Quality development in education

The article suggests that people involved in quality development need a specific competence, called quality literacy, in order to successfully improve learning processes. Quality literacy is viewed as a set of competencies that are needed for professional quality development. Quality literacy emphasizes the importance of professionalism as a necessary component for quality development, in addition to structural quality management models. Quality development is a co-production between learners and their learning environment. This means that the educational process can only be influenced and optimized through participation and not steered externally. Quality strategies cannot, therefore, guarantee a high quality of learning processes but rather aim at professionalisation of the educational process. This article suggests participation and negotiation between educational participants (clients and providers) as a main condition for quality development. © 2009 Springer Berlin Heidelberg

Breastfeeding and maternal cardiovascular risk factors and outcomes:A systematic review

There is growing evidence that breastfeeding has short- and long-term cardiovascular health benefits for mothers. The objectives of this systematic review were to examine the association between breastfeeding and maternal cardiovascular risk factors and outcomes that have not previously been synthesized systematically, including metabolic syndrome, hypertension and cardiovascular disease.This systematic review meets PRISMA guidelines. The MEDLINE, EMBASE and CINAHL databases were systematically searched for relevant publications of any study design from the earliest publication date to March 2016. The reference lists from selected articles were reviewed, and forward and backward referencing were conducted. The methodological quality of reviewed articles was appraised using validated checklists. Twenty-one studies meeting the inclusion criteria examined the association between self-reported breastfeeding and one or more of the following outcomes: metabolic syndrome/metabolic risk factors (n = 10), inflammatory markers/adipokines (n = 2), hypertension (n = 7), subclinical cardiovascular disease (n = 2), prevalence/incidence of cardiovascular disease (n = 3) and cardiovascular disease mortality (n = 2). Overall, 19 studies (10 cross-sectional/retrospective, 9 prospective) reported significant protective effects of breastfeeding, nine studies (3 cross-sectional/retrospective, 5 prospective, 1 cluster randomized controlled trial) reported non-significant findings and none reported detrimental effects of breastfeeding. In most studies reporting significant associations, breastfeeding remained associated with both short- and long-term maternal cardiovascular health risk factors/outcomes, even after covariate adjustment. Findings from several studies suggested that the effects of breastfeeding may diminish with age and a dose-response association between breastfeeding and several metabolic risk factors. However, further longitudinal studies, including studies that measure exclusive breastfeeding, are needed to confirm these findings.The evidence from this review suggests that breastfeeding is associated with cardiovascular health benefits. However, results should be interpreted with caution as the evidence gathered for each individual outcome was limited by the small number of observational studies. Additional prospective studies are needed.CRD42016047766

Study of Women, Infant feeding, and Type 2 diabetes mellitus after GDM pregnancy (SWIFT), a prospective cohort study: methodology and design

<p>Abstract</p> <p>Background</p> <p>Women with history of gestational diabetes mellitus (GDM) are at higher risk of developing type 2 diabetes within 5 years after delivery. Evidence that lactation duration influences incident type 2 diabetes after GDM pregnancy is based on one retrospective study reporting a null association. The Study of Women, Infant Feeding and Type 2 Diabetes after GDM pregnancy (SWIFT) is a prospective cohort study of postpartum women with recent GDM within the Kaiser Permanente Northern California (KPNC) integrated health care system. The primary goal of SWIFT is to assess whether prolonged, intensive lactation as compared to formula feeding reduces the 2-year incidence of type 2 diabetes mellitus among women with GDM. The study also examines whether lactation intensity and duration have persistent favorable effects on blood glucose, insulin resistance, and adiposity during the 2-year postpartum period. This report describes the design and methods implemented for this study to obtain the clinical, biochemical, anthropometric, and behavioral measurements during the recruitment and follow-up phases.</p> <p>Methods</p> <p>SWIFT is a prospective, observational cohort study enrolling and following over 1, 000 postpartum women diagnosed with GDM during pregnancy within KPNC. The study enrolled women at 6-9 weeks postpartum (baseline) who had been diagnosed by standard GDM criteria, aged 20-45 years, delivered a singleton, term (greater than or equal to 35 weeks gestation) live birth, were not using medications affecting glucose tolerance, and not planning another pregnancy or moving out of the area within the next 2 years. Participants who are free of type 2 diabetes and other serious medical conditions at baseline are screened for type 2 diabetes annually within the first 2 years after delivery. Recruitment began in September 2008 and ends in December 2011. Data are being collected through pregnancy and early postpartum telephone interviews, self-administered monthly mailed questionnaires (3-11 months postpartum), a telephone interview at 6 months, and annual in-person examinations at which a 75 g 2-hour OGTT is conducted, anthropometric measurements are obtained, and self- and interviewer-administered questionnaires are completed.</p> <p>Discussion</p> <p>This is the first, large prospective, community-based study involving a racially and ethnically diverse cohort of women with recent GDM that rigorously assesses lactation intensity and duration and examines their relationship to incident type 2 diabetes while accounting for numerous potential confounders not assessed previously.</p

