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CASSAVA LEAVES AND UGALI

Cassava leaves and Ugali - a traditional Congolese dish ... and much, much more. Gigi Mapatano




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Sam Gowing's Kiwi fruit & chia breakfast trifle

This is a perfect breakfast on-the-go! Rich in omega-3 and omega-6, the chia balls absorb water and become jelly-like. You can make this a few days head and store it in the fridge.




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How to cook a leatherjacket

This method is moist and magic! Throw out every notion you might have had about leatherjackets being anything other than juicy and flavoursome. This little trick cooks the fish from within. Usually salt draws but in this case its responsible for keeping every bit of moisture in the fish. Leatherjacket is an inexpensive fish, the presentation is great, and you'll bowl over your dinner guests every time. What's not to love?




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Spring cleansing beetroot and pomegranate salad

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!




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Welcome Wears Thin for Colombians in Ecuador as Venezuelans Become More Visible

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.




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Is the Door Closing? Latin American and Caribbean Responses to Venezuelan Migration

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.




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An Uneven Welcome: Latin American and Caribbean Responses to Venezuelan and Nicaraguan Migration

Large-scale displacement from Venezuela and Nicaragua is reshaping the migration landscape in much of Latin America and the Caribbean. This report, accompanied by the launch of a new Migration Portal offering research and analysis on the region, examines the immigration and integration policy responses of 11 countries, including pathways to legal status and measures to integrate newcomers into schools, health-care systems, and labor markets.




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COVID-19 in Latin America: Tackling Health Care & Other Impacts for Vulnerable Migrant Populations

This MPI webinar brought together public health and migration experts to analyze the impact that COVID-19 preventative measures will have on vulnerable immigrants and refugees in Latin America, with a particular look at Colombia as a case study. Speakers also discussed how policymakers and international organizations can include migrant populations in their emergency response plans.




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Ponting takes aim at 'underdone' Proteas

Ricky Ponting believes South Africa could suffer from a lack of first-class preparation in the opening Test in Cape Town on Wednesday.




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Microvascular and Cardiovascular Outcomes According to Renal Function in Patients Treated With Once-Weekly Exenatide: Insights From the EXSCEL Trial

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.




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Glycated Hemoglobin, Prediabetes, and the Links to Cardiovascular Disease: Data From UK Biobank

OBJECTIVE

HbA1c levels are increasingly measured in screening for diabetes; we investigated whether HbA1c may simultaneously improve cardiovascular disease (CVD) risk assessment, using QRISK3, American College of Cardiology/American Heart Association (ACC/AHA), and Systematic COronary Risk Evaluation (SCORE) scoring systems.

RESEARCH DESIGN AND METHODS

UK Biobank participants without baseline CVD or known diabetes (n = 357,833) were included. Associations of HbA1c with CVD was assessed using Cox models adjusting for classical risk factors. Predictive utility was determined by the C-index and net reclassification index (NRI). A separate analysis was conducted in 16,596 participants with known baseline diabetes.

RESULTS

Incident fatal or nonfatal CVD, as defined in the QRISK3 prediction model, occurred in 12,877 participants over 8.9 years. Of participants, 3.3% (n = 11,665) had prediabetes (42.0–47.9 mmol/mol [6.0–6.4%]) and 0.7% (n = 2,573) had undiagnosed diabetes (≥48.0 mmol/mol [≥6.5%]). In unadjusted models, compared with the reference group (<42.0 mmol/mol [<6.0%]), those with prediabetes and undiagnosed diabetes were at higher CVD risk: hazard ratio (HR) 1.83 (95% CI 1.69–1.97) and 2.26 (95% CI 1.96–2.60), respectively. After adjustment for classical risk factors, these attenuated to HR 1.11 (95% CI 1.03–1.20) and 1.20 (1.04–1.38), respectively. Adding HbA1c to the QRISK3 CVD risk prediction model (C-index 0.7392) yielded a small improvement in discrimination (C-index increase of 0.0004 [95% CI 0.0001–0.0007]). The NRI showed no improvement. Results were similar for models based on the ACC/AHA and SCORE risk models.

