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 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

The effects of duet reading on the reading fluency and comprehension of high school students with learning disabilities

The purpose of this study was to examine the effectiveness of Duet Reading, a peer-mediated repeated reading strategy, for increasing the reading fluency of four diverse ninth and tenth grade students with learning disabilities in a large public high school. The effects of Duet Reading on comprehension were explored as well. A multiple probe single-subject design across two groups of students was used to evaluate the effectiveness of the intervention. The students were placed in dyads based on similar fluency training levels and the intervention was administered in a staggered fashion according to the dictates of the multiple probe design. Dependent measures included the number of words correct per minute and errors per minute along with pre-post data on the Test of Oral Reading Fluency (TORF) and the comprehension subtest of the Woodcock Reading Mastery Test. Social validity data were also collected. Results of the study revealed that no functional relationship existed between the Duet Reading intervention and the students' oral reading fluency. However, two of the students' oral reading fluency rates increased, with modest gains in comprehension. Despite limited results, overall, the students felt that the intervention was beneficial and helped them become better readers. Results are discussed in terms of previous research, limitations, as well as implications for current practice

Coaching while coaching: the functional relationship of elbow coaching on cooperating teacher’s ecoaching, pre-service teacher’s reading instruction, and student outcomes

Pre-service teachers (PST) clinical experiences are critical for transfering theory to practice (e.g., Brownell, Ross, Colon, and McCallum, 2005) and these experiences require effective mentoring, coaching, and supervision from university supervisors and cooperating teachers (e.g., Leko, Brownell, Sindelar, & Murphy, 2012). Yet, many special education teachers enter the field feeling under-prepared to teach effectively, especially in reading (e.g., Brownell et al., 2009). One solution is to maximize support provided by cooperating teachers (CTs). CTs receive little or no training on how to provide mentoring, coaching, and supervision to PSTs (Gareis & Grant, 2014). Therefore, the purpose of this study was to examine the effects of elbow coaching on the CT’s ability to provide online, in-ear eCoaching to the PST during literacy based clinical experiences. Specifically, I investigated how elbow coaching influenced the CT’s provision of online, in-ear eCoaching to the PST; how coaching the PSTs (i.e., in-ear eCoaching plus side-by-side coaching) influenced the PSTs delivery of effective reading instruction; and how coaching the PST positively influenced student outcomes (i.e., student engagement, opportunities to respond, correct responses). Participants for this single case research design included three CT/PST dyads, and their K-1 students with and without disabilities. Social validity and procedural fidelity were measured and IOA was conducted in accord with prevailing standards. Quality standards for SCRD were met without reservation (Kratochwill et al., 2013). Data was analyzed visually based on mean, level, trend, and latency of change (Kratochwill et al., 2010), and effect size was based on Tau-U (Vannest, Parker, & Gonen, 2011). Results indicated that the elbow coaching was effective in modifying CTs’ eCoaching behaviors, PSTs’ provision of effective reading instruction, and student opportunities to respond, correct responses, and behavioral engagement. Results also confirmed the efficacy of an online module plus coaching as an effective way to support CTs as they provide instructional support to PSTs, serving students with and without disabilities. Limitations, implications, and future directions are discussed

Body, pleasure, language and world : a framework for the critical analysis of dance education

This dissertation is a philosophical analysis of the language of dance education. In particular the writer analyses the relation between language and body understanding. The Introduction presents an initial metaphor of consciousness as "world". The dance classroom is characterized as a space for the negotiation of the worlds of the students and teachers. The negotiation is political with unequal distribution of influence over the formation of the classroom world, such negotiation ordinarily favoring the teacher's world. Berger and Luckmann and Rorty are major sources for the analysis. Chapter One relates language to the formation of consciousness. Language functions to prevent us from knowing the world and enables us to come to know the world. Language is characterized as metaphorical, as a set of conflicting languages vying for social ascension and as incorporating a set of dialectical relationships. The individual consciousness is understood to be, at base, socially constructed. Nietzsche, Gadamer, Bakhtin and Jacoby are cited