is Microbiota-Related Metabolites and the Risk of Type 2 Diabetes By care.diabetesjournals.org Published On :: 2020-04-28T10:59:59-07:00 OBJECTIVERecent studies have highlighted the significance of the microbiome in human health and disease. Changes in the metabolites produced by microbiota have been implicated in several diseases. Our objective was to identify microbiome metabolites that are associated with type 2 diabetes.RESEARCH DESIGN AND METHODS5,181 participants from the cross-sectional Metabolic Syndrome in Men (METSIM) study that included Finnish men (age 57 ± 7 years, BMI 26.5 ± 3.5 kg/m2) having metabolomics data available were included in our study. Metabolomics analysis was performed based on fasting plasma samples. On the basis of an oral glucose tolerance test, Matsuda ISI and Disposition Index values were calculated as markers of insulin sensitivity and insulin secretion. A total of 4,851 participants had a 7.4-year follow-up visit, and 522 participants developed type 2 diabetes.RESULTSCreatine, 1-palmitoleoylglycerol (16:1), urate, 2-hydroxybutyrate/2-hydroxyisobutyrate, xanthine, xanthurenate, kynurenate, 3-(4-hydroxyphenyl)lactate, 1-oleoylglycerol (18:1), 1-myristoylglycerol (14:0), dimethylglycine, and 2-hydroxyhippurate (salicylurate) were significantly associated with an increased risk of type 2 diabetes. These metabolites were associated with decreased insulin secretion or insulin sensitivity or both. Among the metabolites that were associated with a decreased risk of type 2 diabetes, 1-linoleoylglycerophosphocholine (18:2) significantly reduced the risk of type 2 diabetes.CONCLUSIONSSeveral novel and previously reported microbial metabolites related to the gut microbiota were associated with an increased risk of incident type 2 diabetes, and they were also associated with decreased insulin secretion and insulin sensitivity. Microbial metabolites are important biomarkers for the risk of type 2 diabetes. Full Article
is Obstructive Sleep Apnea, a Risk Factor for Cardiovascular and Microvascular Disease in Patients With Type 2 Diabetes: Findings From a Population-Based Cohort Study By care.diabetesjournals.org Published On :: 2020-04-28T14:33:04-07:00 OBJECTIVETo determine the risk of cardiovascular disease (CVD), microvascular complications, and mortality in patients with type 2 diabetes who subsequently develop obstructive sleep apnea (OSA) compared with patients with type 2 diabetes without a diagnosis of OSA.RESEARCH DESIGN AND METHODSThis age-, sex-, BMI-, and diabetes duration–matched cohort study used data from a U.K. primary care database from 1 January 2005 to 17 January 2018. Participants aged ≥16 years with type 2 diabetes were included. Exposed participants were those who developed OSA after their diabetes diagnosis; unexposed participants were those without diagnosed OSA. Outcomes were composite CVD (ischemic heart disease [IHD], stroke/transient ischemic attack [TIA], heart failure [HF]), peripheral vascular disease (PVD), atrial fibrillation (AF), peripheral neuropathy (PN), diabetes-related foot disease (DFD), referable retinopathy, chronic kidney disease (CKD), and all-cause mortality. The same outcomes were explored in patients with preexisting OSA before a diagnosis of type 2 diabetes versus diabetes without diagnosed OSA.RESULTSA total of 3,667 exposed participants and 10,450 matched control participants were included. Adjusted hazard ratios for the outcomes were as follows: composite CVD 1.54 (95% CI 1.32, 1.79), IHD 1.55 (1.26, 1.90), HF 1.67 (1.35, 2.06), stroke/TIA 1.57 (1.27, 1.94), PVD 1.10 (0.91, 1.32), AF 1.53 (1.28, 1.83), PN 1.32 (1.14, 1.51), DFD 1.42 (1.16, 1.74), referable retinopathy 0.99 (0.82, 1.21), CKD (stage 3–5) 1.18 (1.02, 1.36), albuminuria 1.11 (1.01, 1.22), and all-cause mortality 1.24 (1.10, 1.40). In the prevalent OSA cohort, the results were similar, but some associations were not observed.CONCLUSIONSPatients with type 2 diabetes who develop OSA are at increased risk of CVD, AF, PN, DFD, CKD, and all-cause mortality compared with patients without diagnosed OSA. Patients with type 2 diabetes who develop OSA are a high-risk population, and strategies to detect OSA and prevent cardiovascular and microvascular complications should be implemented. Full Article
is Screening and Treatment Outcomes in Adults and Children With Type 1 Diabetes and Asymptomatic Celiac Disease: The CD-DIET Study By care.diabetesjournals.org Published On :: 2020-04-28T14:58:19-07:00 OBJECTIVETo describe celiac disease (CD) screening rates and glycemic outcomes of a gluten-free diet (GFD) in patients with type 1 diabetes who are asymptomatic for CD.RESEARCH DESIGN AND METHODSAsymptomatic patients (8–45 years) were screened for CD. Biopsy-confirmed CD participants were randomized to GFD or gluten-containing diet (GCD) to assess changes in HbA1c and continuous glucose monitoring over 12 months.RESULTSAdults had higher CD-seropositivity rates than children (6.8% [95% CI 4.9–8.2%, N = 1,298] vs. 4.7% [95% CI 3.4–5.9%, N = 1,089], P = 0.035) with lower rates of prior CD screening (6.9% vs. 44.2%, P < 0.0001). Fifty-one participants were randomized to a GFD (N = 27) or GCD (N = 24). No HbA1c differences were seen between the groups (+0.14%, 1.5 mmol/mol; 95% CI –0.79 to 1.08; P = 0.76), although greater postprandial glucose increases (4-h +1.5 mmol/L; 95% CI 0.4–2.7; P = 0.014) emerged with a GFD.CONCLUSIONSCD is frequently observed in asymptomatic patients with type 1 diabetes, and clinical vigilance is warranted with initiation of a GFD. Full Article
