Brief lifestyle interventions for prediabetes in primary care: a service evaluation

BackgroundThe increasing number of cases of prediabetes in the UK is concerning, particularly in Wales where there is no standard programme of support. The aim of the current service evaluation was to examine the effectiveness of brief lifestyle interventions on glucose tolerance in people at risk of developing type 2 diabetes.MethodsIn this pragmatic service evaluation clinical data on people deemed at risk of developing type 2 diabetes were evaluated from two GP clusters. Patients (n = 1207) received a single 15 to 30-min, face-to-face, consultation with a health care practitioner. Interventions were assessed by changes in HbA1c and distribution across the HbA1c ranges 12 months following intervention. Statistical significance of reversion to normoglycaemia and development of diabetes were assessed through comparison with expected rates without intervention.ResultsBetween baseline and 12-month follow-up HbA1c fell from 43.85 ± 1.57 mmol/mol (6.16 ± 0.14%) to 41.63 ± 3.84 mmol/mol (5.96 ± 0.35%), a decrease of 2.22 mmol/mol (0.20%) (95% CI 2.01 (0.18%), 2.42 (0.22%); p < 0.0001). The proportion of people with normal glucose tolerance at 12 months (0.50 95%CI 0.47, 0.52) was significantly larger than the lower (0.06 (p < 0.0001) and the upper (0.19 (p < 0.0001)) estimates based on no intervention.ConclusionResults indicate significant improvement in glucose tolerance across GP clusters. The brief intervention has the potential to offer a robust and effective option to support people at risk of developing type 2 diabetes. Further research in the form of a randomised trial is needed to confirm this and identify those likely to benefit most from this intervention

The effect of age, sex, IQ, and functional grade level upon the performance of subjects on a measure of abstract learning ability

The purpose of this study was to determine the effect of age, sex, IQ, and functional grade level on the classification ability of adult and non-adult subjects. The theory presented suggested that age IQ, and. functional grade level would affect classification ability whereas sex would have no effect. -- The sample for testing these hypothesized relationships consisted of six groups (195 subjects); three groups of adults and three groups of non-adults categorized on the basis of their functional grade level. The non-adult subjects were selected from those subjects in attendance in educational institutions at the public school level, whereas adult subjects were chosen from adult education centers and a post-secondary institution. The age range for adult subjects was 16.5-51.1 years, with an age range of 9.4-17.6 years for non-adult subjects. -- The Test of Natural Phenomena, an instrument designed to measure classification ability was administered individually to all subjects included in the study. At that time information was also obtained on the independent variables, age, sex, IQ, and functional grade level. -- Regression analysis was conducted on the four predictor variables (age, sex, IQ, and functional grade level) to establish their effect on the classification ability of adult and non-adult subjects. It was found that the four predictor variables accounted for 55% of the variance in the classification ability of adults and 33.7% for non- adults. In the case of adult subjects functional grade level, and IQ were significant whereas age and sex were insignificant. For non-adult subjects functional grade level, IQ, and age were significant but sex was insignificant. These findings supported the original hypotheses with the only exception being the finding that the predictor variable age was insignificant in the case of adult subjects

The Ursinus Weekly, November 25, 1963

John F. Kennedy buried at Arlington today: Assassination saddens world • Students react to news of murder • Assassination historically • President\u27s life in review • A statement about John Kennedy • Oswald murdered Sunday • Chapel service held in memory of Kennedy • Editorial: Riderless horse; Reign of reason • Letters to the editor • Students petition for corrective measures at 6th Ave. & Main St. • Candace Sprecher struck by auto • Student editors at Scranton\u27s press conference • Messiah to be presented Dec. 12 • Tara theme of Senior Ball • Donald Barnhouse, TV 10 newscaster to speak • Soviets speak at Phila. Council: UC students question • College group visits Saint Gabriels • Lyndon Baines Johnson sworn in as 36 President Friday November 22, 1963 • Lecture presented on Rome Council • Greek gleanings • Curtain Club\u27s first theatre in round production December 6 • Teacher exams to be given Feb. 15https://digitalcommons.ursinus.edu/weekly/1259/thumbnail.jp

Subcutaneous furosemide in advanced heart failure: service improvement project

Objectives: In severe heart disease, parenteral administration of loop diuretic is often needed. We present clinical outcomes from episodes of care using subcutaneous continuous infusion of furosemide (CSCI-furosemide).Methods: Retrospective review of service improvement data. The heart failure nurse specialist, supported by the heart failure-palliative care multi-disciplinary team, works with the community or hospice staff who administer the CSCI-furosemide. Data collected for consecutive patients receiving CSCI-furosemide included: age, sex, New York Heart Association (NYHA) class, preferred place of care, goal of treatment, infusion-site reactions, and signs and symptoms of fluid retention (including weight and self-reported breathlessness).Results: 116 people (men 86 [66%]; mean age 79 years, 49 to 97; NYHA class 3 [36/116, 31%] or 4 heart failure [80/116, 69%]) received 130 episodes of CSCI-furosemide (average duration 10 days, 1 to 49), over half in the patient’s own home/care home (80/129,; 61%) aiming to prevent hospital admission. 40/129 (31%) were managed in the hospice, and 9 (7.0%) in a community hospital. Average daily furosemide dose was 125 mg (40 to 300mg). The goal of treatment was achieved in (119/130, 91.5%) episodes.The median reduction in weight was 4kg (interquartiles -7 kg to -2 kgs, -22 to +9 kgs). Self-reported breathlessness reduced from 8.2 (+/-1.9) to 5.2 (+/-1.8). Adverse events occurred in 31/130 (24%) episodes; all but 4/130 (3%, localised skin infection) were mild.Conclusions: These preliminary data indicate that CSCI-furosemide is safe and effective for people with severe heart failure. An adequately powered randomised controlled trial is indicated