Clinical pharmacology of glucagon-like peptide-1 receptor agonists

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are an important asset in the armamentarium for the treatment of type 2 diabetes mellitus (type 2 DM). Incretin failure is a critical etiopathogenetic feature of type 2 DM, which, if reversed, results in improved glycaemic control. GLP-1 RAs are injectable peptides that resemble the structure and function of endogenous incretin GLP-1, but as they are not deactivated by the dipeptidyl peptidase-4 (DPP-4), their half-life is prolonged compared with native GLP-1. Based on their ability to activate GLP-1 receptor, GLP-1 RAs are classified as short-acting (exenatide twice-daily and lixisenatide once-daily), and long-acting (liraglutide once-daily and the once-weekly formulations of exenatide extended-release, dulaglutide, and albiglutide). Semaglutide, another long-acting, once-weekly GLP-1 RA, was recently approved by the FDA and EMA. Although all of these agents potently reduce haemoglobin A1C (HbA1c), there are unique features and fundamental differences among them related to fasting and postprandial hyperglycaemia reduction, weight loss potency, cardiovascular protection efficacy, and adverse events profile. It is imperative that current evidence be integrated and applied in the context of an individualised patient-centred approach. This should include not only glucose management but also targeting as many as possible of the pathophysiologic mechanisms responsible for type 2 DM development and progression. © 2018, Hellenic Endocrine Society

Quality development in education

The article suggests that people involved in quality development need a specific competence, called quality literacy, in order to successfully improve learning processes. Quality literacy is viewed as a set of competencies that are needed for professional quality development. Quality literacy emphasizes the importance of professionalism as a necessary component for quality development, in addition to structural quality management models. Quality development is a co-production between learners and their learning environment. This means that the educational process can only be influenced and optimized through participation and not steered externally. Quality strategies cannot, therefore, guarantee a high quality of learning processes but rather aim at professionalisation of the educational process. This article suggests participation and negotiation between educational participants (clients and providers) as a main condition for quality development. © 2009 Springer Berlin Heidelberg

Quality development in education

The article suggests that people involved in quality development need a specific competence, called quality literacy, in order to successfully improve learning processes. Quality literacy is viewed as a set of competencies that are needed for professional quality development. Quality literacy emphasizes the importance of professionalism as a necessary component for quality development, in addition to structural quality management models. Quality development is a co-production between learners and their learning environment. This means that the educational process can only be influenced and optimized through participation and not steered externally. Quality strategies cannot, therefore, guarantee a high quality of learning processes but rather aim at professionalisation of the educational process. This article suggests participation and negotiation between educational participants (clients and providers) as a main condition for quality development. © 2009 Springer Berlin Heidelberg

Quality development in education

The article suggests that people involved in quality development need a specific competence, called quality literacy, in order to successfully improve learning processes. Quality literacy is viewed as a set of competencies that are needed for professional quality development. Quality literacy emphasizes the importance of professionalism as a necessary component for quality development, in addition to structural quality management models. Quality development is a co-production between learners and their learning environment. This means that the educational process can only be influenced and optimized through participation and not steered externally. Quality strategies cannot, therefore, guarantee a high quality of learning processes but rather aim at professionalisation of the educational process. This article suggests participation and negotiation between educational participants (clients and providers) as a main condition for quality development. © 2009 Springer Berlin Heidelberg