is Using the BRAVO Risk Engine to Predict Cardiovascular Outcomes in Clinical Trials With Sodium-Glucose Transporter 2 Inhibitors By care.diabetesjournals.org Published On :: 2020-04-28T12:58:49-07:00 OBJECTIVEThis study evaluated the ability of the Building, Relating, Assessing, and Validating Outcomes (BRAVO) risk engine to accurately project cardiovascular outcomes in three major clinical trials—BI 10773 (Empagliflozin) Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients (EMPA-REG OUTCOME), Canagliflozin Cardiovascular Assessment Study (CANVAS), and Dapagliflozin Effect on Cardiovascular Events–Thrombolysis in Myocardial Infarction (DECLARE-TIMI 58) trial—on sodium–glucose cotransporter 2 inhibitors (SGLT2is) to treat patients with type 2 diabetes.RESEARCH DESIGN AND METHODSBaseline data from the publications of the three trials were obtained and entered into the BRAVO model to predict cardiovascular outcomes. Projected benefits of reducing risk factors of interest (A1C, systolic blood pressure [SBP], LDL, or BMI) on cardiovascular events were evaluated, and simulated outcomes were compared with those observed in each trial.RESULTSBRAVO achieved the best prediction accuracy when simulating outcomes of the CANVAS and DECLARE-TIMI 58 trials. For the EMPA-REG OUTCOME trial, a mild bias was observed (~20%) in the prediction of mortality and angina. The effect of risk reduction on outcomes in treatment versus placebo groups predicted by the BRAVO model strongly correlated with the observed effect of risk reduction on the trial outcomes as published. Finally, the BRAVO engine revealed that most of the clinical benefits associated with SGLT2i treatment are through A1C control, although reductions in SBP and BMI explain a proportion of the observed decline in cardiovascular events.CONCLUSIONSThe BRAVO risk engine was effective in predicting the benefits of SGLT2is on cardiovascular health through improvements in commonly measured risk factors, including A1C, SBP, and BMI. Since these benefits are individually small, the use of the complex, dynamic BRAVO model is ideal to explain the cardiovascular outcome trial results. Full Article
is Predicting the Risk of Inpatient Hypoglycemia With Machine Learning Using Electronic Health Records By care.diabetesjournals.org Published On :: 2020-04-29T13:46:01-07:00 OBJECTIVEWe analyzed data from inpatients with diabetes admitted to a large university hospital to predict the risk of hypoglycemia through the use of machine learning algorithms.RESEARCH DESIGN AND METHODSFour years of data were extracted from a hospital electronic health record system. This included laboratory and point-of-care blood glucose (BG) values to identify biochemical and clinically significant hypoglycemic episodes (BG ≤3.9 and ≤2.9 mmol/L, respectively). We used patient demographics, administered medications, vital signs, laboratory results, and procedures performed during the hospital stays to inform the model. Two iterations of the data set included the doses of insulin administered and the past history of inpatient hypoglycemia. Eighteen different prediction models were compared using the area under the receiver operating characteristic curve (AUROC) through a 10-fold cross validation.RESULTSWe analyzed data obtained from 17,658 inpatients with diabetes who underwent 32,758 admissions between July 2014 and August 2018. The predictive factors from the logistic regression model included people undergoing procedures, weight, type of diabetes, oxygen saturation level, use of medications (insulin, sulfonylurea, and metformin), and albumin levels. The machine learning model with the best performance was the XGBoost model (AUROC 0.96). This outperformed the logistic regression model, which had an AUROC of 0.75 for the estimation of the risk of clinically significant hypoglycemia.CONCLUSIONSAdvanced machine learning models are superior to logistic regression models in predicting the risk of hypoglycemia in inpatients with diabetes. Trials of such models should be conducted in real time to evaluate their utility to reduce inpatient hypoglycemia. Full Article
is Strict Preanalytical Oral Glucose Tolerance Test Blood Sample Handling Is Essential for Diagnosing Gestational Diabetes Mellitus By care.diabetesjournals.org Published On :: 2020-04-29T13:46:01-07:00 OBJECTIVEPreanalytical processing of blood samples can affect plasma glucose measurement because on-going glycolysis by cells prior to centrifugation can lower its concentration. In June 2017, ACT Pathology changed the processing of oral glucose tolerance test (OGTT) blood samples for pregnant women from a delayed to an early centrifugation protocol. The effect of this change on the rate of gestational diabetes mellitus (GDM) diagnosis was determined.RESEARCH DESIGN AND METHODSAll pregnant women in the Australian Capital Territory (ACT) are recommended for GDM testing with a 75-g OGTT using the World Health Organization diagnostic criteria. From January 2015 to May 2017, OGTT samples were collected into sodium fluoride (NaF) tubes and kept at room temperature until completion of the test (delayed centrifugation). From June 2017 to October 2018, OGTT samples in NaF tubes were centrifuged within 10 min (early centrifugation).RESULTSA total of 7,509 women were tested with the delayed centrifugation protocol and 4,808 with the early centrifugation protocol. The mean glucose concentrations for the fasting, 1-h and 2-h OGTT samples were, respectively, 0.24 mmol/L (5.4%), 0.34 mmol/L (4.9%), and 0.16 mmol/L (2.3%) higher using the early centrifugation protocol (P < 0.0001 for all), increasing the GDM diagnosis rate from 11.6% (n = 869/7,509) to 20.6% (n = 1,007/4,887).CONCLUSIONSThe findings of this study highlight the critical importance of the preanalytical processing protocol of OGTT blood samples used for diagnosing GDM. Delay in centrifuging of blood collected into NaF tubes will result in substantially lower rates of diagnosis than if blood is centrifuged early. Full Article
