travail accompli et de la carrière. Nous avons aussi visité chaque hôpital où nous avons interviewés des gestionnaires, des surveillants et des représentants syndicaux. En recourant à l’analyse multivariée, nous avons ensuite analysé l’effet de la syndicalisation et des pratiques de travail sur la perception de la dignité au travail dans les établissements. Pour estimer la perception de la dignité au travail par les travailleurs, nous avons retenu trois variables dépendantes clés : la sécurité d’emploi, la satisfaction intrinsèque au travail et le traitement équitable de la part de l’employeur. Nos variables indépendantes incluent une mesure de l’enrichissement du travail, la participation à des comités de résolution de problèmes, la formation sur le tas ou d’ordre institutionnel, le champ d’action du syndicat, la perception de la suffisance du personnel et des ressources matérielles, la charge de travail ainsi que diverses variables de contrôle.Nous avons posé l’hypothèse que le fait de bonifier le travail, soit par un élargissement des tâches, soit par un accroissement du niveau d’habiletés requises, par l’offre de participation à la solution des problèmes au travail, par l’offre d’occasions de formation et le fait de disposer d’une représentation syndicale sur le lieu de travail devraient être liés de façon positive à des niveaux plus élevés de perception de la dignité au travail. Nos données nous indiquent qu’à l’exception des effets positifs de la formation, ni la restructuration du travail, ni la représentation syndicale ne présentaient des effets dans le sens anticipé. Dans le cas de ces travailleurs du secteur des services, les emplois sont si faiblement rémunérés, si exigeants physiquement et si peu gratifiants que le fait de les redessiner n’améliore pas la situation. Ce qui semble améliorer la perception de la dignité au travail est plutôt lié à l’accès à la formation, au fait de pouvoir compter sur du personnel en nombre suffisant et sur du matériel adéquat et en quantité suffisante et aussi de ne pas se faire demander d’accomplir plus que ce qu’on peut faire.Cependant, des modifications dans l’organisation du travail et la représentation syndicale ont été associées avec un niveau plus élevé de rémunération, une mesure de dignité particulièrement importante chez cette catégorie de travailleurs. Bien que la restructuration du travail, la formation et la représentation syndicale sont sources de hausses salariales, elles ne contribuent pas à l’ajout d’une valeur intrinsèque au travail, pas plus qu’à l’impression d’un traitement équitable de la part des employeurs. Ces deux effets sont plutôt liés à des enjeux inhérents au procès de travail, tels que la charge de travail, la présence d’un personnel suffisant et de ressources matérielles adéquates. Seule la formation demeure liée aux trois aspects de la dignité au travail.Ainsi, les changements dans la nature du travail, comme les travaux sur la promotion de la dignité au travail en relations industrielles le laissaient entendre, présentent peu ou pas de relation avec cette dernière variable chez cette catégorie de travailleurs à faibles revenus et peu qualifiés. L’enrichissement du travail, de même que la participation à des comité de résolution de problèmes ou la représentation syndicale n’améliorent pas la perception de dignité au travail chez ces travailleurs. Cependant, des salaires plus élevés, du personnel en nombre suffisant et la formation contribuent à une meilleure perception de la dignité au travail. Par conséquent, les politiques axées sur la formation et les qualifications des travailleurs peu rémunérés sont plus susceptibles d’avoir un impact important sur leur emploi et leurs perspectives d’avenir. De plus, les syndicats pourraient davantage aider leurs membres en négociant non seulement des salaires plus élevés, mais aussi du personnel en nombre suffisant et des ressources adéquates pour que les travailleurs et les travailleuses puissent bien accomplir leurs tâches.A partir de una encuesta telefónica con 589 trabajadores hospitalarios de Estados Unidos caracterizados por sus bajos salarios y nivel bajo de calificación, los autores investigan las características del medio laboral que influyen las percepciones de dignidad en el trabajo. Tanto las variables relativas a la organización del trabajo como aquellas de la representación sindical son investigadas como factores potenciales que afectan las percepciones de los trabajadores a propósito de lo que es un tratamiento justo de la parte de su empleador, la satisfacción intrínseca en el trabajo y la seguridad económica. La organización del trabajo y la representación sindical tienen poco efecto sobre la dignidad en el trabajo excepto cuando está asociada con los salarios elevados y por tanto, con un nivel mas elevado de seguridad económica. Los resultados indican que las remuneraciones mas elevadas, los niveles adecuados de personal y de recursos así como el acceso a la formación, son las variables que están mas fuertemente asociadas con la dignidad en el trabajo

Renal functional adaptation of the adult kidney following transplantation to the child

Renal functional adaptation of the adult kidney following transplantation to the child. Nineteen child renal transplant recipients, aged 1.3 to 19.2 years at transplantation, and their adult living-related kidney donors, 27 to 60 years of age at nephrectomy, were investigated simultaneously with regard to renal function. At a median time of three months after transplantation clearances of inulin (GFR) and para-aminohippuric acid (ERPF) were measured, and serum urea and creatinine concentrations were determined. The absolute values for GFR (72 ± 13 ml/min) and ERPF (369 ± 76 ml/min) in the donors were significantly higher than those of the recipients (37 ± 22 and 196 ± 72 ml/min, respectively). The absolute values of GFR and ERPF were significantly correlated with the body surface areas of the recipients. Thus, in relation to body surface area, the GFR, 68 ± 11 ml/min/1.73m2, and ERPF, 348 ± 65 ml/min/1.73m2, of the donors did not differ from those of the recipients, 68 ± 20 and 375 ± 90 ml/min/1.73m2, respectively. Because of the greater body mass, the serum creatinine concentrations of the donors were significantly higher than those of the recipients, whereas the serum urea concentrations were significantly higher in the recipients. The results suggest that transplantation of an adult kidney to a child results in a functional adaptation to the smaller body size of the recipient, and that this adaptation occurs within three months after transplantation

