si MPI Analysis of All State ESSA Accountability Plans Finds Fractured Picture of Education Policy for English Learners & Differing Approaches By www.migrationpolicy.org Published On :: Tue, 11 Feb 2020 16:45:31 -0500 WASHINGTON – Four years since the Every Student Succeeds Act (ESSA) was signed into law, all 50 states, the District of Columbia and Puerto Rico have developed accountability plans that include blueprints for serving English Learners (ELs), as well as measuring these students’ progress and being accountable for their outcomes. This marked a significant development, as EL performance was previously not well integrated with factors that determined whether a school was performing well or poorly. Full Article
si Effectively Serving Immigrant and Dual Language Learner Families through Home Visiting Programs By www.migrationpolicy.org Published On :: Tue, 13 Aug 2019 14:43:47 -0400 This MPI webinar marks the release of a policy brief that explores program and policy opportunities to improve home visiting services for immigrant and DLL families currently underparticipating in these programs due to a lack of culturally and linguistically responsive programming and other barriers Full Article
si Rebuilding Community after Crisis: Striking a New Social Contract for Diverse Societies (Transatlantic Council Statement) By www.migrationpolicy.org Published On :: Tue, 14 Jan 2020 09:52:21 -0500 Addressing the deep-rooted integration challenges unearthed by large-scale migration and rapid social change will require a combination of strategies. Governments in Europe and North America must create a new social contract for increasingly diverse societies that are confronting cycles of disruption. This report sketches a blueprint for an adaptive process oriented by skill needs rather than national origins. Full Article
si Global Demand for Medical Professionals Drives Indians Abroad Despite Acute Domestic Health-Care Worker Shortages By www.migrationpolicy.org Published On :: Tue, 21 Jan 2020 10:02:55 -0500 India is the world's largest source for immigrant physicians, and for Indian-trained doctors and nurses the allure of working abroad is strong despite an acute domestic shortage of health-care workers. Against this pull, the Indian government has enacted a number of policies to limit and regulate the emigration of health-care professionals, though these have been more ad hoc in nature and not part of a fully realized strategy. Full Article
si Stir-fried twice cooked porkbelly with leek and Sichuan black beans By www.abc.net.au Published On :: Tue, 27 Oct 2015 19:35:00 +1100 This recipe was featured on Foodie Tuesday, a weekly segment with Raf Epstein on Drive, 774 ABC Melbourne, 3:30 PM, courtesy of Neil Perry. Neil's new book is "Spice Temple." Full Article ABC Local melbourne Lifestyle and Leisure:Recipes:All Australia:VIC:Melbourne 3000
si Sticky pineapple and macadamia upside-down cake By www.abc.net.au Published On :: Mon, 16 Nov 2015 12:47:00 +1100 This is what I think of as an honest cake - not tizzy, just homely, buttery and ever-so more-ish with its tender, nutty crumb and sweet, caramelised pineapple topping. I particularly love the way the sides, through some kind of magical alchemy of heat and sugar, become ever-so-slightly crunchy. There are a couple of little things I've noticed when I bake it - the first is that it cooks better and looks better when baked in a regular, not a non-stick, cake tin. And the second is that it's really important not to overload the tin with pineapple or it will release too much liquid and the centre of the cake will be soggy. Full Article ABC Local northcoast Lifestyle and Leisure:Food and Cooking:All Lifestyle and Leisure:Recipes:All Lifestyle and Leisure:Recipes:Main Australia:NSW:Lismore 2480
si Bbq barramundi, Jamon, minted peas, Dijon mustard dressing & Danish fetta By www.abc.net.au Published On :: Mon, 23 Nov 2015 12:16:00 +1000 Delicious fish dish for a summer night. Full Article ABC Local brisbane Lifestyle and Leisure:Food and Cooking:All Australia:QLD:Brisbane 4000
si Josie's chocolate and walnut brownies By www.abc.net.au Published On :: Thu, 26 Nov 2015 12:01:00 +1100 A delicious treat for the serious chocolate lover Full Article ABC Local centralwest Lifestyle and Leisure:All:All Lifestyle and Leisure:Recipes:All Australia:NSW:Orange 2800
