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Standards of Medical Care in Diabetes--2016 Abridged for Primary Care Providers

American Diabetes Association
Jan 1, 2016; 34:3-21
Position Statements




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Standards of Medical Care in Diabetes--2018 Abridged for Primary Care Providers

American Diabetes Association
Jan 1, 2018; 36:14-37
Position Statements




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Standards of Medical Care in Diabetes--2017 Abridged for Primary Care Providers

American Diabetes Association
Jan 1, 2017; 35:5-26
Position Statements




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Standards of Medical Care in Diabetes--2015 Abridged for Primary Care Providers

American Diabetes Association
Apr 1, 2015; 33:97-111
Position Statements




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Jabberwocky. Or: Grand Unified Theory of Uncertainty???


Jabberwocky, Lewis Carroll's whimsical nonsense poem, uses made-up words to create an atmosphere and to tell a story. "Billig", "frumious", "vorpal" and "uffish" have no lexical meaning, but they could have. The poem demonstrates that the realm of imagination exceeds the bounds of reality just as the set of possible words and meanings exceeds its real lexical counterpart.

Uncertainty thrives in the realm of imagination, incongruity, and contradiction. Uncertainty falls in the realm of science fiction as much as in the realm of science. People have struggled with uncertainty for ages and many theories of uncertainty have appeared over time. How many uncertainty theories do we need? Lots, and forever. Would we say that of physics? No, at least not forever.

Can you think inconsistent, incoherent, or erroneous thoughts? I can. (I do it quite often, usually without noticing.) For those unaccustomed to thinking incongruous thoughts, and who need a bit of help to get started, I can recommend thinking of "two meanings packed into one word like a portmanteau," like 'fuming' and 'furious' to get 'frumious' or 'snake' and 'shark' to get 'snark'.

Portmanteau words are a start. Our task now is portmanteau thoughts. Take for instance the idea of a 'thingk':

When I think a thing I've thought,
I have often felt I ought
To call this thing I think a "Thingk",
Which ought to save a lot of ink.

The participle is written "thingking",
(Which is where we save on inking,)
Because "thingking" says in just one word:
"Thinking of a thought thing." Absurd!

All this shows high-power abstraction.
(That highly touted human contraption.)
Using symbols with subtle feint,
To stand for something which they ain't.

Now that wasn't difficult: two thoughts at once. Now let those thoughts be contradictory. To use a prosaic example: thinking the unthinkable, which I suppose is 'unthingkable'. There! You did it. You are on your way to a rich and full life of thinking incongruities, fallacies and contradictions. We can hold in our minds thoughts of 4-sided triangles, parallel lines that intersect, and endless other seeming impossibilities from super-girls like Pippi Longstockings to life on Mars (some of which may actually be true, or at least possible).

Scientists, logicians, and saints are in the business of dispelling all such incongruities, errors and contradictions. Banishing inconsistency is possible in science because (or if) there is only one coherent world. Belief in one coherent world and one grand unified theory is the modern secular version of the ancient monotheistic intuition of one universal God (in which saints tend to believe). Uncertainty thrives in the realm in which scientists and saints have not yet completed their tasks (perhaps because they are incompletable). For instance, we must entertain a wide range of conflicting conceptions when we do not yet know how (or whether) quantum mechanics can be reconciled with general relativity, or Pippi's strength reconciled with the limitations of physiology. As Henry Adams wrote:

"Images are not arguments, rarely even lead to proof, but the mind craves them, and, of late more than ever, the keenest experimenters find twenty images better than one, especially if contradictory; since the human mind has already learned to deal in contradictions."

The very idea of a rigorously logical theory of uncertainty is startling and implausible because the realm of the uncertain is inherently incoherent and contradictory. Indeed, the first uncertainty theory - probability - emerged many centuries after the invention of the axiomatic method in mathematics. Today we have many theories of uncertainty: probability, imprecise probability, information theory, generalized information theory, fuzzy logic, Dempster-Shafer theory, info-gap theory, and more (the list is a bit uncertain). Why such a long and diverse list? It seems that in constructing a logically consistent theory of the logically inconsistent domain of uncertainty, one cannot capture the whole beast all at once (though I'm uncertain about this).

A theory, in order to be scientific, must exclude something. A scientific theory makes statements such as "This happens; that doesn't happen." Karl Popper explained that a scientific theory must contain statements that are at risk of being wrong, statements that could be falsified. Deborah Mayo demonstrated how science grows by discovering and recovering from error.