CONCLUSIONS

The near twofold higher unadjusted risk for CVD in people with prediabetes is driven mainly by abnormal levels of conventional CVD risk factors. While HbA1c adds minimally to cardiovascular risk prediction, those with prediabetes should have their conventional cardiovascular risk factors appropriately measured and managed.




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Visit-to-Visit HbA1c Variability Is Associated With Cardiovascular Disease and Microvascular Complications in Patients With Newly Diagnosed Type 2 Diabetes

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.




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Genetic Susceptibility Determines {beta}-Cell Function and Fasting Glycemia Trajectories Throughout Childhood: A 12-Year Cohort Study (EarlyBird 76)

OBJECTIVE

Previous studies suggested that childhood prediabetes may develop prior to obesity and be associated with relative insulin deficiency. We proposed that the insulin-deficient phenotype is genetically determined and tested this hypothesis by longitudinal modeling of insulin and glucose traits with diabetes risk genotypes in the EarlyBird cohort.

RESEARCH DESIGN AND METHODS

EarlyBird is a nonintervention prospective cohort study that recruited 307 healthy U.K. children at 5 years of age and followed them throughout childhood. We genotyped 121 single nucleotide polymorphisms (SNPs) previously associated with diabetes risk, identified in the adult population. Association of SNPs with fasting insulin and glucose and HOMA indices of insulin resistance and β-cell function, available from 5 to 16 years of age, were tested. Association analysis with hormones was performed on selected SNPs.

RESULTS

Several candidate loci influenced the course of glycemic and insulin traits, including rs780094 (GCKR), rs4457053 (ZBED3), rs11257655 (CDC123), rs12779790 (CDC123 and CAMK1D), rs1111875 (HHEX), rs7178572 (HMG20A), rs9787485 (NRG3), and rs1535500 (KCNK16). Some of these SNPs interacted with age, the growth hormone–IGF-1 axis, and adrenal and sex steroid activity.

CONCLUSIONS

The findings that genetic markers influence both elevated and average courses of glycemic traits and β-cell function in children during puberty independently of BMI are a significant step toward early identification of children at risk for diabetes. These findings build on our previous observations that pancreatic β-cell defects predate insulin resistance in the onset of prediabetes. Understanding the mechanisms of interactions among genetic factors, puberty, and weight gain would allow the development of new and earlier disease-management strategies in children.




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Impact of Glucose Level on Micro- and Macrovascular Disease in the General Population: A Mendelian Randomization Study

OBJECTIVE

To evaluate whether high glucose levels in the normoglycemic range and higher have a causal genetic effect on risk of retinopathy, neuropathy, nephropathy, chronic kidney disease (CKD), peripheral arterial disease (PAD), and myocardial infarction (MI; positive control) in the general population.

RESEARCH DESIGN AND METHODS

This study applied observational and one-sample Mendelian randomization (MR) analyses to individual-level data from 117,193 Danish individuals, and validation by two-sample MR analyses on summary-level data from 133,010 individuals from the Meta-Analyses of Glucose and Insulin-Related Traits Consortium (MAGIC), 117,165 from the CKDGen Consortium, and 452,264 from the UK Biobank.

RESULTS

Observationally, glucose levels in the normoglycemic range and higher were associated with high risks of retinopathy, neuropathy, diabetic nephropathy, PAD, and MI (all P for trend <0.001). In genetic causal analyses, the risk ratio for a 1 mmol/L higher glucose level was 2.01 (95% CI 1.18–3.41) for retinopathy, 2.15 (1.38–3.35) for neuropathy, 1.58 (1.04–2.40) for diabetic nephropathy, 0.97 (0.84–1.12) for estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2, 1.19 (0.90–1.58) for PAD, and 1.49 (1.02–2.17) for MI. Summary-level data from the MAGIC, the CKDGen Consortium, and the UK Biobank gave a genetic risk ratio of 4.55 (95% CI 2.26–9.15) for retinopathy, 1.48 (0.83–2.66) for peripheral neuropathy, 0.98 (0.94–1.01) for eGFR <60 mL/min/1.73 m2, and 1.23 (0.57–2.67) for PAD per 1 mmol/L higher glucose level.