si Tasha's simple no fuss Christmas cake By www.abc.net.au Published On :: Wed, 23 Dec 2015 10:22:00 +1100 I absolutely adore a rich moist fruit cake laced with brandy. We love this cake in our house and will stay fresh in a airtight tin for months. Full Article ABC Local northcoast Lifestyle and Leisure:Food and Cooking:All Lifestyle and Leisure:Recipes:All Lifestyle and Leisure:Recipes:Main Australia:NSW:Lismore 2480
si ZUCCHINI, BASIL AND GOAT'S CHEESE FRITTATA By www.abc.net.au Published On :: Thu, 24 Dec 2015 11:06:00 +1100 A good frittata is really simple to make, but it does need a little TLC to make sure that the eggs don't overcook. At its best the eggs are softly set and still really tender and the whole thing is such a pleasure to eat. So do take just a little extra care with this, it's really worth it. Full Article ABC Local northcoast Lifestyle and Leisure:Food and Cooking:All Lifestyle and Leisure:Recipes:All Lifestyle and Leisure:Recipes:Main Australia:NSW:Lismore 2480
si Chicken & Lemongrass Pot stickers Asian slaw By www.abc.net.au Published On :: Mon, 01 Feb 2016 14:38:00 +1000 Fresh and tasty chicken pot stickers with a delicious Asian slaw. Full Article ABC Local brisbane Lifestyle and Leisure:All:All Australia:QLD:Brisbane 4000
si Baked figs stuffed with goat's cheese, black garlic and herbs, mint and purple basil salad By www.abc.net.au Published On :: Thu, 10 Mar 2016 05:43:00 +1100 Figs are such a versatile fruit, they can be eaten raw, cooked, and sweet or savoury. Here I am baking them with goat's curd which is truly delicious. Wrapping them in prosciutto adds texture and saltiness and the mint salad adds a lovely freshness to the dish. Full Article ABC Local northcoast Lifestyle and Leisure:Food and Cooking:All Lifestyle and Leisure:Recipes:All Lifestyle and Leisure:Recipes:Main Australia:NSW:Lismore 2480
si Malaysian curry puffs By www.abc.net.au Published On :: Mon, 09 May 2016 09:10:00 +1000 A short, crunchy crust that breaks open with a burst of flavour and just a touch of heat. Full Article ABC Local widebay Health:All:All Health:Diet and Nutrition:All Lifestyle and Leisure:All:All Lifestyle and Leisure:Recipes:All Lifestyle and Leisure:Recipes:Entree Australia:QLD:Bundaberg 4670
si Milk poached veal, beets, brassica, avocado By www.abc.net.au Published On :: Mon, 04 Jul 2016 12:05:00 +1000 A different take on veal to warm up a dinner party. Full Article ABC Local brisbane Lifestyle and Leisure:Recipes:All Australia:QLD:Brisbane 4000
si Malaysian chicken satay with roasted macadamia dipping sauce By www.abc.net.au Published On :: Fri, 08 Jul 2016 12:48:00 +1000 I seriously love cooking on the Weber more in winter cooler temperature make us feel more cosy and accentuate the taste buds and smell . Replaced the traditional peanuts with our wonderful local macadamias Full Article ABC Local northcoast Lifestyle and Leisure:Food and Cooking:All Lifestyle and Leisure:Recipes:All Lifestyle and Leisure:Recipes:Main Australia:NSW:Lismore 2480
si Six Simple Steps to Making Stock By www.abc.net.au Published On :: Tue, 12 Jul 2016 12:16:00 +1000 This recipe was featured on Foodie Tuesday, a weekly segment on 774 Drive with Raf Epstein, 3.30PM, courtesy of Alice Zaslavsky. Full Article ABC Local melbourne Lifestyle and Leisure:Recipes:All Australia:VIC:Melbourne 3000
si Citrus cured salmon, pickled clams, herb emulsion By www.abc.net.au Published On :: Tue, 19 Jul 2016 14:28:00 +1000 This recipe features on Foodie Tuesday, a weekly segment on 774 Drive with Raf Epstein, 3.30PM, courtesy of David Hall of Pure South Dining. Full Article ABC Local melbourne Lifestyle and Leisure:Recipes:Main Australia:VIC:Melbourne 3000
si Chargrilled Salmon with Thai Salad of roast ground rice and nahm jim dressing By www.abc.net.au Published On :: Fri, 05 Aug 2016 12:04:00 +1000 A fresh and light dish. Full Article ABC Local brisbane Lifestyle and Leisure:Recipes:All Australia:QLD:Brisbane 4000
si Silverbeet Dolmas By www.abc.net.au Published On :: Tue, 23 Aug 2016 15:44:00 +1000 This recipe featured on Foodie Tuesday, a weekly segment on 774 Drive with Raf Epstein, 3.30PM, shared by Jad Choucair of Mankoushe. Full Article ABC Local melbourne Lifestyle and Leisure:Recipes:All Australia:VIC:Melbourne 3000
si Cres with passionfruit and cottage cheese By www.abc.net.au Published On :: Thu, 08 Sep 2016 07:15:00 +1000 Guaranteed to tempt fussy eaters, with lots of hidden nutrients. Full Article ABC Local northcoast Lifestyle and Leisure:Food and Cooking:All Lifestyle and Leisure:Recipes:All Lifestyle and Leisure:Recipes:Main Australia:NSW:Lismore 2480