The realm of uncertainty contains contradictions (ostensible or real) such as the pair of statements: "Nine year old girls can lift horses" and "Muscle fiber generates tension through the action of actin and myosin cross-bridge cycling". A logically consistent theory of uncertainty can handle improbabilities, as can scientific theories like quantum mechanics. But a logical theory cannot encompass outright contradictions. Science investigates a domain: the natural and physical worlds. Those worlds, by virtue of their existence, are perhaps coherent in a way that can be reflected in a unified logical theory. Theories of uncertainty are directed at a larger domain: the natural and physical worlds and all imaginable (and unimaginable) other worlds. That larger domain is definitely not coherent, and a unified logical theory would seem to be unattainable. Hence many theories of uncertainty are needed.

Scientific theories are good to have, and we do well to encourage the scientists. But it is a mistake to think that the scientific paradigm is suitable to all domains, in particular, to the study of uncertainty. Logic is a powerful tool and the axiomatic method assures the logical consistency of a theory. For instance, Leonard Savage argued that personal probability is a "code of consistency" for choosing one's behavior. Jim March compares the rigorous logic of mathematical theories of decision to strict religious morality. Consistency between values and actions is commendable says March, but he notes that one sometimes needs to deviate from perfect morality. While "[s]tandard notions of intelligent choice are theories of strict morality ... saints are a luxury to be encouraged only in small numbers." Logical consistency is a merit of any single theory, including a theory of uncertainty. However, insisting that the same logical consistency apply over the entire domain of uncertainty is like asking reality and saintliness to make peace.




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Accidental Education


"He had to take that life as he best could, 
with such accidental education as luck had given him". 

I am a university professor. Universities facilitate efficient and systematic learning, so I teach classes, design courses, and develop curricula. Universities have tremendously benefitted technology, the economy, health, cultural richness and awareness, and many other "goods".

Nonetheless, some important lessons are learned strictly by accident. Moreover, without accidental surprises, education would be a bit dry, sometimes even sterile. As Adams wrote: "The chief wonder of education is that it does not ruin everybody concerned in it, teachers and taught."

An example. I chose my undergraduate college because of their program in anthropology. When I got there I took a chemistry course in my first semester. I was enchanted, by the prof as much as by the subject. I majored in chemistry and never went near the anthro department. If that prof had been on sabbatical I might have ended up an anthropologist.

Universities promote lifelong learning. College is little more than a six-pack of knowledge, a smattering of understanding and a wisp of wisdom. But lifelong learning doesn't only mean "come back to grad school". It means perceiving those rarities and strangenesses that others don't notice. Apples must have fallen on lots of peoples' heads before some clever fellow said "Hmmm, what's going on here?".

Accidental education is much more than keeping your eyes and mind open (though that is essential). To understand the deepest importance of accidental education we need to enlist two concepts: the boundlessness of the unknown, and human free will. We will then understand that accidental education feeds the potential for uniqueness of the individual.

As we have explained elsewhere, in discussing grand unified theories and imagination, the unknown is richer and stranger - and more contradictory - than the single physical reality that we actually face. The unknown is the realm of all possible as well as impossible worlds. It is the domain in which our dreams and speculations wander. It may be frightening or heartening, but taken as a whole it is incoherent, contradictory and endlessly amazing, variable and stimulating.

We learn about the unknown in part by speculating, wondering, and dreaming (awake and asleep). Imagining the impossible is very educational. For instance, most things are impossible for children (from tying their shoes to running the country), but they must be encouraged to imagine that they can or will be able to do them. Adults also can re-make themselves in line with their dreams. We are free and able to imagine ourselves and the world in endless new and different ways. Newton's apple brought to his mind a picture of the universe unlike any that had been imagined before. Surprises, like dreams, can free us from the mundane. Cynics sometimes sneer at personal or collective myths and musings, but the ability to re-invent ourselves is the essence of humanity. The children of Israel imagined at Sinai that the covenant was given directly to them all - men, women and children equally - with no royal or priestly intermediary. This launched the concept and the possibility of political equality.