CONCLUSIONS

Glucose levels in the normoglycemic range and higher were prospectively associated with a high risk of retinopathy, neuropathy, diabetic nephropathy, eGFR <60 mL/min/1.73 m2, PAD, and MI. These associations were confirmed in genetic causal analyses for retinopathy, neuropathy, diabetic nephropathy, and MI, but they could not be confirmed for PAD and seemed to be refuted for eGFR <60 mL/min/1.73 m2.




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Effects of Bariatric Surgery in Early- and Adult-Onset Obesity in the Prospective Controlled Swedish Obese Subjects Study

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.




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Predicting 10-Year Risk of End-Organ Complications of Type 2 Diabetes With and Without Metabolic Surgery: A Machine Learning Approach

OBJECTIVE

To construct and internally validate prediction models to estimate the risk of long-term end-organ complications and mortality in patients with type 2 diabetes and obesity that can be used to inform treatment decisions for patients and practitioners who are considering metabolic surgery.

RESEARCH DESIGN AND METHODS

A total of 2,287 patients with type 2 diabetes who underwent metabolic surgery between 1998 and 2017 in the Cleveland Clinic Health System were propensity-matched 1:5 to 11,435 nonsurgical patients with BMI ≥30 kg/m2 and type 2 diabetes who received usual care with follow-up through December 2018. Multivariable time-to-event regression and random forest machine learning models were built and internally validated using fivefold cross-validation to predict the 10-year risk for four outcomes of interest. The prediction models were programmed to construct user-friendly web-based and smartphone applications of Individualized Diabetes Complications (IDC) Risk Scores for clinical use.

RESULTS

The prediction tools demonstrated the following discrimination ability based on the area under the receiver operating characteristic curve (1 = perfect discrimination and 0.5 = chance) at 10 years in the surgical and nonsurgical groups, respectively: all-cause mortality (0.79 and 0.81), coronary artery events (0.66 and 0.67), heart failure (0.73 and 0.75), and nephropathy (0.73 and 0.76). When a patient’s data are entered into the IDC application, it estimates the individualized 10-year morbidity and mortality risks with and without undergoing metabolic surgery.

CONCLUSIONS

The IDC Risk Scores can provide personalized evidence-based risk information for patients with type 2 diabetes and obesity about future cardiovascular outcomes and mortality with and without metabolic surgery based on their current status of obesity, diabetes, and related cardiometabolic conditions.




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Coronary Artery Disease and Type 2 Diabetes: A Proteomic Study

OBJECTIVE

Coronary artery disease (CAD) is a major challenge in patients with type 2 diabetes (T2D). Coronary computed tomography angiography (CCTA) provides a detailed anatomic map of the coronary circulation. Proteomics are increasingly used to improve diagnostic and therapeutic algorithms. We hypothesized that the protein panel is differentially associated with T2D and CAD.

RESEARCH DESIGN AND METHODS

In CAPIRE (Coronary Atherosclerosis in Outlier Subjects: Protective and Novel Individual Risk Factors Evaluation—a cohort of 528 individuals with no previous cardiovascular event undergoing CCTA), participants were grouped into CAD (clean coronaries) and CAD+ (diffuse lumen narrowing or plaques). Plasma proteins were screened by aptamer analysis. Two-way partial least squares was used to simultaneously rank proteins by diabetes status and CAD.