is The Association of Energy and Macronutrient Intake at Dinner Versus Breakfast With Disease-Specific and All-Cause Mortality Among People With Diabetes: The U.S. National Health and Nutrition Examination Survey, 2003-2014 By care.diabetesjournals.org Published On :: 2020-04-30T07:25:50-07:00 OBJECTIVEThis study aims to evaluate the association of energy and macronutrient intake at dinner versus breakfast with disease-specific and all-cause mortality in people with diabetes.RESEARCH DESIGN AND METHODSA total of 4,699 people with diabetes who enrolled in the National Health and Nutrition Examination Survey from 2003 to 2014 were recruited for this study. Energy and macronutrient intake was measured by a 24-h dietary recall. The differences () in energy and macronutrient intake between dinner and breakfast ( = dinner – breakfast) were categorized into quintiles. Death information was obtained from the National Death Index until 2015. Cox proportional hazards regression models were developed to evaluate the survival relationship between and diabetes, cardiovascular disease (CVD), and all-cause mortality.RESULTSAmong the 4,699 participants, 913 deaths, including 269 deaths due to diabetes and 314 deaths due to CVD, were documented. After adjustment for potential confounders, compared with participants in the lowest quintile of in terms of total energy and protein, participants in the highest quintile were more likely to die due to diabetes (hazard ratio [HR]energy 1.92, 99% CI 1.08–3.42; HRprotein 1.92, 99% CI 1.06–3.49) and CVD (HRenergy 1.69, 99% CI 1.02–2.80; HRprotein 1.96, 99% CI 1.14–3.39). The highest quintile of total fat was related to CVD mortality (HR 1.67, 99% CI 1.01–2.76). Isocalorically replacing 5% of total energy at dinner with breakfast was associated with 4% and 5% lower risk of diabetes (HR 0.96, 95% CI 0.94–0.98) and CVD (HR 0.95, 95% CI 0.93–0.97) mortality, respectively.CONCLUSIONSHigher intake of energy, total fat, and protein from dinner than breakfast was associated with greater diabetes, CVD, and all-cause mortality in people with diabetes. Full Article
is microRNA-21/PDCD4 Proapoptotic Signaling From Circulating CD34+ Cells to Vascular Endothelial Cells: A Potential Contributor to Adverse Cardiovascular Outcomes in Patients With Critical Limb Ischemia By care.diabetesjournals.org Published On :: 2020-05-01T07:23:01-07:00 OBJECTIVEIn patients with type 2 diabetes (T2D) and critical limb ischemia (CLI), migration of circulating CD34+ cells predicted cardiovascular mortality at 18 months after revascularization. This study aimed to provide long-term validation and mechanistic understanding of the biomarker.RESEARCH DESIGN AND METHODSThe association between CD34+ cell migration and cardiovascular mortality was reassessed at 6 years after revascularization. In a new series of T2D-CLI and control subjects, immuno-sorted bone marrow CD34+ cells were profiled for miRNA expression and assessed for apoptosis and angiogenesis activity. The differentially regulated miRNA-21 and its proapoptotic target, PDCD4, were titrated to verify their contribution in transferring damaging signals from CD34+ cells to endothelial cells.RESULTSMultivariable regression analysis confirmed that CD34+ cell migration forecasts long-term cardiovascular mortality. CD34+ cells from T2D-CLI patients were more apoptotic and less proangiogenic than control subjects and featured miRNA-21 downregulation, modulation of several long noncoding RNAs acting as miRNA-21 sponges, and upregulation of the miRNA-21 proapoptotic target PDCD4. Silencing miR-21 in control subject CD34+ cells phenocopied the T2D-CLI cell behavior. In coculture, T2D-CLI CD34+ cells imprinted naïve endothelial cells, increasing apoptosis, reducing network formation, and modulating the TUG1 sponge/miRNA-21/PDCD4 axis. Silencing PDCD4 or scavenging reactive oxygen species protected endothelial cells from the negative influence of T2D-CLI CD34+ cells.CONCLUSIONSMigration of CD34+ cells predicts long-term cardiovascular mortality in T2D-CLI patients. An altered paracrine signaling conveys antiangiogenic and proapoptotic features from CD34+ cells to the endothelium. This damaging interaction may increase the risk for life-threatening complications. Full Article
is Cardiovascular Risk Reduction With Liraglutide: An Exploratory Mediation Analysis of the LEADER Trial By care.diabetesjournals.org Published On :: 2020-05-04T10:48:32-07:00 OBJECTIVEThe LEADER trial (ClinicalTrials.gov reg. no. NCT01179048) demonstrated a reduced risk of cardiovascular (CV) events for patients with type 2 diabetes who received the glucagon-like peptide 1 receptor agonist liraglutide versus placebo. The mechanisms behind this CV benefit remain unclear. We aimed to identify potential mediators for the CV benefit observed with liraglutide in the LEADER trial.RESEARCH DESIGN AND METHODSWe performed exploratory analyses to identify potential mediators of the effect of liraglutide on major adverse CV events (MACE; composite of CV death, nonfatal myocardial infarction, or nonfatal stroke) from the following candidates: glycated hemoglobin (HbA1c), body weight, urinary albumin-to-creatinine ratio (UACR), confirmed hypoglycemia, sulfonylurea use, insulin use, systolic blood pressure, and LDL cholesterol. These candidates were selected as CV risk factors on which liraglutide had an effect in LEADER such that a reduction in CV risk might result. We used two methods based on a Cox proportional hazards model and the new Vansteelandt method designed to use all available information from the mediator and to control for confounding factors.RESULTSAnalyses using the Cox methods and Vansteelandt method indicated potential mediation by HbA1c (up to 41% and 83% mediation, respectively) and UACR (up to 29% and 33% mediation, respectively) on the effect of liraglutide on MACE. Mediation effects were small for other candidates.CONCLUSIONSThese analyses identify HbA1c and, to a lesser extent, UACR as potential mediators of the CV effects of liraglutide. Whether either is a marker of an unmeasured factor or a true mediator remains a key question that invites further investigation. Full Article