A randomized controlled trial and economic evaluation of the Parents Under Pressure Program for parents in substance abuse treatment

Background There is growing interest in the provision of parenting support to substance misusing parents. Methods This pragmatic, multi-center randomized controlled trial compared an intensive one-to-one parenting program (Parents under Pressure, PuP) with Treatment as Usual (TAU) in the UK. Parents were engaged in community-based substance misuse services and were primary caregivers of children less than 2.5 years of age. The primary outcome was child abuse potential, and secondary outcomes included measures of parental emotional regulation assessed at baseline, 6 and 12-months. A prospective economic evaluation was also conducted. Results Of 127 eligible parents, 115 met the inclusion criteria, and subsequently parents were randomly assigned to receive PuP (n = 48) or TAU (n = 52). Child abuse potential was significantly improved in those receiving the PuP program while those in TAU showed a deterioration across time in both intent-to-treat (p < 0.03) and per-protocol analyses (p < 0.01). There was also significant reliable change (recovery/improvement) in 30.6% of the PuP group compared with 10.3% of the TAU group (p < 0.02), and deterioration in 3% compared with 18% (p < 0.02). The probability that the program is cost-effective was approximately 51.8% if decision-makers are willing to pay £1000 for a unit improvement in the primary outcome, increasing to 98.0% at a £20,000 cost-effectiveness threshold for this measure. Conclusions Up to one-third of substance dependent parents of children under 3-years of age can be supported to improve their parenting, using a modular, one-to-one parenting program. Further research is needed

Brief Lifestyle Interventions for Prediabetes in Primary Care:A Service Evaluation

BACKGROUND: The increasing number of cases of prediabetes in the UK is concerning, particularly in Wales where there is no standard programme of support. The aim of the current service evaluation was to examine the effectiveness of brief lifestyle interventions on glucose tolerance in people at risk of developing type 2 diabetes. METHODS: In this pragmatic service evaluation clinical data on people deemed at risk of developing type 2 diabetes were evaluated from two GP clusters. Patients (n = 1207) received a single 15 to 30-min, face-to-face, consultation with a health care practitioner. Interventions were assessed by changes in HbA1c and distribution across the HbA1c ranges 12 months following intervention. Statistical significance of reversion to normoglycaemia and development of diabetes were assessed through comparison with expected rates without intervention. RESULTS: Between baseline and 12-month follow-up HbA1c fell from 43.85 ± 1.57 mmol/mol (6.16 ± 0.14%) to 41.63 ± 3.84 mmol/mol (5.96 ± 0.35%), a decrease of 2.22 mmol/mol (0.20%) (95% CI 2.01 (0.18%), 2.42 (0.22%); p < 0.0001). The proportion of people with normal glucose tolerance at 12 months (0.50 95%CI 0.47, 0.52) was significantly larger than the lower (0.06 (p < 0.0001) and the upper (0.19 (p < 0.0001)) estimates based on no intervention. CONCLUSION: Results indicate significant improvement in glucose tolerance across GP clusters. The brief intervention has the potential to offer a robust and effective option to support people at risk of developing type 2 diabetes. Further research in the form of a randomised trial is needed to confirm this and identify those likely to benefit most from this intervention

Faculty Brass Quintet

Kemp Recital Hall Monday Evening April 8, 2002 8:00p.m

A Study of Teacher Growth, Supervision, and Evaluation in Alberta: Policy and Perception in a Collective Case Study

Teacher effectiveness has long been identified as critical to student success and, more recently, supporting students attaining the skills and dispositions required to be successful in the early 21st century. To do so requires that teachers engage in professional learning characterized as a shift away from conventional models of evaluation and judgment. Accordingly, school and system leaders must create “policies and environments designed to actively support teacher professional growth” (Bakkenes, Vermunt, & Webbels, 2010). This paper reports on the Alberta Teacher Growth, Supervision, and Evaluation (TGSE) Policy (Government of Alberta, 1998) through the eyes of teachers, school leaders, and superintendents. The study sought to answer the following two questions: (1) To what extent, and in what ways, do teachers, principals, and superintendents perceive that ongoing supervision by the principal provides teachers with the guidance and support they need to be successful? and, (2) To what degree, and in what ways, does the TGSE policy provide a foundation to inform future effective policy and implementation of teacher growth, supervision, and evaluation? Results affirm international findings that although a majority of principals consider themselves as instructional leaders, only about one third actually act accordingly (OECD, 2016)