RESULTS

Though CAD+ was more prevalent among participants with T2D (HbA1c 6.7 ± 1.1%) than those without diabetes (56 vs. 30%, P < 0.0001), CCTA-based atherosclerosis burden did not differ. Of the 20 top-ranking proteins, 15 were associated with both T2D and CAD, and 3 (osteomodulin, cartilage intermediate-layer protein 15, and HTRA1) were selectively associated with T2D only and 2 (epidermal growth factor receptor and contactin-1) with CAD only. Elevated renin and GDF15, and lower adiponectin, were independently associated with both T2D and CAD. In multivariate analysis adjusting for the Framingham risk panel, patients with T2D were "protected" from CAD if female (P = 0.007), younger (P = 0.021), and with lower renin levels (P = 0.02).

CONCLUSIONS

We concluded that 1) CAD severity and quality do not differ between participants with T2D and without diabetes; 2) renin, GDF15, and adiponectin are shared markers by T2D and CAD; 3) several proteins are specifically associated with T2D or CAD; and 4) in T2D, lower renin levels may protect against CAD.




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Inoreader v13 is Here With Improved Looks and New Features!

Since the beginning, Inoreader was meant to be a power-user tool, pushing the boundaries of what RSS readers can do.…




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Declutter Your Inbox. Subscribe to Email Newsletters Straight Into Inoreader

You have mail! Inoreader now allows you to subscribe to Email Newsletters just as regular RSS feeds. By creating a…




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Inoreader mobile apps updated to support Automatic Night Mode, Microblogs, Sort by Magic and popularity indicators.

Hey, it’s been quite some time without updates on this front, but our latest updates to our Android and iOS…




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Send Daily Email Digests to Friends, Colleagues or Even to Yourself

When we announced our v13 update, we mentioned a new feature called Email Digests that we’ll explain further in this…




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Get Free Local COVID-19 Alerts with Inoreader

Everyone is concerned as the novel Coronavirus spreads at rapid rates across all countries of the world. We believe every…




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Get Your Friends Into RSS With Inoreader’s New Invite Feature

Have you ever tried to convince somebody to start using an RSS reader, only to hear back from them something…




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Convert Almost Any Webpage Into RSS Feed With Inoreader’s Web Feeds

So, you wanted to follow this nice website for new content, but it doesn’t have an RSS feed yet? Don’t…




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Keep Your YouTube Subscriptions in Sync With Inoreader

Did you know you can subscribe to YouTube channels and playlist in Inoreader? Simply paste the URL of the channel…




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Effects of MK-0941, a Novel Glucokinase Activator, on Glycemic Control in Insulin-Treated Patients With Type 2 Diabetes

OBJECTIVE

To assess the efficacy and safety of MK-0941, a glucokinase activator (GKA), when added to stable-dose insulin glargine in patients with type 2 diabetes.

RESEARCH DESIGN AND METHODS

In this double-blind study, 587 patients taking stable-dose insulin glargine (±metformin ≥1,500 mg/day) were randomized (1:1:1:1:1) to MK-0941 10, 20, 30, or 40 mg or matching placebo t.i.d. before meals (a.c.). This study included an initial 14-week, dose-ranging phase followed by a 40-week treatment phase during which patients were to be uptitrated as tolerated to 40 mg (or placebo) t.i.d. a.c. The primary efficacy end point was change from baseline in A1C at Week 14.

RESULTS

At Week 14, A1C and 2-h postmeal glucose (PMG) improved significantly versus placebo with all MK-0941 doses. Maximal placebo-adjusted least squares mean changes from baseline in A1C (baseline A1C 9.0%) and 2-h PMG were –0.8% and –37 mg/dL (–2 mmol/L), respectively. No significant effects on fasting plasma glucose were observed at any dose versus placebo. By 30 weeks, the initial glycemic responses noted at 14 weeks were not sustained. MK-0941 at one or more doses was associated with significant increases in the incidence of hypoglycemia, triglycerides, systolic blood pressure, and proportion of patients meeting criteria for predefined limits of change for increased diastolic blood pressure.