The Israelites had no map of the desert because the promised land that they sought was first of all an idea. Only after re-inventing themselves as a free people created equal in the image of God, and not slaves, only after finding a collective identity and mission, only then could they enter the land of Canaan. Theirs wanderings were random and their discoveries were accidental, but their formative value is with us to this day. No map or curriculum can organize one's wandering in the land of imagination. Unexpected events happen in the real world, but they stimulate our imagination of the infinity of other possible worlds. Our most important education is the accidental stumbling on new thoughts that feed our potential for innovation and uniqueness. For the receptive mind, accidental education can be the most sublime.




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We're Just Getting Started: A Glimpse at the History of Uncertainty


We've had our cerebral cortex for several tens of thousands of years. We've lived in more or less sedentary settlements and produced excess food for 7 or 8 thousand years. We've written down our thoughts for roughly 5 thousand years. And Science? The ancient Greeks had some, but science and its systematic application are overwhelmingly a European invention of the past 500 years. We can be proud of our accomplishments (quantum theory, polio vaccine, powered machines), and we should worry about our destructive capabilities (atomic, biological and chemical weapons). But it is quite plausible, as Koestler suggests, that we've only just begun to discover our cerebral capabilities. It is more than just plausible that the mysteries of the universe are still largely hidden from us. As evidence, consider the fact that the main theories of physics - general relativity, quantum mechanics, statistical mechanics, thermodynamics - are still not unified. And it goes without say that the consilient unity of science is still far from us.

What holds for science in general, holds also for the study of uncertainty. The ancient Greeks invented the axiomatic method and used it in the study of mathematics. Some medieval thinkers explored the mathematics of uncertainty, but it wasn't until around 1600 that serious thought was directed to the systematic study of uncertainty, and statistics as a separate and mature discipline emerged only in the 19th century. The 20th century saw a florescence of uncertainty models. Lukaczewicz discovered 3-valued logic in 1917, and in 1965 Zadeh introduced his work on fuzzy logic. In between, Wald formulated a modern version of min-max in 1945. A plethora of other theories, including P-boxes, lower previsions, Dempster-Shafer theory, generalized information theory and info-gap theory all suggest that the study of uncertainty will continue to grow and diversify.

In short, we have learned many facts and begun to understand our world and its uncertainties, but the disputes and open questions are still rampant and the yet-unformulated questions are endless. This means that innovations, discoveries, inventions, surprises, errors, and misunderstandings are to be expected in the study or management of uncertainty. We are just getting started. 




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Why We Need Libraries, Or, Memory and Knowledge


"Writing is thinking in slow motion. We see what at normal speeds escapes us, can rerun the reel at will to look for errors, erase, interpolate, and rethink. Most thoughts are a light rain, fall upon the ground, and dry up. Occasionally they become a stream that runs a short distance before it disappears. Writing stands an incomparably better chance of getting somewhere.

"... What is written can be given endlessly and yet retained, read by thousands even while it is being rewritten, kept as it was and revised at the same time. Writing is magic." 
Walter Kaufmann

We are able to know things because they happen again and again. We know about the sun because it glares down on us day after day. Scientists learn the laws of nature, and build confidence in their knowledge, by testing their theories over and over and getting the same results each time. We would be unable to learn the patterns and ways of our world if nothing were repeatable.

But without memory, we could learn nothing even if the world were tediously repetitive. Even though the sun rises daily in the east, we could not know this if we couldn't remember it.

The world has stable patterns, and we are able to discover these patterns because we remember. Knowledge requires more than memory, but memory is an essential element.

The invention of writing was a great boon to knowledge because writing is collective memory. For instance, the Peloponnesian wars are known to us through Thucydides' writings. People understand themselves and their societies in part through knowing their history. History, as distinct from pre-history, depends on the written word. For example, each year at the Passover holiday, Jewish families through the ages have read the story of the Israelite exodus from Egypt. We are enjoined to see ourselves as though we were there, fleeing Egypt and trudging through the desert. Memory, recorded for all time, creates individual and collective awareness, and motivates aspirations and actions.

Without writing, much collective memory would be lost, just as books themselves are sometimes lost. We know, for instance, that Euclid wrote a book called Porisms, but the book is lost and we know next to nothing about its message. Memory, and knowledge, have been lost.