si Sweet wasabi dressing By www.abc.net.au Published On :: Wed, 21 Sep 2016 14:18:00 +1000 10g Wasabi paste 25ml Rice wine 25ml White vinegar 50ml Vegetable oil 5ml Soy sauce Salt and pepper Full Article ABC Local shepparton goulburnmurray Lifestyle and Leisure:Recipes:All Australia:VIC:Shepparton 3630 Australia:VIC:Wodonga 3690
si Medallions of Beef, with pan juice sauce, wilted cherry tomatoes, wine and basil By www.abc.net.au Published On :: Thu, 06 Oct 2016 10:07:00 +1100 Medallions of Beef, with pan juice sauce, wilted cherry tomatoes, any old wine and basil. Really nice with a potato salad, with fresh spring peas and crispy bacon pieces. Something I do very often is knock up quick tasty dinner utilising your favourite heavy-based frying pan. Full Article ABC Local northcoast Lifestyle and Leisure:Food and Cooking:All Lifestyle and Leisure:Recipes:All Lifestyle and Leisure:Recipes:Main Australia:NSW:Lismore 2480
si Simple Raspberry Sorbet By www.abc.net.au Published On :: Tue, 15 Nov 2016 15:44:00 +1100 This recipe features on Foodie Tuesday, a weekly segment on 774 Drive with Raf Epstein, 3.30PM, shared by Alice Zaslavsky, author of Alice's Food A-Z. Full Article ABC Local melbourne Lifestyle and Leisure:Recipes:All Australia:VIC:Melbourne 3000
si Upside down local tomato, goats cheese and onion tart By www.abc.net.au Published On :: Thu, 05 Jan 2017 10:24:00 +1100 Always a winner taking advantage of the local summer tomatoes . Who doesn't like flaky puff pastry? Full Article ABC Local northcoast Lifestyle and Leisure:Food and Cooking:All Lifestyle and Leisure:Recipes:All Lifestyle and Leisure:Recipes:Main Australia:NSW:Lismore 2480
si Tash's Passionfruit &Coconut �� Slice By www.abc.net.au Published On :: Thu, 02 Feb 2017 11:27:00 +1100 Love this tasty slice with the combo of coconut and the passion fruit what's there not to like? Full Article ABC Local northcoast Lifestyle and Leisure:Food and Cooking:All Lifestyle and Leisure:Recipes:All Lifestyle and Leisure:Recipes:Main Australia:NSW:Lismore 2480
si Spring cleansing beetroot and pomegranate salad By www.abc.net.au Published On :: Wed, 11 Oct 2017 13:10:00 +1100 Beets have strong detoxifying properties, as they are high in chlorine, which assists in the cleansing of the liver, kidneys and bloodstream. They are also rich in potassium, which balances the metabolism. The mighty beets nourish the blood, tonify the heart, calm the spirit and nervousness, and they lubricate the intestines and cleanse the liver! Oh my giddy Aunt! Full Article ABC Local northcoast Lifestyle and Leisure:Food and Cooking:All Lifestyle and Leisure:Recipes:All Lifestyle and Leisure:Recipes:Main Australia:NSW:Lismore 2480
si The Colombian Response to the Venezuelan Migration Crisis: A Dialogue with Colombia’s Migration Czar By www.migrationpolicy.org Published On :: Wed, 18 Sep 2019 15:40:54 -0400 Felipe Muñoz, Advisor to the President of Colombia for the Colombian-Venezuelan Border, discusses how Colombia is coping with the influx of Venezuelan migrants, plans for future policy decisions surrounding this migration, and developments in regional and international cooperation. Full Article
si As More Migrants from Africa and Asia Arrive in Latin America, Governments Seek Orderly and Controlled Pathways By www.migrationpolicy.org Published On :: Mon, 21 Oct 2019 12:48:50 -0400 Growing numbers of African and Asian migrants are moving through Latin America, many hoping to reach the United States or Canada after expensive, arduous, and often dangerous journeys that can take months or even years. As more extracontinental migrants transit through South and Central America, Colombia, Panama, and Costa Rica have developed the most comprehensive policies to manage these flows, sometimes working in coordination with the U.S. government. Full Article
si Respuestas latinoamericanas a las crisis migratorias venezolanas y nicaragüenses By www.migrationpolicy.org Published On :: Fri, 01 Nov 2019 17:38:50 -0400 Responsables de políticos principales y partes interesadas de América Latina, así como representantes de instituciones internacionales claves, ofrecen sus puntos de vista sobre los desafíos futuros mientras gobiernos latinoamericanos buscan establecer las estrategias para responder a flujos migratorios forzados a gran escala, como los de Venezuela y Nicaragua. Full Article
