Menopause and diabetes : EMAS clinical guide

Introduction: Whether menopause increases the risk of type 2 diabetes mellitus (T2DM) independently of ageing has been a matter of debate. Controversy also exists about the benefits and risks of menopausal hormone therapy (MHT) in women with T2DM. Aims: To summarise the evidence on 1) the effect of menopause on metabolic parameters and the risk of T2DM, 2) the effect of T2DM on age at menopause, 3) the effect of MHT on the risk of T2DM, and 4) the management of postmenopausal women with T2DM. Materials and methods: Literature review and consensus of experts' opinions. Results and conclusion: Metabolic changes during the menopausal transition include an increase in and the central redistribution of adipose tissue, as well as a decrease in energy expenditure. In addition, there is impairment of insulin secretion and insulin sensitivity and an increase in the risk of T2DM. MHT has a favourable effect on glucose metabolism, both in women with and in women without T2DM, while it may delay the onset of T2DM. MHT in women with T2DM should be administered according to their risk of cardiovascular disease (CVD). In women with T2DM and low CVD risk, oral oestrogens may be preferred, while transdermal 17 beta-oestradiol is preferred for women with T2DM and coexistent CVD risk factors, such as obesity. In any case, a progestogen with neutral effects on glucose metabolism should be used, such as progesterone, dydrogesterone or transdermal norethisterone. Postmenopausal women with T2DM should be managed primarily with lifestyle intervention, including diet and exercise. Most of them will eventually require pharmacological therapy. The selection of antidiabetic medications should be based on the patient's specific characteristics and comorbidities, as well on the metabolic, cardiovascular and bone effects of the medications.Peer reviewe

Utility and Validity of Authentic Assessments and Conventional Tests for International Early Childhood Intervention Purposes: Evidence from U.S. National Social Validity Research

The reported U.S. incidence of delay/disability in young children, and thus need for services, is far higher than those currently receiving early intervention supports and services [1]. Government representatives and policymakers in the U.S. have concluded that traditional tests fail to capture sufficient numbers of young children who must access early intervention supports at a critical life moment [2], even though state regulations often mandate their use. The early intervention field regards authentic assessments as a more effective alternative. However, few U.S. studies have been conducted to compare and validate the use of either conventional tests or authentic assessments for early intervention purposes. National social validity research in the United States by Bagnato et al. [3,4] revealed that authentic assessments fulfill the qualities/needs of the early childhood intervention field better than conventional tests. However, no national studies had been conducted to examine the qualities and patterns of use for authentic and conventional measures among interdisciplinary professionals. Based on an expanded national internet survey in the current follow-up research, we compared the qualities/patterns of use among professionals for both types of measures in the early childhood intervention field. Overall, median ratings indicate that the top authentic assessments are more valid/useful than the most popular conventional tests to accomplish most early intervention purposes. Based on the results, we share the implications as "practice-based research evidence" to guide international policymakers, professionals, and parents to advocate, choose, and use "best measures for best practices.

Direct end-user interaction with and through IoT devices

Research addressing the Internet of Things (IoT) has been predominantly concerned with the interconnection of physical devices. However, increasingly complex application scenarios require us to further investigate the interface between IoT devices and users. In this book chapter, we explore the possibilities of direct end-user interaction with and through IoT devices. We do this by examining the increasing automation of environmental factors, such as temperature and lighting, in open-office environments. Increasing automation offers many benefits around responsiveness of buildings to environmental conditions and improved energy efficiency, but can result in a reduction in office inhabitants’ options for manual control of their environment. To inquire into this issue, we designed and evaluated an IoT device called the MiniOrb. The device employs tangible and ambient interaction and feedback mechanisms to support office environment inhabitants in maintaining awareness about environmental conditions. It reports on their subjective perceptions and opinions around comfort levels in the office and receives feedback on how their individual preferences compare with their colleagues’. A mobile-device-based version of the application was also created. Employing screen and touch interactions, this version of the interface enables users to access the same information as the tangible device, but with different degrees of input precision and ambient interaction. We describe the design of the system along with the results of a trial of the device with real users, including a post-trial interview. The results shed light on how IoT devices can support direct end-user interaction by combining ambient and tangible interaction approaches. Such devices can mediate the interpretation of sensed data by end-users, as well as help collect crowd-sourced data that directly relate to sensed data