Teaching Punctuation: Seventh Graders, Mentor Texts, and Commas

In the middle grades, learning about writing mechanics often occurs through inauthentic language drills, which do not expose students to the practical and contextual implementation of punctuation and syntax. This study, conducted with seventeen seventh-grade students, explored how students can gain knowledge of basic conventions by reviewing the writing of a published author to observe the correct placement of punctuation. In this study, students, provided with excerpts from Tomie dePaola’s rendition of The Legend of the Indian Paintbrush, were guided to discover how the author used commas to communicate with his readers. Subsequent to the lesson and to assess how much information they had retained, students were asked to describe the different uses of the comma. Results showed that while students needed additional practice to apply their understandings, most were able to recall the five major comma rules. The findings of this study serve as a foundation for further exploration of how mentor texts can be used with other aspects of English language conventions

Advanced Physical Diagnosis: An Innovative Interprofessional Approach for Teaching Clinical Skills to Senior Medical Students

Conclusions: This interprofessional education session, employing a case-based videotape, was successful in illustrating to senior medical students the roles of OT and PT in patient management, and in increasing their awareness of the types of patient problems that would warrant referral for OT and PT services. The team is developing learning activities for future modules for medical students to teach the role of occupational and physical therapies in interprofessional health care

Political Opinion Formation as Epistemic Practice: The Hashtag Assemblage of #metwo

The article contributes to the literature on the political use of hashtags. We argue that hashtag assemblages could be understood in the tradition of representing public opinion through datafication in the context of democratic politics. While traditional data-based epistemic practices like polls lead to the ‘passivation’ of citizens, in the digital constellation this tendency is currently challenged. In media like Twitter, hashtags serve as a technical operator to order the discursive fabrication of diverse publicly articulated opinions that manifest in the assemblage of tweets, algorithms and criticisms. We conceptualize such a critical public as an epistemic sensorium for dislocations based on the expression of experienced social imbalances and its political amplification. On the level of opinion formation, this constitutes a process of democratization, allowing for the expression of diverse opinions and issues even under singular hashtags. Despite this diversity, we see a strong tendency of publicly relevant actors such as news outlets to represent digital forms of opinion expression as unified movements. We argue that this tendency can partly be explained by the affordances of networked media, relating the process of objectification to the network position of the observer. We make this argument empirically plausible by applying methods of network analysis and topic modelling to a dataset of 196,987 tweets sampled via the hashtag #metwo that emerged in the German Twittersphere in the summer of 2018 and united a discourse concerned with racism and identity. In light of this data, we not only demonstrate the hashtag assemblage’s heterogeneity and potential for subaltern agency; we also make visible how hashtag assemblages as epistemic practices are inherently dynamic, distinguishing it from opinion polling through the limited observational capacities and active participation of the actors representing its claims within the hybrid media system

The Importance of Authentic Workplace-Based Assessment: A Study From VET Teacher Education

Context: This article is based on a pragmatic theoretical perspective on education, in which theoretical and practical competences are developed through experiences and participation in real-world teaching contexts. Previous research points to a lack of culture for authentic workplace-based assessment in vocational and professional education in many countries. Prior to this study, professors/authors and student-teachers in a vocational teacher education program in Norway experienced that student-teachers were unable to demonstrate comprehensive teaching competence, as examinations and assessments assess theoretical knowledge separately from practice. Research questions: 1) How can an authentic workplace-based exam during placement give student-teachers an opportunity to showcase their comprehensive teacher competence? 2) What factors are important to emphasize in such an exam? 3) How do the student-teachers demonstrate and develop comprehensive teacher competence through an authentic exam?Methods: Using action research, professors/authors carried out sequential actions to develop a practical-theoretical exam in an authentic professional setting. This included demonstrating elements of practical and theoretical competence conducted during teaching practice. The exam involved planning in line with a guidance document and practical teaching in the classroom in VET-schools, followed by a piece of reflective writing based on teaching experiences. Supervisors and professors/authors observed the student-teachers teaching as part of multiple qualitative methods.Findings: The empirical results show how student-teachers demonstrate and develop comprehensive teaching competence. Both the student-teacher and the supervisors in VET-schools experienced the authentic exam as realistic and professionally based. The biggest challenge involved logistics: Compensating the professors’/authors’ time and financial frameworks related to the observation of the student-teachers. However, this kind of authentic assessment leads to stronger coherence between both theory and practice, and between the vocational teacher education at the university and the VET in upper secondary school. It also supports the job-relevant learning process towards comprehensive teacher competence.Conclusions: This kind of authentic assessment i.e. an authentic exam requires an understanding of the complex role of teachers within their professional context in VET. Therefore, the professors/authors see the need of a broader, more comprehensive teacher competence in VET to meet the work life needs for competence.