CONCLUSIONS

In patients receiving stable-dose insulin glargine, the GKA MK-0941 led to improvements in glycemic control that were not sustained. MK-0941 was associated with an increased incidence of hypoglycemia and elevations in triglycerides and blood pressure.




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Effectively Serving Immigrant and Dual Language Learner Families through Home Visiting Programs

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.




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Employment Services for Refugees: Leveraging Mainstream U.S. Systems and Funding

On this webinar, experts and state refugee resettlement program leaders discuss activities that can be key parts of a broader strategy for sustaining and improving employment services for refugees, including partnerships with experts in workforce development strategies, access to federal workforce development funding, and other policies and resources.




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Is the Door Closing? Latin American and Caribbean Responses to Venezuelan Migration

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. 




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An Uneven Landscape: The Differing State Approaches to English Learner Policies under ESSA

Experts share how states have approached Every Student Succeeds Act (ESSA) implementation, areas where the law and state efforts to support English Learners can be improved, and findings from the compendium, The Patchy Landscape of State English Learner Policies under ESSA




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Seasonal Worker Programs in Europe: Lessons Learned and Ways Forward

As the European Union prepares to review the implementation of its Seasonal Workers Directive, as well as countries such as the United Kingdom continue to explore new approaches to selecting seasonal workers, this webinar features findings from a policy brief on the topic. 




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Expert Podcast: Understanding How English Learners Count in ESSA Reporting

This podcast features a discussion between MPI's Margie McHugh and Julie Sugarman about how to understand the varying composition of states' English Learner (EL) subgroup under ESSA, and why understanding these technical differences matters when making decisions about how ELs and schools are faring. They also talk about different groups of ELs: newcomers, students with interrupted formal education, and long-term ELs, and data collection around these different cohorts.




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Migration &amp; Coronavirus: A Complicated Nexus Between Migration Management and Public Health

This webinar, organized by MPI and the Zolberg Institute on Migration and Mobility at The New School, discussed migration policy responses around the globe in response to the COVID-19 pandemic, and examined where migration management and enforcement tools may be useful and where they may be ill-suited to advancing public health goals. 




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Expert Podcast: Meeting Seasonal Labor Needs in the Age of COVID-19

Governments are facing urgent pandemic-related questions. One of the more pressing ones: Who is going to harvest crops in countries that rely heavily on seasonal foreign workers? In this podcast, MPI experts examine ways in which countries could address labor shortages in agriculture, including recruiting native-born workers and letting already present seasonal workers stay longer. Catch an interesting discussion as border closures have halted the movement of seasonal workers even as crops are approaching harvest in some places.




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COVID-19 in Latin America: Tackling Health Care &amp; Other Impacts for Vulnerable Migrant Populations

This MPI webinar brought together public health and migration experts to analyze the impact that COVID-19 preventative measures will have on vulnerable immigrants and refugees in Colombia and Latin America. Speakers also discussed how policymakers and international organizations can include migrant populations in their emergency response plans.




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Mental Health Risks and Resilience among Somali and Bhutanese Refugee Parents

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.




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The Nutritional Health of Young Refugee Children Resettling in Washington State

Refugee children are vulnerable to health and nutrition risks that can have long-term consequences for their development and well-being. This report examines the prevalence of malnutrition—from stunting and wasting to overweight and obesity—among refugee children from birth to age 10, using data from an overseas medical screening exam before they were resettled in Washington State between 2012 and 2014.




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In the Age of Trump: Populist Backlash and Progressive Resistance Create Divergent State Immigrant Integration Contexts

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.




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Mitigating the Effects of Trauma among Young Children of Immigrants and Refugees: The Role of Early Childhood Programs

The first years of a child’s life are a time of immense growth, and exposure to trauma—if left unaddressed—can have significant, lifelong effects. This issue brief examines how young children of refugees and other immigrants may be affected by trauma, and what early childhood education and care programs, health-care providers, and others can do to mitigate its adverse effects.




