Partnering for Engineering Teacher Education

The aim of this article is to describe a specific approach to preparing elementary teacher candidates to teach engineering through a field-based undergraduate course that incorporates various engineering experiences. First, candidates visit a children’s museum to engage in engineering challenges and reflect on their experiences as learners as well as teachers. The majority of course sessions occur on-site in a neighborhood elementary school with a dedicated engineering lab space and teacher, where candidates help facilitate small group work to develop their own understandings about engineering and instructional practices specific to science and engineering. Candidates also have the option to attend the elementary school’s Family STEM Night which serves as another example of how informal engineering experiences can complement formal school-day experiences as well as how teachers and schools work with families to support children’s learning. Overall, candidates have shown increased confidence in engineering education as demonstrated by quantitative data collected through a survey instrument measuring teacher beliefs regarding teaching engineering self-efficacy. The survey data was complemented by qualitative data collected through candidates’ written reflections and interviews. This approach to introducing elementary teacher candidates to engineering highlights the value of a) capitalizing on partnerships, b) immersing candidates as learners in various educational settings with expert educators, c) providing opportunities to observe, enact, and analyze the enactment of high-leverage instructional practices, and d) incorporating opportunities for independent and collaborative reflection

Empagliflozin in Patients with Chronic Kidney Disease

Background The effects of empagliflozin in patients with chronic kidney disease who are at risk for disease progression are not well understood. The EMPA-KIDNEY trial was designed to assess the effects of treatment with empagliflozin in a broad range of such patients. Methods We enrolled patients with chronic kidney disease who had an estimated glomerular filtration rate (eGFR) of at least 20 but less than 45 ml per minute per 1.73 m(2) of body-surface area, or who had an eGFR of at least 45 but less than 90 ml per minute per 1.73 m(2) with a urinary albumin-to-creatinine ratio (with albumin measured in milligrams and creatinine measured in grams) of at least 200. Patients were randomly assigned to receive empagliflozin (10 mg once daily) or matching placebo. The primary outcome was a composite of progression of kidney disease (defined as end-stage kidney disease, a sustained decrease in eGFR to < 10 ml per minute per 1.73 m(2), a sustained decrease in eGFR of & GE;40% from baseline, or death from renal causes) or death from cardiovascular causes. Results A total of 6609 patients underwent randomization. During a median of 2.0 years of follow-up, progression of kidney disease or death from cardiovascular causes occurred in 432 of 3304 patients (13.1%) in the empagliflozin group and in 558 of 3305 patients (16.9%) in the placebo group (hazard ratio, 0.72; 95% confidence interval [CI], 0.64 to 0.82; P < 0.001). Results were consistent among patients with or without diabetes and across subgroups defined according to eGFR ranges. The rate of hospitalization from any cause was lower in the empagliflozin group than in the placebo group (hazard ratio, 0.86; 95% CI, 0.78 to 0.95; P=0.003), but there were no significant between-group differences with respect to the composite outcome of hospitalization for heart failure or death from cardiovascular causes (which occurred in 4.0% in the empagliflozin group and 4.6% in the placebo group) or death from any cause (in 4.5% and 5.1%, respectively). The rates of serious adverse events were similar in the two groups. Conclusions Among a wide range of patients with chronic kidney disease who were at risk for disease progression, empagliflozin therapy led to a lower risk of progression of kidney disease or death from cardiovascular causes than placebo