si Welcome Wears Thin for Colombians in Ecuador as Venezuelans Become More Visible By www.migrationpolicy.org Published On :: Wed, 08 Jan 2020 19:31:49 -0500 Though Colombians displaced by a decades-long civil war found a welcome refuge in Ecuador, life has become more difficult for them in recent years, in part as a result of the influx of Venezuelans seeking safety. This article draws on surveys of migrants in Quito, comparing and contrasting the experiences of Colombians and Venezuelans, and assessing their perceptions of discrimination, victimization, trust in institutions, and hopes for the future. Full Article
si La Bienvenida Se Agota para Colombianos en Ecuador Mientras Venezolanos Se Hacen Más Visibles By www.migrationpolicy.org Published On :: Thu, 09 Jan 2020 10:42:56 -0500 Aunque colombianos encontraron un refugio cálido en Ecuador después de ser desplazados de su país por una guerra civil que duro décadas, la vida se ha vuelto más difícil para ellos en los últimos años, en parte como resultado del flujo de venezolanos que buscan seguridad. Este artículo se basa en encuestas de migrantes en Quito, comparando y contrastando las experiencias de colombianos y venezolanos, y evaluando sus percepciones de discriminación, victimización y esperanzas para el futuro. Full Article
si Is the Door Closing? Latin American and Caribbean Responses to Venezuelan Migration By www.migrationpolicy.org Published On :: Fri, 31 Jan 2020 16:30:49 -0500 This webinar marks the release of MPI's Latin American and Caribbean Migration Portal that offers up-to-date, authoritative research and data on migration trends and policies, and a report examining the policy responses of 11 countries in Latin America and the Caribbean to increased Venezuelan and Nicaraguan migration. Full Article
si Bienvenidas asimétricas: Respuestas de América Latina y el Caribe a la migración venezolana y nicaragüense By www.migrationpolicy.org Published On :: Mon, 10 Feb 2020 10:44:38 -0500 El gran desplazamiento forzado de personas en Venezuela y Nicaragua está transformando el panorama migratorio en gran parte de América Latina y el Caribe. Este informe examina las respuestas de las políticas de inmigración e integración de once países, incluyendo vías de regularización y medidas para integrar a los recién llegados en las escuelas y mercados laborales. Este informe acompaña el lanzamiento de un Portal Sobre Migración que ofrece investigación y análisis actualizados sobre tendencias y políticas de inmigración en la región. Full Article
si David wins record sixth squash world title By www.abc.net.au Published On :: Mon, 07 Nov 2011 14:07:00 +1100 Malaysian squash superstar Nicol David has won a record sixth women's World Open title, overtaking Australia's Sarah Fitz-Gerald. Full Article
si O'Driscoll out of Six Nations By www.abc.net.au Published On :: Tue, 08 Nov 2011 08:17:00 +1100 Ireland rugby captain Brian O'Driscoll has been ruled out of action for up to six months and will miss his country's Six Nations campaign when the annual tournament kicks off in February. Full Article
si Efficacy and Safety of Dapagliflozin in the Elderly: Analysis From the DECLARE-TIMI 58 Study By care.diabetesjournals.org Published On :: 2020-01-20T12:00:30-08:00 OBJECTIVE Data regarding the effects of sodium–glucose cotransporter 2 inhibitors in the elderly (age ≥65 years) and very elderly (age ≥75 years) are limited. RESEARCH DESIGN AND METHODS The Dapagliflozin Effect on Cardiovascular Events (DECLARE)–TIMI 58 assessed cardiac and renal outcomes of dapagliflozin versus placebo in patients with type 2 diabetes. Efficacy and safety outcomes were studied within age subgroups for treatment effect and age-based treatment interaction. RESULTS Of the 17,160 patients, 9,253 were <65 years of age, 6,811 ≥65 to <75 years, and 1,096 ≥75 years. Dapagliflozin reduced the composite of cardiovascular death or hospitalization for heart failure consistently, with a hazard ratio (HR) of 0.88 (95% CI 0.72, 1.07), 0.77 (0.63, 0.94), and 0.94 (0.65, 1.36) in age-groups <65, ≥65 to <75, and ≥75 years, respectively (interaction P value 0.5277). Overall, dapagliflozin did not significantly decrease the rates of major adverse cardiovascular events, with HR 0.93 (95% CI 0.81, 1.08), 0.97 (0.83, 1.13), and 0.84 (0.61, 1.15) in age-groups <65, ≥65 to <75, and ≥75 years, respectively (interaction P value 0.7352). The relative risk reduction for the secondary prespecified cardiorenal composite outcome ranged from 18% to 28% in the different age-groups with no heterogeneity. Major