The clinical utility of C-peptide measurement in the care of patients with diabetes

This is the final version of the article. Available from the publisher via the DOI in this record.C-peptide is produced in equal amounts to insulin and is the best measure of endogenous insulin secretion in patients with diabetes. Measurement of insulin secretion using C-peptide can be helpful in clinical practice: differences in insulin secretion are fundamental to the different treatment requirements of Type 1 and Type 2 diabetes. This article reviews the use of C-peptide measurement in the clinical management of patients with diabetes, including the interpretation and choice of C-peptide test and its use to assist diabetes classification and choice of treatment. We provide recommendations for where C-peptide should be used, choice of test and interpretation of results. With the rising incidence of Type 2 diabetes in younger patients, the discovery of monogenic diabetes and development of new therapies aimed at preserving insulin secretion, the direct measurement of insulin secretion may be increasingly important. Advances in assays have made C-peptide measurement both more reliable and inexpensive. In addition, recent work has demonstrated that C-peptide is more stable in blood than previously suggested or can be reliably measured on a spot urine sample (urine C-peptide:creatinine ratio), facilitating measurement in routine clinical practice. The key current clinical role of C-peptide is to assist classification and management of insulin-treated patients. Utility is greatest after 3-5 years from diagnosis when persistence of substantial insulin secretion suggests Type 2 or monogenic diabetes. Absent C-peptide at any time confirms absolute insulin requirement and the appropriateness of Type 1 diabetes management strategies regardless of apparent aetiology

Patterns of physical activity among preschoolers in a childcare setting: a pilot study

The rates of children’s physical activity (PA) have declined over the past several decades in the U.S. While the increased number of women entering the workforce has led to more children than ever before attending childcare centers, studies examining PA have largely focused on school-aged children so far. Currently, there is some knowledge in the existing literature on the amount of PA among preschoolers, but the knowledge is so far very limited. The main purpose of this study was to assess the amount and specific patterns of PA of preschool-aged children in a childcare setting. The second purpose of the study was to examine personal, environmental, and policy factors that have been proposed to influence PA in a childcare setting. A list of 98 five-star childcare centers in Guilford County was compiled and three childcare centers were randomly selected for potential participation in the study (1 agreed to participate). The amount and patterns of children’s PA were measured using accelerometers. The multi-level factors related to PA within the childcare setting were assessed using the Environmental Policy Assessment and Observation tool (EPAO), in-depth interviews with the center director and informal interviews with teachers (guided by the Social Cognitive Theory). An Actigraph GT3x accelerometer was placed on each child upon arrival and removed during pickup from the childcare center to measure total PA. Sixty-eight percent of children met the recommendation of at least 60 minutes of moderate-to-vigorous PA a day (MVPA). The childcare center’s PA environment was scored at 18.7/20, indicating a very positive PA environment. Using a manual content analysis, several themes emerged from the interview with the center’s director: 1) awareness of PA importance on learning, growth, and health; 2) importance of buy-in from parents and teachers/staff; 3) the need for PA policy to be in place; 4) knowledge of PA recommendations; 5) lack of gym access perceived as a main barrier. The field interviews with teachers generated the following themes: 1) strong awareness of the importance of PA for children’s learning, growth and overall health; 2) equipment, space and time perceived as the major facilitators of PA; 3) focus on safety perceived as major barrier to teacher participation in PA with children; 4) low PA among teachers due to lack of time in their schedules; and 5) confusion about current PA recommendations for young children. Most children in the sample met the minimum PA recommendations. Our findings highlight the importance of a positive environment, with childcare staff being aware of the importance of PA for children during the day. Further studies should assess both the PA environment and the social climate related to PA across childcare centers in order to make individualized improvements and thus optimize children’s PA across childcare centers

The feminist we never knew we needed: digitally archiving and recovering the works of Fanny Fern

This thesis, divided into two chapters, examines how Fanny Fern’s columns and words have either been lost or taken out of their original context (such as in the use of the phrase: “the way to a man’s heart is through his stomach”) and provides an overview of how this context has been slanted given dominating canons, and further examines the dominant canon in relation to active public memory, feminist rhetoric and scholarship. The first chapter of this dissertation seeks to insinuate a connection between intentional acts of forgetting and remembering to maintain a certain social order. Throughout my dissertation, I assert the idea of active remembering and how the current canon uses this act to uphold male writers over female writers, indicating my engagement with public memory scholarship in rhetoric and writing studies. The thesis then explores the intentional squandering of female writers in comparison to their male counterparts through the act of remembering, which can alternatively be recoded to benefit feminist rhetoric, such as in the incorporation of Fanny Fern (and other female writers) into the modern, while also combatting the current male-dominated canon. My research then shifts into its final section, in which I make a rationale for creating a digital archive to promote active remembrance of Fanny Fern as an important 19th century rhetorician, activist, satirist, and public commentator. In the second chapter, I recount the creation of Fanny Fern’s digital archive, starting with twenty columns selected from her works that insinuate, in my opinion, a connective theme to modern day society thus giving them relevancy in current public memory. I argue against the scholarship that an archive is passive since I see it as a useful building block for my overall goal of reinserting Fern into the public sphere of memory. It is not my intention to simply “place” this archive on the internet, where it simply serves as an additive; instead, I hope to make Fern’s writing engaging and interesting among a new generation; a generation that arguably needs her championing of females now more than ever. This chapter covers the process of the initial creation of a digital archive, and then analyzes rhetorical devices utilized throughout the site’s implementation. I also reflect on the creation of other modes of memory and assertion, such as a Twitter bot among other social media platforms to promote Fern and her publicly accessible archive. This also means the inclusion of both an academic and a public audience. It is my goal to give Fanny Fern’s writing a medium in which she can reach new audiences, ones that she would have never dreamed of reaching. Fanny Fern’s writing belongs in the present, and much like the digital medium on which she will be hosted, it is my intent to provide Fern’s writing with a new audience that will evolve and utilize her words to their maximum potential