is Effects of Novel Dual GIP and GLP-1 Receptor Agonist Tirzepatide on Biomarkers of Nonalcoholic Steatohepatitis in Patients With Type 2 Diabetes By care.diabetesjournals.org Published On :: 2020-05-07T07:52:43-07:00 OBJECTIVETo determine the effect of tirzepatide, a dual agonist of glucose-dependent insulinotropic polypeptide and glucagon-like peptide 1 receptors, on biomarkers of nonalcoholic steatohepatitis (NASH) and fibrosis in patients with type 2 diabetes mellitus (T2DM).RESEARCH DESIGN AND METHODSPatients with T2DM received either once weekly tirzepatide (1, 5, 10, or 15 mg), dulaglutide (1.5 mg), or placebo for 26 weeks. Changes from baseline in alanine aminotransferase (ALT), aspartate aminotransferase (AST), keratin-18 (K-18), procollagen III (Pro-C3), and adiponectin were analyzed in a modified intention-to-treat population.RESULTSSignificant (P < 0.05) reductions from baseline in ALT (all groups), AST (all groups except tirzepatide 10 mg), K-18 (tirzepatide 5, 10, 15 mg), and Pro-C3 (tirzepatide 15 mg) were observed at 26 weeks. Decreases with tirzepatide were significant compared with placebo for K-18 (10 mg) and Pro-C3 (15 mg) and with dulaglutide for ALT (10, 15 mg). Adiponectin significantly increased from baseline with tirzepatide compared with placebo (10, 15 mg).CONCLUSIONSIn post hoc analyses, higher tirzepatide doses significantly decreased NASH-related biomarkers and increased adiponectin in patients with T2DM. Full Article
is Continuous Positive Airway Pressure Treatment, Glycemia, and Diabetes Risk in Obstructive Sleep Apnea and Comorbid Cardiovascular Disease By care.diabetesjournals.org Published On :: 2020-05-07T07:52:43-07:00 OBJECTIVEDespite evidence of a relationship among obstructive sleep apnea (OSA), metabolic dysregulation, and diabetes, it is uncertain whether OSA treatment can improve metabolic parameters. We sought to determine effects of long-term continuous positive airway pressure (CPAP) treatment on glycemic control and diabetes risk in patients with cardiovascular disease (CVD) and OSA.RESEARCH DESIGN AND METHODSBlood, medical history, and personal data were collected in a substudy of 888 participants in the Sleep Apnea Cardiovascular End Points (SAVE) trial in which patients with OSA and stable CVD were randomized to receive CPAP plus usual care, or usual care alone. Serum glucose and glycated hemoglobin A1c (HbA1c) were measured at baseline, 6 months, and 2 and 4 years and incident diabetes diagnoses recorded.RESULTSMedian follow-up was 4.3 years. In those with preexisting diabetes (n = 274), there was no significant difference between the CPAP and usual care groups in serum glucose, HbA1c, or antidiabetic medications during follow-up. There were also no significant between-group differences in participants with prediabetes (n = 452) or in new diagnoses of diabetes. Interaction testing suggested that women with diabetes did poorly in the usual care group, while their counterparts on CPAP therapy remained stable.CONCLUSIONSAmong patients with established CVD and OSA, we found no evidence that CPAP therapy over several years affects glycemic control in those with diabetes or prediabetes or diabetes risk over standard-of-care treatment. The potential differential effect according to sex deserves further investigation. Full Article
is Circulating Retinol-Binding Protein 4 Is Inversely Associated With Pancreatic {beta}-Cell Function Across the Spectrum of Glycemia By care.diabetesjournals.org Published On :: 2020-05-07T08:41:18-07:00 OBJECTIVEThe aim of this study was to examine the association of circulating retinol-binding protein 4 (RBP4) levels with β-cell function across the spectrum of glucose tolerance from normal to overt type 2 diabetes.RESEARCH DESIGN AND METHODSA total of 291 subjects aged 35–60 years with normal glucose tolerance (NGT), newly diagnosed impaired fasting glucose or glucose tolerance (IFG/IGT), or type 2 diabetes were screened by a standard 2-h oral glucose tolerance test (OGTT) with the use of traditional measures to evaluate β-cell function. From these participants, 74 subjects were recruited for an oral minimal model test, and β-cell function was assessed with model-derived indices. Circulating RBP4 levels were measured by a commercially available ELISA kit.RESULTSCirculating RBP4 levels were significantly and inversely correlated with β-cell function indicated by the Stumvoll first-phase and second-phase insulin secretion indices, but not with HOMA of β-cell function, calculated from the 2-h OGTT in 291 subjects across the spectrum of glycemia. The inverse association was also observed in subjects involved in the oral minimal model test with β-cell function assessed by both direct measures and model-derived measures, after adjustment for potential confounders. Moreover, RBP4 emerged as an independent factor of the disposition index-total insulin secretion.CONCLUSIONSCirculating RBP4 levels are inversely and independently correlated with β-cell function across the spectrum of glycemia, providing another possible explanation of the linkage between RBP4 and the pathogenesis of type 2 diabetes. Full Article