hypoglycemia was less frequent with dapagliflozin versus placebo, with HR 0.97 (95% CI 0.58, 1.64), 0.50 (0.29, 0.84), and 0.68 (0.29, 1.57) in age-groups <65, ≥65 to <75, and ≥75 years, respectively (interaction P value 0.2107). Safety outcomes, including fractures, volume depletion, cancer, urinary tract infections, and amputations were balanced with dapagliflozin versus placebo, and acute kidney injury was reduced, all regardless of age. Genital infections that were serious or led to discontinuation of the study drug and diabetic ketoacidosis were uncommon, yet more frequent with dapagliflozin versus placebo, without heterogeneity (interaction P values 0.1058 and 0.8433, respectively). CONCLUSIONS The overall efficacy and safety of dapagliflozin are consistent regardless of age. Full Article
si Myocardial Ischemic Burden and Differences in Prognosis Among Patients With and Without Diabetes: Results From the Multicenter International REFINE SPECT Registry By care.diabetesjournals.org Published On :: 2020-01-20T12:00:30-08:00 OBJECTIVE Prevalence and prognostic impact of cardiovascular disease differ between patients with or without diabetes. We aimed to explore differences in the prevalence and prognosis of myocardial ischemia by automated quantification of total perfusion deficit (TPD) among patients with and without diabetes. RESEARCH DESIGN AND METHODS Of 20,418 individuals who underwent single-photon emission computed tomography myocardial perfusion imaging, 2,951 patients with diabetes were matched to 2,951 patients without diabetes based on risk factors using propensity score. TPD was categorized as TPD = 0%, 0% < TPD < 1%, 1% ≤ TPD < 5%, 5% ≤ TPD ≤ 10%, and TPD >10%. Major adverse cardiovascular events (MACE) were defined as a composite of all-cause mortality, myocardial infarction, unstable angina, or late revascularization. RESULTS MACE risk was increased in patients with diabetes compared with patients without diabetes at each level of TPD above 0 (P < 0.001 for interaction). In patients with TPD >10%, patients with diabetes had greater than twice the MACE risk compared with patients without diabetes (annualized MACE rate 9.4 [95% CI 6.7–11.6] and 3.9 [95% CI 2.8–5.6], respectively, P < 0.001). Patients with diabetes with even very minimal TPD (0% < TPD < 1%) experienced a higher risk for MACE than those with 0% TPD (hazard ratio 2.05 [95% CI 1.21–3.47], P = 0.007). Patients with diabetes with a TPD of 0.5% had a similar MACE risk as patients without diabetes with a TPD of 8%. CONCLUSIONS For every level of TPD >0%, even a very minimal deficit of 0% < TPD < 1%, the MACE risk was higher in the patients with diabetes compared with patients without diabetes. Patients with diabetes with minimal ischemia had comparable MACE risk as patients without diabetes with significant ischemia. Full Article
si Microvascular and Cardiovascular Outcomes According to Renal Function in Patients Treated With Once-Weekly Exenatide: Insights From the EXSCEL Trial By care.diabetesjournals.org Published On :: 2020-01-20T12:00:30-08:00 OBJECTIVE To evaluate the impact of once-weekly exenatide (EQW) on microvascular and cardiovascular (CV) outcomes by baseline renal function in the Exenatide Study of Cardiovascular Event Lowering (EXSCEL). RESEARCH DESIGN AND METHODS Least squares mean difference (LSMD) in estimated glomerular filtration rate (eGFR) from baseline between the EQW and placebo groups was calculated for 13,844 participants. Cox regression models were used to estimate effects by group on incident macroalbuminuria, retinopathy, and major adverse CV events (MACE). Interval-censored time-to-event models estimated effects on renal composite 1 (40% eGFR decline, renal replacement, or renal death) and renal composite 2 (composite 1 variables plus macroalbuminuria). RESULTS EQW did not change eGFR significantly (LSMD 0.21 mL/min/1.73 m2 [95% CI –0.27 to 0.70]). Macroalbuminuria occurred in 2.2% of patients in the EQW group and in 2.5% of those in the placebo group (hazard ratio [HR] 0.87 [95% CI 0.70–1.07]). Neither renal composite was reduced with EQW in unadjusted analyses, but renal composite 2 was reduced after adjustment (HR 0.85 [95% CI 0.74–0.98]). Retinopathy rates did not differ by treatment group or in the HbA1c-lowering or prior retinopathy subgroups. CV outcomes in those with eGFR <60 mL/min/1.73 m2 did not differ by group. Those with eGFR ≥60 mL/min/1.73 m2 had nominal risk reductions for MACE, all-cause mortality, and CV death, but interactions by renal function group were significant for only stroke (HR 0.74 [95% CI 0.58–0.93]; P for interaction = 0.035) and CV death (HR 1.08 [95% CI 0.85–1.38]; P for interaction = 0.031). CONCLUSIONS EQW had no impact on unadjusted retinopathy or renal outcomes. CV risk was modestly reduced only in those with eGFR ≥60 mL/min/1.73 m2 in analyses unadjusted for multiplicity. Full Article