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Addressing Trauma in Young Children in Immigrant and Refugee Families through Early Childhood Programs

During this webinar, speakers provide an overview of an MPI policy brief that seeks to raise awareness of the intersection of trauma and early childhood development, and how U.S. early childhood programs could more effectively address this trauma in young children in refugee and immigrant households. The participants discuss efforts to integrate trauma-informed approaches into early childhood systems and how home visiting services can effectively address trauma and mental health through a two-generation approach.




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Leveraging the Potential of Home Visiting Programs to Serve Immigrant and Dual Language Learner Families

Home visiting programs for young families are growing in popularity across the United States, and have demonstrated their effectiveness in supporting maternal health and child well-being. At the same time, more infants and toddlers are growing up in immigrant families and households where a language other than English is spoken. Why then are these children under-represented in these programs? This brief explores common barriers, ways to address them, and why it is important to do so.




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Health Insurance Test for Green-Card Applicants Could Sharply Cut Future U.S. Legal Immigration

A new Trump administration action requiring intending immigrants to prove they can purchase eligible health insurance within 30 days of arrival has the potential to block fully 65 percent of those who apply for a green card from abroad, MPI estimates.




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Health Insurance Coverage of Immigrants and Latinos in the Kansas City Metro Area

Latinos and immigrants are at least twice as likely to lack health insurance coverage as the overall population in the Kansas City metropolitan area. This gap that has significant implications for the region, as Latinos and immigrants will form an ever-growing share of the area’s labor force and tax base amid anticipated declines in the native-born, non-Latino population.




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As U.S. Health-Care System Buckles under Pandemic, Immigrant &amp; Refugee Professionals Could Represent a Critical Resource

In a time of critical shortages of U.S. health-care workers during the COVID-19 pandemic, retired doctors are being called back to work and medical students are graduating on a fast track. There is another important pool that could be tapped: Immigrants and refugees who have college degrees in health fields but are working in low-skilled jobs or out of work. MPI estimates 263,000 immigrants are experiencing skill underutilization and could be a valuable resource.




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Barriers to COVID-19 Testing and Treatment: Immigrants without Health Coverage in the United States

As millions of U.S. workers lose jobs and the health insurance associated with them, Medicaid and similar programs are increasingly important for people seeking COVID-19 testing and treatment. Yet many low-income uninsured noncitizens, including green-card holders, are excluded from such programs because of their immigration status, as this fact sheet explores.




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Can a Company be pro-regulation and pro-commerce? Gregg Renfrew from Beautycounter thinks so

It’s the middle of an election year and, according to the Pew Research Center, the country hasn’t been this polarized since the Civil War. In such a climate, it would seem to be an oxymoron for a company to push for both financial growth and tighter regulations. Gregg Renfrew, CEO & Founder of Beautycounter, wouldn’t […]




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Reflections on Business, Leadership, and Branding: Shelly Lazarus ’70

Much has changed in the world of advertising from the picture painted by Mad Men. Shelly Lazarus ’70, Chairman Emeritus, Ogilvy & Mather, was one of the women helping pioneer these changes. Making the journey from ‘the only woman in the room’ to CEO and Chairman of Ogilvy gives Lazarus a lot to reflect on […]




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Case Study: Potential Pitfalls of Using Hemoglobin A1c as the Sole Measure of Glycemic Control

Huy A. Tran
Jul 1, 2004; 22:141-143
Case Studies




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Diabetes and Back Pain: Markers of Diabetes Disease Progression Are Associated With Chronic Back Pain

Lorenzo Rinaldo
Jul 1, 2017; 35:126-131
Feature Articles




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Integration of Clinical Psychology in the Comprehensive Diabetes Care Team

Steven B. Leichter
Jul 1, 2004; 22:129-131
The Business of Diabetes