Self-Efficacy And The Transfer Of Collabortive Learning To Independent Assessments In The Mathematics Classroom

This capstone investigates the research question: What instructional strategies best allow middle school students to develop self-efficacy as they transfer collaborative learning to individual assessments in the mathematics classroom? The author conducted action research in urban schools with an at-risk student population. Within the action research framework, the author applies a qualitative approach to examine instructional strategies that encourage all students to become flexible learners. This capstone ultimately argues that clear expectations and mindset largely impact student success, regardless of the task. It discusses the influence of mindset on student engagement during both collaborative and independent tasks

Virginia as a Response to Parental Influence

In his 1807 poem, Resolution and Independence, a poem that brings to mind Oliver Treadwell\u27s artistic crisis in Virginia, William Wordsworth describes the precipice that he faces when trying to come to terms with the emotional extremes he must allow himself in creating the art he desires

Beyond the physical outcomes: An investigation into the experience of a pediatric mCIMT camp

Objective: Modified constraint induced movement therapy (mCIMT) is a technique for treating children with unilateral neurological motor impairments by constraining a child’s unaffected upper extremity to force the use of the affected upper extremity. Outcomes from mCIMT camp participation reported in the literature tend to be heavily overrepresented by quantitative measures. When included, qualitative information was anecdotal and lacked the depth and rigor necessary to recognize psychosocial changes as a meaningful camp outcome. The purpose of this study was to investigate the experience of a mCIMT camp, as reported by parents and children who participated in a mCIMT camp. Method: In order to gather empirical qualitative information regarding the mCIMT camp experience, two focus groups were held with camp participants: one with 4 children and one with 5 parents. Results: The four themes that emerged to describe the experience were relationships, fun, empowerment, and frustrations. The relationships and fun experienced during camp created a social context in which therapeutic activities occurred, which facilitated the development of empowerment. Frustrations tended to be logistical and were not deterrents to pursuing future camp opportunities. Conclusion: The results from this qualitative study validated the importance of gathering data on any psychosocial changes attained during camp in addition to the typical quantitative changes. Suggestions provided by both the care providers and child participants may assist occupational therapists in the development of a more consistent, family-friendly mCIMT camp

Comparison of Recycling Outcomes in Three Types of Recycling Collection Units

Commercial institutions have many factors to consider when implementing an effective recycling program. This study examined the effectiveness of three different types of recycling bins on recycling accuracy by determining the percent weight of recyclable material placed in the recycling bins, comparing the percent weight of recyclable material by type of container used, and examining whether a change in signage increased recycling accuracy. Data were collected over 6 weeks totaling 30 days from 3 different recycling bin types at a Midwest university medical center. Five bin locations for each bin type were used. Bags from these bins were collected, sorted into recyclable and nonrecyclable material, and weighed. The percent recyclable material was calculated using these weights. Common contaminates found in the bins were napkins and paper towels, plastic food wrapping, plastic bags, and coffee cups. The results showed a significant difference in percent recyclable material between bin types and bin locations. Bin type 2 was found to have one bin location to be statistically different (p = 0.048), which may have been due to lack of a trash bin next to the recycling bin in that location. Bin type 3 had significantly lower percent recyclable material (p \u3c 0.001), which may have been due to lack of a trash bin next to the recycling bin and increased contamination due to the combination of commingled and paper into one bag. There was no significant change in percent recyclable material in recycling bins post signage change. These results suggest a signage change may not be an effective way, when used alone, to increase recycling compliance and accuracy. This study showed two or three-compartment bins located next to a trash bin may be the best bin type for recycling accuracy

Development of a brief, reliable and valid diet assessment tool for impaired glucose tolerance and diabetes:The UK Diabetes and Diet Questionnaire

OBJECTIVE: Dietary advice is fundamental in the prevention and management of type 2 diabetes (T2DM). Advice is improved by individual assessment but existing methods are time-consuming and require expertise. We developed a twenty-five-item questionnaire, the UK Diabetes and Diet Questionnaire (UKDDQ), for quick assessment of an individual’s diet. The present study examined the UKDDQ’s repeatability and relative validity compared with 4 d food diaries. DESIGN: The UKDDQ was completed twice with a median 3 d gap (interquartile range=1–7 d) between tests. A 4 d food diary was completed after the second UKDDQ. Diaries were analysed and food groups were mapped on to the UKDDQ. Absolute agreement between total scores was examined using intra-class correlation (ICC). Agreement for individual items was tested with Cohen’s weighted kappa (κ (w)). SETTING: South West of England. SUBJECTS: Adults (n 177, 50·3 % women) with, or at high risk for, T2DM; mean age 55·8 (sd 8·6) years, mean BMI 34·4 (sd 7·3) kg/m(2); participants were 91 % White British. RESULTS: The UKDDQ showed excellent repeatability (ICC=0·90 (0·82, 0·94)). For individual items, κ (w) ranged from 0·43 (‘savoury pastries’) to 0·87 (‘vegetables’). Total scores from the UKDDQ and food diaries compared well (ICC=0·54 (0·27, 0·70)). Agreement for individual items varied and was good for ‘alcohol’ (κ (w)=0·71) and ‘breakfast cereals’ (κ (w)=0·70), with no agreement for ‘vegetables’ (κ (w)=0·08) or ‘savoury pastries’ (κ (w)=0·09). CONCLUSIONS: The UKDDQ is a new British dietary questionnaire with excellent repeatability. Comparisons with food diaries found agreements similar to those for international dietary questionnaires currently in use. It targets foods and habits important in diabetes prevention and management

The Impact of Sleep Debt on Excess Adiposity and Insulin Sensitivity in Patients with Early Type 2 Diabetes Mellitus