si Visit-to-Visit HbA1c Variability Is Associated With Cardiovascular Disease and Microvascular Complications in Patients With Newly Diagnosed Type 2 Diabetes By care.diabetesjournals.org Published On :: 2020-01-20T12:00:30-08:00 OBJECTIVE To investigate the association between visit-to-visit HbA1c variability and cardiovascular events and microvascular complications in patients with newly diagnosed type 2 diabetes. RESEARCH DESIGN AND METHODS This retrospective cohort study analyzed patients from Tayside and Fife in the Scottish Care Information–Diabetes Collaboration (SCI-DC) who were observable from the diagnosis of diabetes and had at least five HbA1c measurements before the outcomes were evaluated. We used the previously reported HbA1c variability score (HVS), calculated as the percentage of the number of changes in HbA1c >0.5% (5.5 mmol/mol) among all HbA1c measurements within an individual. The association between HVS and 10 outcomes was assessed using Cox proportional hazards models. RESULTS We included 13,111–19,883 patients in the analyses of each outcome. The patients with HVS >60% were associated with elevated risks of all outcomes compared with the lowest quintile (for example, HVS >80 to ≤100 vs. HVS ≥0 to ≤20, hazard ratio 2.38 [95% CI 1.61–3.53] for major adverse cardiovascular events, 2.4 [1.72–3.33] for all-cause mortality, 2.4 [1.13–5.11] for atherosclerotic cardiovascular death, 2.63 [1.81–3.84] for coronary artery disease, 2.04 [1.12–3.73] for ischemic stroke, 3.23 [1.76–5.93] for heart failure, 7.4 [3.84–14.27] for diabetic retinopathy, 3.07 [2.23–4.22] for diabetic peripheral neuropathy, 5.24 [2.61–10.49] for diabetic foot ulcer, and 3.49 [2.47–4.95] for new-onset chronic kidney disease). Four sensitivity analyses, including adjustment for time-weighted average HbA1c, confirmed the robustness of the results. CONCLUSIONS Our study shows that higher HbA1c variability is associated with increased risks of all-cause mortality, cardiovascular events, and microvascular complications of diabetes independently of high HbA1c. Full Article
si Association of BMI, Fitness, and Mortality in Patients With Diabetes: Evaluating the Obesity Paradox in the Henry Ford Exercise Testing Project (FIT Project) Cohort By care.diabetesjournals.org Published On :: 2020-02-20T11:55:30-08:00 OBJECTIVE To determine the effect of fitness on the association between BMI and mortality among patients with diabetes. RESEARCH DESIGN AND METHODS We identified 8,528 patients with diabetes (self-report, medication use, or electronic medical record diagnosis) from the Henry Ford Exercise Testing Project (FIT Project). Patients with a BMI <18.5 kg/m2 or cancer were excluded. Fitness was measured as the METs achieved during a physician-referred treadmill stress test and categorized as low (<6), moderate (6–9.9), or high (≥10). Adjusted hazard ratios for mortality were calculated using standard BMI (kilograms per meter squared) cutoffs of normal (18.5–24.9), overweight (25–29.9), and obese (≥30). Adjusted splines centered at 22.5 kg/m2 were used to examine BMI as a continuous variable. RESULTS Patients had a mean age of 58 ± 11 years (49% women) with 1,319 deaths over a mean follow-up of 10.0 ± 4.1 years. Overall, obese patients had a 30% lower mortality hazard (P < 0.001) compared with normal-weight patients. In adjusted spline modeling, higher BMI as a continuous variable was predominantly associated with a lower mortality risk in the lowest fitness group and among patients with moderate fitness and BMI ≥30 kg/m2. Compared with the lowest fitness group, patients with higher fitness had an ~50% (6–9.9 METs) and 70% (≥10 METs) lower mortality hazard regardless of BMI (P < 0.001). CONCLUSIONS Among patients with diabetes, the obesity paradox was less pronounced for patients with the highest fitness level, and these patients also had the lowest risk of mortality. Full Article