is Promising New Research on Early Intervention for Autism By schoolpsychologistfiles.blogspot.com Published On :: Tue, 01 Dec 2009 00:55:00 +0000 CNN reports that a study confirms that early autism intervention in toddlers is effective. A study was completed with a program called the Early Start Denver Model (ESDM). This program involves about twenty hours a week in the child's own home. It involves play and parents can easily learn some of the skills that can be applied in other settings. The study compared a group of toddlers that were given ESDM intervention to a group of toddlers receiving typical community interventions. Both groups showed improvement, but the ESDM group improved IQ by 18 points compared to 8 points with traditional interventions. The study is reporting that some of the children "virtually caught up to the typical kids their age." However, they are not claiming it is a cure for autism. According to the article they are working on a replication study to determine if there are similar results. Personally, I'm looking forward to the results of the replication study and want to find out more about this method. From what I understand it is less of a time constraint than ABA therapy. This study also demonstrated the need for early intervention, which also includes early identification. When children are diagnosed early, they can begin receiving interventions that are proven effective. The study showed that current methods are working, but there may be a new program that can be even more effective on the horizon. I'd love to hear more from my readers if you have any experience with ESDM or more information about it. Full Article Autism
is Why is My Child Defiant or Explosive? By schoolpsychologistfiles.blogspot.com Published On :: Fri, 24 Aug 2012 14:56:00 +0000 Dedicated to the lady at Walmart with the screaming kid and all of us "good parents" who have been that lady at Walmart.One of the most difficult behaviors for parents or teachers to address is explosive behavior, a child who has little control over emotions and "melts down" in the classroom or at home. It is frustrating, it is embarrassing, it is anxiety producing, it causes intense emotions in ourselves. Parents agonize over why it happens or what they did wrong? Often the parents are blamed or judged by bystanders in stores, family members, friends, or school staff. However, I have seen parents with a variety of parenting styles have kids with poor emotional control, including those who are strict, those who are quick to give in, those who spank, those who use time out, those who take away privileges, and a whole lot of parents who feel like they have tried everything. I know children with very little emotional control from homes that are falling apart, from homes that are loving and supportive, from poor families, from affluent families, from parents who have no clue how to parent, from parents with excellent skills, even from School Psychologists. This is not to say that parenting styles do not have a role in this, but there IS more to it. We have to stop judging each other and get to the root of the problem. What is the Root of the Problem?The problem, the reason some children "explode" or act out with little emotional control, is because he or she is lacking a skill. Emotional control is a skill. Most kids will learn this skill through consistent discipline strategies, but some do not. Another way to look at it.We don't tell our kids how to read and then expect them to do it. We show them step by step. Some kids will pick it up easy, others will need to be taught and retaught and retaught and will need extensive help in doing so. Do we blame ourselves? Do we look at our friends judgementally and think to ourselves "look at the book she is using, it's all wrong?" No, we assume the child has a problem learning to read and we find a way to teach him. WE HAVE TO START LOOKING AT BEHAVIOR IN THE SAME WAY. When a child is exploding, the first step should not be to label the child or blame the parent. Lets start looking for the skill that is lacking. When we find that skill, lets teach it.It's NOT always a control issue. Sometimes kids act out because they have not been taught to obey and respect authority, but sometimes they act out in spite of good training at home. The explosions lead to self esteem problems in the child and the child feeling like a "bad kid," which in turn makes explosions bigger and more frequent. Have you ever looked at a screaming child and demanded he control himself right now or "act your age." It's a common thing to do. Have you ever looked at a child with a Learning Disability and said "read on your grade level, now!" or "I have told you and told you how to read, why aren't you reading?" Of course you haven't. We work with the reader at his level and patiently try different strategies to improve reading. We can't demand them to be good readers and we can't demand that a child who does not have the skills to control his emotions "act his age." These explosive kids need skills and truth be told, we who work with these kids need skills. If you are a parent with a child who acts "out of control" stop blaming yourself. It isn't necessarily because you spanked or didn't spank or were too strict or too lenient. Your child is lacking the skills she needs to control her emotions. Also, realize you are going to need to learn new skills to help your child learn the lacking skills. You are no longer in the Parenting 101 class, you need to move on to the Advanced skill- teaching parenting class. The BEST book I have read on this topic is The Explosive Child by Ross Greene. He addresses the skills these children might be lacking and he has great strategies to address the issue. (see Amazon link below)If you are a teacher and have an "explosive child" in your class, rethink your perspective of the student. The child needs to learn skills, so lets focus on teaching the skills and being patient with the children who are slower to learn emotional control. We as school staff can not make excuses or blame the parents. We have to reach the child at her level. We teach a child to read at her level. We must teach a child to control emotions at her level as well. Challenge for EveryoneLet us stop labeling these kids with emotional skill deficits as "bad kids" and stop judging the parents. Let's be honest with ourselves and recognize we all have shortcomings and could use skills in certain areas. Maybe our kids need skills in emotional control, maybe we do, maybe we need skills in teaching emotional control, or maybe we need skills in some other area all together. Let's be patient with our children and our peers and ourselves. Let's stop criticizing ourselves and others and start learning and teaching new skills. We don't live in a world with bad kids, we live in a world will kids who need skills, so let's teach. Full Article Interventions