STUDY OBJECTIVES: We examined cross-sectional and prospective associations between sleep debt and adiposity measures, as well as homeostatic model assessment-insulin resistance (HOMA-IR) in early type 2 diabetes. METHODS: Prospective data analysis from participants of a randomized controlled trial based on an intensive lifestyle intervention (usual care, diet, or diet and physical activity). Data were collected at baseline, 6 months, and 12 months post-intervention. The study was performed across five secondary care centers in the United Kingdom. Patients (n = 593) with a recent diagnosis of type 2 diabetes were recruited. Objective height and weight were ascertained for obesity status (body mass index [BMI]; ≥ 30 kg/m(2)), waist circumference (cm) for central adiposity, and fasting blood samples drawn to examine insulin resistance (IR). Seven-day sleep diaries were used to calculate weekday sleep debt at baseline, calculated as average weekend sleep duration minus average weekday sleep duration. RESULTS: At baseline, compared to those without weekday sleep debt, those with weekday sleep debt were 72% more likely to be obese (OR = 1.72 [95% CI:1.03–2.88]). At six months, weekday sleep debt was significantly associated with obesity and IR after adjustment, OR = 1.90 (95% CI:1.10–3.30), OR = 2.07 (95% CI:1.02–4.22), respectively. A further increase at 12 months was observed for sleep debt with obesity and IR: OR = 2.10 (95% CI:1.14–3.87), OR = 3.16 (95% CI:1.38–7.24), respectively. For every 30 minutes of weekday sleep debt, the risk of obesity and IR at 12 months increased by 18% and 41%, respectively. CONCLUSIONS: Sleep debt resulted in long-term metabolic disruption, which may promote the progression of type 2 diabetes in newly diagnosed patients. Sleep hygiene/education could be an important factor for future interventions to target early diabetes. CITATION: Arora T, Chen MZ, Cooper AR, Andrews RC, Taheri S. The impact of sleep debt on excess adiposity and insulin sensitivity in patients with early type 2 diabetes mellitus. J Clin Sleep Med 2016;12(5):673–680

Effect of diet or diet plus physical activity versus usual care on inflammatory markers in patients with newly diagnosed type 2 diabetes: The Early ACTivity in Diabetes (ACTID) randomized, controlled trial

This is the final version. Available on open access from Wiley via the DOI in this recordBACKGROUND: Inflammation plays a major role in diabetes-associated cardiovascular disease (CVD). There is uncertainty whether diet and physical activity interventions can be successfully integrated into healthcare settings and reduce markers of inflammation and risk of CVD in patients with type 2 diabetes (T2D). METHODS AND RESULTS: Systemic markers of inflammation were determined in a 12-month, real-world, multicenter, randomized, controlled trial that investigated the effect of diet, diet plus physical activity, and usual care in 593 individuals with newly diagnosed T2D. During the first 6 months, serum C-reactive protein (CRP) improved by -21 (-36 to -1.4)% and -22 (-38 to -3.1)% in diet and diet plus physical activity arms versus usual care. There were also improvements in adiponectin and soluble intercellular adhesion molecule-1 (sICAM-1). Though medication-adjusted CRP was improved between 6 and 12 months for usual care, both interventions were more successful in reducing the relative risk of a high-risk CRP level of >3 mg/L (risk ratios of 0.72 [0.55 to 0.95] for diet versus usual care and 0.67 [0.50 to 0.90] for diet plus activity versus usual care). Furthermore, sICAM-1 (a marker of vascular risk), remained substantially lower than usual care in both intervention arms at 12 months. CONCLUSIONS: Motivational, unsupervised diet and/or diet plus physical activity interventions given soon after diagnosis in real-world healthcare settings improve markers of inflammation and cardiovascular risk in patients with T2D, even after accounting for the effect of adjustments to medication to try and control blood pressure, glycated hemoglobin, and lipids. CLINICAL TRIAL REGISTRATION URL: http://www.controlled-trials.com/. Unique identifier: ISRCTN92162869.British Heart FoundationDiabetes UKUK Department of Healt

Evaluation of Trends in Diabetes Care in a Patient-centered Medical Home

Background: The patient-centered medical home (PCMH) is a model used in primary care to achieve effective management of chronic diseases. The Augusta University Health Family Medicine Center (AUFMC), a PCMH recognized by the National Committee for Quality Assurance, has implemented strategies to manage its patient population with diabetes. The present study evaluated the effects of these interventions through trend analysis of selected diabetic core measures by use of a qualified clinical data registry, the Practice Partner Research Network. Methods: For this retrospective study, de-identified data were abstracted for adult patients with diabetes for the period of 2013-2015. Process and outcome measures were determined for selected diabetic core measures, based on the 2015 American Diabetes Association and Physician Quality Reporting System of the Centers for Medicaid and Medicare (CMS). These measures included glycated hemoglobin (HbA1c), blood pressure (BP), low-density lipoprotein cholesterol (LDL), urine microalbumin (Um), diabetic foot and eye exams, and influenza and pneumococcal vaccinations. These values were analyzed by the CochranArmitage test for trends over time to determine the proportions of patients at the recommended goals. Results: Over time, there were increasing trends for patients who were at the goals for frequencies of HbA1c, Um, LDL, pneumococcal vaccinations, and diabetic retinal exams. Conclusions: Since AUFMC achieved PCMH recognition status, efforts to improve the management of patients with diabetes have yielded positive outcomes and valuable lessons. Areas of strength include utilization of the diabetes registry, education by regular providers, tailored use of electronic health records for patient education and physician documentation, and appropriate utilization of all team members. Trend analysis indicated that targeted diabetic interventions contributed to improved outcomes in selected diabetic core measures