si Confirming the Bidirectional Nature of the Association Between Severe Hypoglycemic and Cardiovascular Events in Type 2 Diabetes: Insights From EXSCEL By care.diabetesjournals.org Published On :: 2020-02-20T11:55:30-08:00 OBJECTIVE We sought to confirm a bidirectional association between severe hypoglycemic events (SHEs) and cardiovascular (CV) event risk and to characterize individuals at dual risk. RESEARCH DESIGN AND METHODS In a post hoc analysis of 14,752 Exenatide Study of Cardiovascular Event Lowering (EXSCEL) participants, we examined time-dependent associations between SHEs and subsequent major adverse cardiac events (CV death, nonfatal myocardial infarction [MI] or stroke), fatal/nonfatal MI, fatal/nonfatal stroke, hospitalization for acute coronary syndrome (hACS), hospitalization for heart failure (hHF), and all-cause mortality (ACM), as well as time-dependent associations between nonfatal CV events and subsequent SHEs. RESULTS SHEs were uncommon and not associated with once-weekly exenatide therapy (hazard ratio 1.13 [95% CI 0.94–1.36], P = 0.179). In fully adjusted models, SHEs were associated with an increased risk of subsequent ACM (1.83 [1.38–2.42], P < 0.001), CV death (1.60 [1.11–2.30], P = 0.012), and hHF (2.09 [1.37–3.17], P = 0.001), while nonfatal MI (2.02 [1.35–3.01], P = 0.001), nonfatal stroke (2.30 [1.25–4.23], P = 0.007), hACS (2.00 [1.39–2.90], P < 0.001), and hHF (3.24 [1.98–5.30], P < 0.001) were all associated with a subsequent increased risk of SHEs. The elevated bidirectional time-dependent hazards linking SHEs and a composite of all CV events were approximately constant over time, with those individuals at dual risk showing higher comorbidity scores compared with those without. CONCLUSIONS These findings, showing greater risk of SHEs after CV events as well as greater risk of CV events after SHEs, validate a bidirectional relationship between CV events and SHEs in patients with high comorbidity scores. Full Article
si Effects of Bariatric Surgery in Early- and Adult-Onset Obesity in the Prospective Controlled Swedish Obese Subjects Study By care.diabetesjournals.org Published On :: 2020-03-20T11:50:34-07:00 OBJECTIVE Bariatric surgery is an effective treatment for obesity, but it is unknown if outcomes differ between adults with early- versus adult-onset obesity. We investigated how obesity status at 20 years of age affects outcomes after bariatric surgery later in life. RESEARCH DESIGN AND METHODS The Swedish Obese Subjects study is a prospective matched study performed at 25 surgical departments and 480 primary health care centers. Participants aged 37–60 years with BMI ≥34 kg/m2 (men) or ≥38 kg/m2 (women) were recruited between 1987 and 2001; 2,007 participants received bariatric surgery and 2,040 usual care. Self-reported body weight at 20 years of age was used to stratify patients into subgroups with normal BMI (<25 kg/m2), overweight (BMI 25–29.9 kg/m2), or obesity (BMI ≥30 kg/m2). Body weight, energy intake, and type 2 diabetes status were examined over 10 years, and incidence of cardiovascular and microvascular disease was determined over up to 26 years using data from health registers. RESULTS There were small but statistically significant differences in reduction of body weight among the subgroups after bariatric surgery (interaction P = 0.032), with the largest reductions among those with obesity aged 20 years. Bariatric surgery increased type 2 diabetes remission (odds ratios 4.51, 4.90, and 5.58 in subgroups with normal BMI, overweight, or obesity at 20 years of age, respectively; interaction P = 0.951), reduced type 2 diabetes incidence (odds ratios 0.15, 0.13, and 0.15, respectively; interaction P = 0.972), and reduced microvascular complications independent of obesity status at 20 years of age (interaction P = 0.650). The association between bariatric surgery and cardiovascular disease was similar in the subgroups (interaction P = 0.674). Surgical complications were similar in the subgroups. CONCLUSIONS The treatment benefits of bariatric surgery in adults are similar regardless of obesity status at 20 years of age. Full Article