is Check out this Awesome Special Education Infographic by USC Rossier By schoolpsychologistfiles.blogspot.com Published On :: Sun, 21 Oct 2012 17:56:00 +0000 USC Rossier Online Full Article
is Is It ADHD? By schoolpsychologistfiles.blogspot.com Published On :: Wed, 12 Dec 2012 14:51:00 +0000 Do you wonder if your child might have ADHD?More than 5% of children now have a diagnosis of Attention Deficit Hyperactivity Disorder. Parents often look at hyperactive or impulsive behaviors and wonder, “Is this normal or is this ADHD?” The following charts are made to help parents get a sense of whether their child is exhibiting age appropriate behaviors or if it could be something more. These charts are not intended to diagnose. If you have concerns that many of the examples of ADHD describe your child, talk to your doctor or a Psychologist for a formal assessment.Read the full article at school psychologist files, with charts to help you compare normal child behavior with behavior more consistent with ADHD. Full Article
is The Blog is moving to School Psychologist Files By schoolpsychologistfiles.blogspot.com Published On :: Sat, 02 Feb 2013 21:18:00 +0000 You can find all of the same articles in a more visually appealing Blog. From now on use www.schoolpsychologistfiles.com/blog. Thanks! Full Article
is Is U.S.-Mexico Cooperation on Migration Possible? By www.migrationpolicy.org Published On :: Mon, 08 Apr 2019 09:48:29 -0400 As the numbers of Central American migrants crossing into Mexico and the United States rises—putting migration front and center in the U.S.-Mexico relationship again—this event examines the opportunities for cooperation between the two countries, along with ways to improve U.S. and Mexican asylum systems, create new approaches to labor migration, address smuggling networks, and modernize border management. Full Article
is Protecting the DREAM: The Potential Impact of Different Legislative Scenarios for Unauthorized Youth By www.migrationpolicy.org Published On :: Tue, 10 Oct 2017 11:06:34 -0400 With the Trump administration having announced the end of the DACA program, Congress is facing growing calls to protect unauthorized immigrants who came to the U.S. as children. This fact sheet examines DREAM Act bills introduced in Congress as of mid-2017, offering estimates of who might earn conditional legal status—and ultimately legal permanent residence—based on educational, professional, and other requirements in the legislation. Full Article
is The Diversity Visa Program Holds Lessons for Future Legal Immigration Reform By www.migrationpolicy.org Published On :: Thu, 08 Feb 2018 18:23:47 -0500 On paper, the Diversity Visa Program is not set up to bring in the highly skilled; applicants need only a high school diploma (or equivalent) or two years of mid-level work experience. Yet as this commentary explains, the green-card lottery has become a channel for entry of the highly skilled—with half of recipients coming to the United States in recent years having a college degree. Full Article
is Frequently Requested Statistics on Immigrants and Immigration in the United States By www.migrationpolicy.org Published On :: Mon, 11 Mar 2019 12:00:22 -0400 Immigrant arrivals to the United States and the makeup of the foreign-born population have been changing in significant ways: Recent immigrants are more likely to be from Asia than from Mexico and the overall immigrant population is growing at a slower rate than before the 2008-09 recession. This useful article collects in one place some of the most sought-after statistics on immigrants in the United States. Full Article
is Mexican Migration to Canada: Temporary Worker Programs, Visa Imposition, and NAFTA Shape Flows By www.migrationpolicy.org Published On :: Tue, 19 Mar 2019 11:06:16 -0400 Mexicans migrate to Canada in much smaller numbers than to the United States, yet over the last 30 years the country has become an increasingly attractive destination. Canada prioritizes highly skilled, educated Mexicans for permanent residency, but also attracts temporary workers from Mexico. This article examines Mexican migration to Canada and how it has been shaped by visa requirements, trade policy, and more. Full Article