Memory can be uncertain. We've all experienced that on the personal level. Collective memory can also be uncertain. We're sometimes uncertain of the meaning of rare ancient words, such as lilit in Isaiah (34:14) or gvina in Job (10:10). Written traditions, while containing an element of truth, may be of uncertain meaning or veracity. For instance, we know a good deal, both from the Bible and from archeological findings, about Hezekiah who ruled the kingdom of Judea in the late 8th century BCE. About David, three centuries earlier, we can be much less certain. Biblical stories are told in great detail but corroboration is hard to obtain.

Memory can be deliberately corrupted. Records of history can be embellished or prettified, as when a king commissions the chronicling of his achievements. Ancient monuments glorifying imperial conquests are invaluable sources of knowledge of past ages, but they are unreliable and must be interpreted cautiously. Records of purported events that never occurred can be maliciously fabricated. For instance, The Protocols of the Elders of Zion is pure invention, though that book has been re-published voluminously throughout the world and continues to be taken seriously by many people. Memory is alive and very real, even if it is memory of things that never happened.

Libraries are the physical medium of human collective memory, and an essential element in maintaining and enlarging our knowledge. There are many types of libraries. The family library may have a few hundred books, while the library of Congress has 1,349 km of bookshelves and holds about 147 million items. Libraries can hold paper books or digital electronic documents. Paper can perish in fire as happened to the Alexandrian library, while digital media can be erased, or become damaged and unreadable. Libraries, like memory itself, are fragile and need care.

Why do we need libraries? Being human means, among other things, the capacity for knowledge, and the ability to appreciate and benefit from it. The written record is a public good, like the fresh air. I can read Confucius or Isaiah centuries after they lived, and my reading does not consume them. Our collective memory is part of each individual, and preserving that memory preserves a part of each of us. Without memory, we are without knowledge. Without knowledge, we are only another animal.








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New History of Psychiatry: Melancholy, Madness, Chinese Psychiatry, Psychedelic Therapy, and More

The June 2020 issue of History of Psychiatry is now online. Full details follow below: “Wild melancholy. On the historical plausibility of a black bile theory of blood madness, or hæmatomania,” Jan Verplaetse. Abstract: Nineteenth-century art historian John Addington Symonds coined the term hæmatomania (blood madness) for the extremely bloodthirsty behaviour of a number of … Continue reading New History of Psychiatry: Melancholy, Madness, Chinese Psychiatry, Psychedelic Therapy, and More




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New JHBS: Mind-Body Medicine Before Freud, Psychology and Biography, Jung and Einstein

The Spring 2020 issue of the Journal of the History of the Behavioral Sciences is now online. Full details about contributions to this issue follow below. “Practicing mind-body medicine before Freud: John G. Gehring, the “Wizard of the Androscoggin”” by. Ben Harris and Courtney J. Stevens. Abstract: This article describes the psychotherapy practice of physician … Continue reading New JHBS: Mind-Body Medicine Before Freud, Psychology and Biography, Jung and Einstein




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This Essential Mineral Linked To COVID-19 Recovery

An essential mineral in the body have been linked to recovery of COVID-19 patients.

Support PsyBlog for just $5 per month. Enables access to articles marked (M) and removes ads.

→ Explore PsyBlog's ebooks, all written by Dr Jeremy Dean:




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How Technology Is Improving Safety On the Roads and Reducing Driving Anxiety

Technology has changed a number of aspects of our everyday lives and has led to increased efficiency. But when it comes to driving, has it helped or hindered the process? In this article, we will be looking into some of the ways that technology has improved safety on our roads in the last 10 years. […]




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Is Addiction Hereditary?

Addiction is a major health problem, both mentally and physically. In fact, it is probably one of the most complicated illnesses to deal with because it is has to be dealt with on both a physical and psychological level. Approximately one in eight adults struggle with drug and alcohol addiction at the same time and […]




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Does Insurance Cover Therapy Costs in the United States?

Although mental health is just as important as physical health in promoting overall well-being, many insurance companies in the past did not agree with that viewpoint. This is shown by the fact that, for many years,  a large percentage of insurers provided better insurance coverage for physical issues than mental health issues. However, in 2008, […]




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Where is behavioral economics headed in the world of marketing?

The Nudge blog sat down (electronically) with John Kenny, Senior Vice President of Strategic Planning in Draftfcb’s Chicago office, to explore whether behavioral economics is just a fad in marketing or a legitimate tool to help the industry perform better. Starting with the Institute of Decision Making, Draftfcb has been one of the leaders in [...]