si Autologous Umbilical Cord Blood Transfusion in Young Children With Type 1 Diabetes Fails to Preserve C-Peptide By care.diabetesjournals.org Published On :: 2011-11-21T22:32:39-08:00 OBJECTIVE We conducted an open-label, phase I study using autologous umbilical cord blood (UCB) infusion to ameliorate type 1 diabetes (T1D). Having previously reported on the first 15 patients reaching 1 year of follow-up, herein we report on the complete cohort after 2 years of follow-up. RESEARCH DESIGN AND METHODS A total of 24 T1D patients (median age 5.1 years) received a single intravenous infusion of autologous UCB cells and underwent metabolic and immunologic assessments. RESULTS No infusion-related adverse events were observed. β-Cell function declined after UCB infusion. Area under the curve C-peptide was 24.3% of baseline 1 year postinfusion (P < 0.001) and 2% of baseline 2 years after infusion (P < 0.001). Flow cytometry revealed increased regulatory T cells (Tregs) (P = 0.04) and naive Tregs (P = 0.001) 6 and 9 months after infusion, respectively. CONCLUSIONS Autologous UCB infusion in children with T1D is safe and induces changes in Treg frequency but fails to preserve C-peptide. Full Article
si Effectively Serving Immigrant and Dual Language Learner Families through Home Visiting Programs By www.migrationpolicy.org Published On :: Thu, 29 Aug 2019 12:01:27 -0400 Marking a policy brief's release, this webinar explores the promise of home visiting services that support new parents alongside their infants and toddlers, plus strategies for improving how these programs work with immigrant and linguistically diverse families. Full Article
si The Colombian Response to the Venezuelan Migration Crisis: A Dialogue with Colombia’s Migration Czar By www.migrationpolicy.org Published On :: Mon, 30 Sep 2019 19:29:42 -0400 Felipe Muñoz, Advisor to the President of Colombia for the Colombian-Venezuelan Border, discusses how Colombia is coping with the influx of Venezuelan migrants, plans for future policy decisions surrounding this migration, and developments in regional and international cooperation. Full Article
si Respuestas latinoamericanas a las crisis migratorias venezolanas y nicaragüenses By www.migrationpolicy.org Published On :: Mon, 04 Nov 2019 08:58:25 -0500 Responsables de políticos principales y partes interesadas de América Latina, así como representantes de instituciones internacionales claves, ofrecen sus puntos de vista sobre los desafíos futuros mientras gobiernos latinoamericanos buscan establecer las estrategias para responder a flujos migratorios forzados a gran escala, como los de Venezuela y Nicaragua. Full Article
si Turning the Tide: Addressing the Long-Term Challenges of EU Mobility for Sending Countries By www.migrationpolicy.org Published On :: Thu, 05 Dec 2019 15:26:24 -0500 Amid ongoing debates about the costs and benefits of free movement, this MPI webinar examines evidence from the EU-funded REMINDER project on different types of East-West mobility. Speakers examine big-picture trends of East-West migration; consider possible policy responses at regional, national, and EU levels to alleviate some of the challenges; and reflect on realistic actions that could be taken under a new European Commission. Full Article
si Is the Door Closing? Latin American and Caribbean Responses to Venezuelan Migration By www.migrationpolicy.org Published On :: Thu, 13 Feb 2020 11:40:37 -0500 Fleeing crisis, nearly 4 million Venezuelans have moved to other Latin American and Caribbean countries over the past few years. This webinar marked the launch of a Latin American and Caribbean Migration Portal, and a report examining the migration and integration policy responses in the region. Full Article
si Mental Health Risks and Resilience among Somali and Bhutanese Refugee Parents By www.migrationpolicy.org Published On :: Wed, 26 Oct 2016 10:00:06 -0400 Somali and Bhutanese refugees are two of the largest groups recently resettled in the United States and Canada. This report examines factors that might promote or undermine the mental health and overall well-being of children of these refugees, with regard to factors such as past exposure to trauma, parental mental health, educational attainment, social support, and discrimination. Full Article
si In the Age of Trump: Populist Backlash and Progressive Resistance Create Divergent State Immigrant Integration Contexts By www.migrationpolicy.org Published On :: Wed, 17 Jan 2018 10:26:51 -0500 As long-simmering passions related to federal immigration policies have come to a full boil, less noted but no less important debates are taking place at state and local levels with regards to policies affecting immigrants and their children. As states are increasingly diverging in their responses, this report examines how some of the key policies and programs that support long-term integration success are faring in this volatile era. Full Article