is Electrolyte disorders in a young female following short-term omeprazole therapy By resources.medipacademy.com Published On :: 23 September 2018 08:07:02 A 29 years old female presented to us in the metabolic clinic of the University of Port Harcourt Teaching Hospital (UPTH) on account of a week history of easy fatigability, weakness, and lower extremity muscle cramps associated with numbness and tingling sensation in the peri-oral area, fingers and toes. Two weeks prior to the onset of her presenting symptoms, she had visited a local pharmaceutical shop on account of a distressing epigastric discomfort and was subsequently placed on daily oral omeprazole 20mg daily for a month by a pharmacist. She had been on the omeprazole medication for two weeks before her present symptoms manifested. Her past medical history was not suggestive of hypoparathyroidism nor pancreatitis. She was married with three children and has an uneventful family, social and obstetric histories. On examination, she was a healthy well-oriented young female with positive Trousseau’s, Chvostek’s and epigastric tenderness signs. Further Laboratory evaluation revealed she had low plasma magnesium, low plasma albumin-corrected calcium, and low serum parathyroid hormone levels, while other laboratory parameters were essentially normal. A diagnosis of omeprazole-induced electrolyte disorders (hypomagnesaemia and hypocalcaemia) associated with hypoparathyroidism was made following the review of her clinical examination and laboratory findings. She was subsequently managed with oral magnesium supplements following the withdrawal of the omeprazole medication (replaced with oral ranitidine), monitored weekly, and full recovery was achieved after three weeks. Full Article
is Honey bees face chronic paralysis pandemic in Britain By www.upi.com Published On :: Fri, 01 May 2020 12:06:18 -0400 The virus responsible for chronic bee paralysis is spreading rapidly among honey bee colonies in Britain, according to a new study. Full Article
is NASA lengthens SpaceX's first crewed mission to International Space Station By www.upi.com Published On :: Fri, 01 May 2020 12:13:47 -0400 The duration of SpaceX's first mission with astronauts on board -- planned for launch at 4:32 p.m. EDT on May 27 from Florida -- has been extended from a few days to potentially weeks aboard the space station. Full Article
is Coldest material in the cosmos could help scientists find dark matter particles By www.upi.com Published On :: Fri, 01 May 2020 12:59:36 -0400 Researchers suggest the coldest material in the universe could reveal the presence of dark matter particles. Full Article
is Global warming fuels algal bloom disrupting fisheries in Arabian Sea By www.upi.com Published On :: Mon, 04 May 2020 14:47:01 -0400 A new scientific study published Monday found that global warming is fueling a destructive algal bloom that is disrupting fisheries in the Arabian sea. Full Article
is Amino acid swap may help wheat tolerate rising heat, scientists say By www.upi.com Published On :: Mon, 04 May 2020 17:18:55 -0400 British scientists said Monday that an amino acid swap can help protect wheat crops from rising heat due to global warming. Full Article
is Trade can spread economic toll of local disasters globally, study finds By www.upi.com Published On :: Mon, 04 May 2020 17:50:09 -0400 Damage from a natural disaster in one place can spread globally due to urban trade networks, a Yale study said Monday. Full Article
is Climate change is influencing where tropical cyclones are formed By www.upi.com Published On :: Tue, 05 May 2020 12:30:50 -0400 Over the last 40 years, climate change has been influencing where tropical cyclones form, according to a new study. Full Article
is Tests show heating is the best way to disinfect N95 masks for reuse By www.upi.com Published On :: Tue, 05 May 2020 17:47:45 -0400 Test results suggest N95 masks can be safely disinfected through heating 50 times before their filtration efficiency begins to decline. Full Article
is Scientists unveil fossil fuel-free jet propulsion that uses microwave air plasmas By www.upi.com Published On :: Wed, 06 May 2020 08:49:26 -0400 Engineers in China have developed a fossil fuel-free jet propulsion prototype design that uses microwave air plasmas. Full Article
is New map highlights China's export-driven CO2 emissions By www.upi.com Published On :: Thu, 07 May 2020 14:43:27 -0400 China produces a whole lot of stuff -- stuff that gets bought by the rest of the world. In 2019, China exported approximately $2.5 trillion dollars worth of goods. Full Article
is Early marine reptiles used pebble-like teeth to crush shellfish By www.upi.com Published On :: Fri, 08 May 2020 11:43:37 -0400 Some early ichthyosaurs used rounded, pebble-like teeth to crush the shells of snails and clam-like bivalves, according to new research. Full Article
is Cannibalism helps comb jellies survive harsh conditions, invade new environs By www.upi.com Published On :: Fri, 08 May 2020 14:57:57 -0400 The warty comb jelly is native to the western Atlantic, but in recent decades, it has invaded the waters of Eurasia. New research suggests cannibalism is key to the species' ability to move into new environs. Full Article
is Disabled flies sleep more as they learn to adapt By www.upi.com Published On :: Fri, 08 May 2020 17:31:05 -0400 New research suggests flies that are unable to fly sleep more as they learn to adapt to their disability. Full Article
is Crisis within a Crisis: Immigration in the United States in a Time of COVID-19 By www.migrationpolicy.org Published On :: Thu, 26 Mar 2020 12:50:47 -0400 The global COVID-19 pandemic has brought into sharp focus the intersection of U.S. immigration and public health policy, and the unique challenges that immigrants face. This article analyzes the Trump administration’s introduction of some of the most stringent immigration restrictions in modern times, the often disparate fallout of the outbreak on immigrant communities, the status of federal immigration agency operations, and more. Full Article
is Immigration Enforcement in the United States: The Rise of a Formidable Machinery By www.migrationpolicy.org Published On :: Mon, 07 Jan 2013 00:00:00 -0500 MPI has released a major study that describes and analyzes today’s immigration enforcement programs, as they have developed and grown in the 25 years since IRCA launched the current enforcement era. Full Article