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does resurge work : Resurge weight reduction supplement is a...



does resurge work : Resurge weight reduction supplement is a distinct advantage program that would bolster your ascent to control. It will change you and make you more grounded than at any other time with improved wellbeing that can assist you with getting away from heftiness. This Resurge audit tells how the Supplement will help your lack of sleep and weight reduction cause. Improved digestion change will enable the body to acquire vitality.




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How Do You Help a Partner Who is Depressed? Advice From a Sex Therapist

Depression is one of the most common mental health issues in the United States. In fact, according to the National Institutes of Mental Health, 1 in 14 Americans experienced an episode of major depression in the last year alone. Given the circumstances surrounding the current COVID-19 coronavirus pandemic, many in the mental health community predict that the number will be even higher this year because these circumstances are creating a “perfect storm” of depression risks. The widespread prevalence of depression has a lot of implications for our lives, even if we don’t personally have depression ourselves. Many of us will have loved ones, such as a romantic partner, who develops depression at some point. In these situations, it’s common for people to wonder how they can help their partner most effectively. So what should they do?




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5 Common Myths About Sexually Transmitted Infections

April is STD Awareness Month, so let’s take a little time to set the record straight on some popular myths about sexually transmitted infections and diseases. In this post, we’ll explore five of the most common misconceptions.




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Have You Reached Out to or Heard From an Ex During the Pandemic? You're Not Alone

Anecdotally, I’ve heard from a lot of people who have said that they reached out to (or heard from) and ex-partner since the COVID-19 coronavirus pandemic began. But just how many people have done so? And what motivated them to reconnect? Some of my colleagues and I at The Kinsey Institute are currently in the midst of researching how this pandemic is affecting people’s intimate lives (click here if you’d like to participate and learn more about the study), and our preliminary data suggest that reaching out to an ex isn’t a rare occurrence.




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Without farmers, you'd be hungry, naked and sober | Eric Sannerud

Farmers keep us fed and our economies stable, but in the US they're retiring faster than they're being replaced. Take a crash course in agricultural policy with Eric Sannerud to see why this problem can't be solved by simply buying from your local farmer's market -- and learn how you can use your vote to create a better future for farmers.




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Indigenous knowledge meets science to solve climate change | Hindou Oumarou Ibrahim

To tackle a problem as large as climate change, we need both science and Indigenous wisdom, says environmental activist Hindou Oumarou Ibrahim. In this engaging talk, she shares how her nomadic community in Chad is working closely with scientists to restore endangered ecosystems -- and offers lessons on how to create more resilient communities.




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It's OK to feel overwhelmed. Here's what to do next | Elizabeth Gilbert

If you're feeling anxious or fearful during the coronavirus pandemic, you're not alone. Offering hope and understanding, author Elizabeth Gilbert reflects on how to stay present, accept grief when it comes and trust in the strength of the human spirit. "Resilience is our shared genetic inheritance," she says. (This virtual conversation is part of the TED Connects series, hosted by head of TED Chris Anderson and head of curation Helen Walters. Recorded April 2, 2020)




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How the coronavirus is impacting India -- and what needs to happen next | Gayathri Vasudevan

The coronavirus pandemic put India's population of 1.3 billion into an extreme and sudden lockdown. Social entrepreneur Gayathri Vasudevan explains how the situation is impacting the country's migrant workers, who are stuck far from home with limited access to food and shelter, and calls for an overhaul of India's social infrastructure in order to get people the essentials they need right now. (This virtual conversation is part of the TED Connects series, hosted by current affairs curator Whitney Pennington Rodgers. Recorded April 9, 2020)




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How the coronavirus pandemic is changing the world | Fareed Zakaria

The coronavirus pandemic is more global, dramatic and unusual than any crisis we've seen in a long time, says journalist Fareed Zakaria. Listen as he shares his perspective on how we can recover from the economic fallout, why certain countries were able to avoid major outbreaks and what this might mean for the balance of global power. (This virtual conversation is part of the TED Connects series, hosted by head of TED Chris Anderson and current affairs curator Whitney Pennington Rodgers. Recorded April 9, 2020)




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The wonders of the molecular world, animated | Janet Iwasa

Some biological structures are so small that scientists can't see them with even the most powerful microscopes. That's where molecular animator and TED Fellow Janet Iwasa gets creative. Explore vast, unseen molecular worlds as she shares mesmerizing animations that imagine how they might work.