Using realistic fiction to enhance social decision making in middle grades students

The purpose of this study was to describe how a literature-based curriculum influenced middle grades students' perceptions of the social decisions that they may make. This eight-week study initially explored the decision-making agendas that were employed by 28 seventh-grade reading students. The study's curriculum then introduced 31 novels which featured literary peers who were immersed in social decision-making situations that were analogous to the students1 concerns. Each student read six novels of choice, examined the decisions that the characters made, and then compared the characters’ decisions to their own. A systematic model for decision making served as structure for the analysis. The study concluded with the students again discussing their personal agendas, particularly in regard to the influence of realistic fiction. Data was gathered through a host of written classroom assignments and analyzed qualitatively. An overview of the entire class was reported, with four case studies detailing the evolution of the students' decision-making agendas

The relationship between teaching experience and effective administrative behavior

The purpose of this study was to examine the possible relationship between two variables, years of teaching experience and administrative behavior. The common practice of boards of education requiring teaching experience as one of the criteria necessary for employment as principal provided the impetus needed to examine quantitatively this possible correlation. The implications of such a requirement prompted the development of a second phase of the study which qualitatively examined the world of the principalship as perceived by' practicing administrators. As a result of this two-phase study, it was determined that, mainly due to the bureaucratic structure of our public school system, very little leadership behavior is exhibited by the school principal. On the other hand, due to the school structure, the main type of behavior exhibited by principals is administrative. The participating principals indicated that administrative behavior is advocated and promoted by the central administration and local boards of education. Furthermore, it was determined that instructional leadership is considered by the central administration a secondary role of the principal

A comparative study of specific nuclear binding of estrogen in some target and nontarget organs of rats

When this research project was initiated, my advisor, Dr. David Maxwell, said to me, “Freda, good research answers one question and asks ten more.” Thus, we prepared to test our hypothesis regarding specific nuclear binding of estrogen in four organs of the laboratory rat. Based on information obtained from studies involving estrogen binding in the uterus, spleen, liver and large intestine, we hypothesized that the uterus, a well known target organ for estrogen, would have a high degree of specific nuclear binding. The large intestine, for which no evidence was found that implicated it as a target organ, would characteristically have a small amount of specific nuclear estrogen binding. The liver and spleen are two possible target organs. More substantial research has been found that implicates the liver as a target organ than has been found implicating the spleen, so we expected to find a degree of specific binding in the liver somewhat less than the uterus, but significantly greater than the large intestine. The spleen, while it is a controversial organ does not seem to be as good a candidate for a target organ as the liver--at least not at the present--so we expected specific nuclear binding to be less than the liver but still significantly greater than the large intestine. This states the hypothesis of this paper and what we expect to see in the results. The remainder of the paper concerns itself with giving background information about estrogen and estrogen binding, with a statement of the procedure used to test the hypothesis and the results of that test

Searching for design energy: re-visiting my generative process using selection, evaluation, and morphing to generate new ideas

My interests lie primarily with the energy behind the design of products. In pursuing the question of that energy and its potential, it has become clear to me that prior to any claims regarding transferability it is vital to first document and analyze the components that comprise the whole of design energy. Design Energy, in this case, is the creativity and intellect behind the process of design, from idea generation to production. I have focused on the creation of a method for documenting the design process that incorporates scans and images and other process data by utilizing AutoCAD, 3DMax, Photoshop, Morpheus, and various animation creating software. Through this method I re-visited my generative process in three phases; one by searching and selecting snapshots of my creative work, two by manipulating these found images using morphing software, and three by comparing and mimicking aspects of other design processes as explained by Nigel Cross. By looking back at my process I was able to reevaluate my steps through comparing them to other processes and through my analysis method of using morphing software which led to new idea generation

Report on a follow-up study of business education graduates of the Woman's College, University of North Carolina, for the years, 1933-1941

The Woman's College of the University of North Carolina, in 1942-1943, launched a follow-up study of graduates and dropouts of the College for the period from 1933 through 1941. Differentiated questionnaires for the two groups were prepared in printed form and mailed with appropriate letters from administrative officials. The questionnaire sent to graduates with a letter signed by the head of the department represented by the individual's degree and approved by the Dean of Administration covered four phases of information: I, Personal Information; II, Educational Information; III, Occupational Information; and IV, Community Activities. In addition, a notation on the questionnaire invited comments from the graduates. Copies of letter and questionnaire are reproduced on the following pages. A total of 3,045 questionnaires, representing the five degrees granted by the College, were sent out, and responses were received from 1,354 graduates (44.5 per cent). The five degrees given by the College ares Bachelor of Science in Home Economics, Bachelor of Science in Physical Education, Bachelor of Science in Secretarial Administration, Bachelor of Science in Music, and Bachelor of Arts

A cure for shapes

Of the twenty-five poems collected in this thesis all but two have been written during the last fifteen months. Most of these poems have been written in the free verse tradition, which is to say that symmetry depends more upon rhetorical sequence than rhyme. Other than that, the aesthetic of any singular poem I hold to be self-evident