is Immigration Enforcement in the United States: The Rise of a Formidable Machinery By www.migrationpolicy.org Published On :: Mon, 07 Jan 2013 15:00:00 -0500 Release of a major report that describes and analyzes the immigration enforcement system in the United States as it has developed and grown in the quarter century since the Immigration Reform and Control Act of 1986 launched the current era of enforcement. Full Article
is Side-by-Side Comparison of 2013 Senate Immigration Bill with 2006 and 2007 Senate Legislation By www.migrationpolicy.org Published On :: Mon, 01 Apr 2013 00:00:00 -0400 This fact sheet compares key components of immigration reform outlined in the 2013 Senate immigration bill against provisions included in bills considered by the Senate in 2006 and 2007: border security, detention, and enforcement; worksite enforcement; visa reforms; earned legalization of unauthorized immigrants; strengthening the U.S. economy and workforce; and integration of new Americans. Full Article
is Side-by-Side Comparison of the 2013 Senate Immigration Framework with 2006 and 2007 Senate Legislation By www.migrationpolicy.org Published On :: Mon, 01 Apr 2013 00:00:00 -0400 MPI has completed an analysis of the major provisions in the 2013 framework, comparing them to provisions of the legislation the Senate considered in 2006 and 2007. This fact sheet is formatted as a chart comparing the framework of comprehensive immigration reform outlined in the 2013 Senate immigration bill against provisions included in bills considered by the Senate in 2006 and 2007. Full Article
is Side-by-Side Comparison of 2013 Senate Immigration Bill with Individual 2013 House Bills By www.migrationpolicy.org Published On :: Thu, 01 Aug 2013 00:00:00 -0400 This fact sheet offers a detailed review of the comprehensive immigration reform legislation approved by the U.S. Senate in June 2013 and compares its major provisions with those of the five targeted immigration bills approved by the House Judiciary Committee and the House Homeland Security Committee. Full Article
is Leadership Visions: A Discussion with Mexican Foreign Minister Claudia Ruiz-Massieu By www.migrationpolicy.org Published On :: Tue, 15 Dec 2015 11:41:39 -0500 An MPI Leadership Visions discussion with the Foreign Minister of Mexico, Claudia Ruiz-Massieu, for her first public appearance in Washington, DC. Full Article
is Will White House Immigration Wish List Tank Emerging DREAMer Momentum in Congress? By www.migrationpolicy.org Published On :: Tue, 17 Oct 2017 17:28:11 -0400 The Trump administration has released a list of hardline immigration demands—including border wall funding, restrictions on federal grants to “sanctuary” cities, and cuts to legal immigration—in exchange for legislation protecting DREAMers. This article examines the prospects for these proposals and more broadly for a legislative fix to resolve the status of unauthorized immigrants brought to the United States as children. Full Article
is Shifting Gears, Trump Administration Launches High-Profile Worksite Enforcement Operations By www.migrationpolicy.org Published On :: Wed, 24 Jan 2018 10:52:22 -0500 An unannounced sweep of 98 convenience stores by U.S. immigration authorities—resulting in the arrest of 21 unauthorized workers—may signal a new approach to worksite enforcement under the Trump administration, moving away from a strategy of paper-based audits that resulted in higher employer fines and fewer worker arrests. This article explores worksite enforcement over recent decades. Full Article
is Ask Ariely: On Doing Dishes, Curbing Consumerism, and Reducing Regret By danariely.com Published On :: Sat, 30 Nov 2019 12:30:49 +0000 Here’s my Q&A column from the WSJ this week — and if you have any questions for me, you can tweet them to @danariely with the hashtag #askariely, post a comment on my Ask Ariely Facebook page, or email them to AskAriely@wsj.com. ___________________________________________________ Dear Dan, When I host friends for dinner,... Full Article Ask Ariely Blog advice column ask ariely Behavioral Economics & Psychology dear dan wall street journal wsj
is Ask Ariely: On Simple Savings, Better Bonuses, and Revised Resolutions By danariely.com Published On :: Sat, 01 Feb 2020 12:30:50 +0000 Here’s my Q&A column from the WSJ this week — and if you have any questions for me, you can tweet them to @danariely with the hashtag #askariely, post a comment on my Ask Ariely Facebook page, or email them to AskAriely@wsj.com. ___________________________________________________ Dear Dan, My partner and I are students,... Full Article Ask Ariely Blog advice column ask ariely Behavioral Economics & Psychology dear dan wall street journal wsj
is Ask Ariely: On Paper Punishments, Pious Patterns, and Painful Plans By danariely.com Published On :: Sun, 01 Mar 2020 12:30:56 +0000 Here’s my Q&A column from the WSJ this week — and if you have any questions for me, you can tweet them to @danariely with the hashtag #askariely, post a comment on my Ask Ariely Facebook page, or email them to AskAriely@wsj.com. ___________________________________________________ Dear Dan, I shop at two different grocery... Full Article Ask Ariely Blog advice column ask ariely Behavioral Economics Behavioral Economics & Psychology dear dan wall street journal wsj
is Mike Pompeo to travel to Israel, meet with Benjamin Netanyahu, Benny Gantz By www.upi.com Published On :: Fri, 08 May 2020 14:22:07 -0400 Secretary of State Mike Pompeo plans to travel to Israel next week to meet with Prime Minister Benjamin Netanyahu in his first international trip since coronavirus-related restrictions were put in place. Full Article
is U.S. stocks rise again on Wall Street despite job losses By www.upi.com Published On :: Fri, 08 May 2020 16:29:06 -0400 The United States' bellwether stock index, the Dow Jones Industrial Average, climbed another 455 points Friday, posting its first weekly gain in three weeks. Full Article