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The cost of work stress -- and how to reduce it | Rob Cooke

By some estimates, work-related stress drains the US economy of nearly 300 billion dollars a year -- and it can hurt your productivity and personal health too, says wellness advocate Rob Cooke. He shares some strategies to help put your mental, physical and emotional well-being back at the forefront.




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How face surveillance threatens your privacy and freedom | Kade Crockford

Privacy isn't dead, but face surveillance technology might kill it, says civil rights advocate Kade Crockford. In an eye-opening talk, Kade outlines the startling reasons why this invasive technology -- powered by often-flawed facial recognition databases that track people without their knowledge -- poses unprecedented threats to your fundamental rights. Learn what can be done to ban government use before it's too late.




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How American and Chinese values shaped the coronavirus response | Huang Hung

To combat COVID-19, countries have enforced city-wide shutdowns, stay-at-home orders and mask mandates -- but the reaction (and adherence) to these rules has differed markedly in the East and West. In conversation with TED's head of curation Helen Walters, writer and publisher Huang Hung sheds light on how Chinese and American cultural values shaped their responses to the outbreak -- and provides perspective on why everyone needs to come together to end the pandemic. (Recorded April 16, 2020)




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57th Edwards Bayesian Research Conference, Feb 27-29, 2020, Fullerton, CA

SUBMISSION DEADLINE DECEMBER 13, 2019 In this conference, investigators present original research on a variety of topics related to judgment and decision making, including but not limited to: Decision making under risk, uncertainty, and ambiguity Intertemporal choice Cognitive models of judgment and decision making Mathematical and statistical methodology for analyzing behavioral data Applications of JDM […]

The post 57th Edwards Bayesian Research Conference, Feb 27-29, 2020, Fullerton, CA appeared first on Decision Science News.






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How Massachusetts Is Building Capacity of Educator-Preparation Programs

Research findings on the implementation of a new teacher candidate performance assessment in Massachusetts inform the development of additional supports for educator preparation programs.




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Educational Opportunities and Performance in Massachusetts

This Quality Counts 2019 Highlights Report captures all the data you need to assess your state's performance on key educational outcomes.




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Briefly Stated: Stories You May Have Missed

A collection of short news stories from this week.




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Deval Patrick, Obama Education Ally, Announces Presidential Run

A businessman, Patrick served two terms as governor of Massachusetts and has credited education with his own dramatic rise to success.




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Educational Opportunities and Performance in Massachusetts

This Quality Counts 2020 Highlights Report captures all the data you need to assess your state's performance on key educational outcomes.




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Schools Struggle to Meet Students' Mounting Mental-Health Needs

Keeping up with students’ growing mental-health needs was a concern for districts long before the pandemic began. It’s even harder now, educators and psychologists say.




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Massachusetts schools to stay closed; virus deaths hit 1,961




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Schools in Massachusetts to Remain Closed for Rest of Year

School buildings in Massachusetts will remain closed through the end of the academic year, but remote learning will continue, Gov. Charlie Baker announced Tuesday.




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Educational Opportunities and Performance in North Carolina

This Quality Counts 2020 Highlights Report captures all the data you need to assess your state's performance on key educational outcomes.




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Hidden Segregation Within Schools Is Tracked in New Study

When schools reduce racial segregation between schools, racial isolation within the classes inside those schools goes up, according to an analysis of 20 years of North Carolina data.




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The Latest in a Season of Protests: N.C. Teachers Will Rally on Wednesday

Thousands of teachers will head to the state capital on Wednesday to call for a nearly $10,000 raise over four years and an increase to per-pupil spending.




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Educators Who Ran for Office Share Their Lessons Learned (Video)

Watch a discussion between three educators who ran for their state legislatures about their experiences on the campaign trail.




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A RedForEd Wave: Teachers in North and South Carolina Leave Classrooms in Protest

A sea of red swept the capitals of North and South Carolina on Wednesday, as thousands of teachers turned out to demand higher pay and more school funding.




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North Carolina public schools closed for rest of school year




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Federal Watchdog Finds Risk of Head Start Fraud, Ranking Republican Seeks Hearing

Officials have not done enough to prevent fraud in Head Start programs, the GAO said. The findings prompted Rep. Virginia Foxx, R-N.C., the ranking member of the House education and labor committee, to call for a hearing on the federally funded preschool program for low-income children.