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Insulin Strategies for Primary Care Providers

Karen L. Herbst
Jan 1, 2002; 20:
Feature Articles




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Health Care Transition in Adolescents and Young Adults With Diabetes

Michael E. Bowen
Jun 1, 2010; 28:99-106
Feature Articles




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Engaging Patients in Education for Self-Management in an Accountable Care Environment

Christine A. Beebe
Jul 1, 2011; 29:123-126
Practical Pointers




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Helping Patients Make and Sustain Healthy Changes: A Brief Introduction to Motivational Interviewing in Clinical Diabetes Care

Michele Heisler
Oct 1, 2008; 26:161-165
Practical Pointers




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Standards of Medical Care in Diabetes--2019 Abridged for Primary Care Providers

American Diabetes Association
Jan 1, 2019; 37:11-34
Position Statements




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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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A Real-World Approach to Insulin Therapy in Primary Care Practice

Irl B. Hirsch
Apr 1, 2005; 23:78-86
Practical Pointers




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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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Beware the Rareness Illusion When Exploring the Unknown

Here's a great vacation idea. Spend the summer roaming the world in search of the 10 lost tribes of Israel, exiled from Samaria by the Assyrians 2700 years ago (2 Kings 17:6). Or perhaps you'd like to search for Prester John, the virtuous ruler of a kingdom lost in the Orient? Or would you rather trace the gold-laden kingdom of Ophir (1 Kings 9:28)? Or do you prefer the excitement of tracking the Amazons, that nation of female warriors? Or perhaps the naval power mentioned by Plato, operating from the island of Atlantis? Or how about unicorns, or the fountain of eternal youth? The Unknown is so vast that the possibilities are endless.

Maybe you don't believe in unicorns. But Plato evidently "knew" about the island of Atlantis. The conquest of Israel is known from Assyrian archeology and from the Bible. That you've never seen a Reubenite or a Naphtalite (or a unicorn) means that they don't exist?

It is true that when something really does not exist, one might spend a long time futilely looking for it. Many people have spent enormous energy searching for lost tribes, lost gold, and lost kingdoms. Why is it so difficult to decide that what you're looking for really isn't there? The answer, ironically, is that the world has endless possibilities for discovery and surprise.

Let's skip vacation plans and consider some real-life searches. How long should you (or the Libyans) look for Muammar Qaddafi? If he's not in the town of Surt, maybe he's Bani Walid, or Algeria, or Timbuktu? How do you decide he cannot be found? Maybe he was pulverized by a NATO bomb. It's urgent to find the suicide bomber in the crowded bus station before it's too late - if he's really there. You'd like to discover a cure for AIDS, or a method to halt the rising global temperature, or a golden investment opportunity in an emerging market, or a proof of the parallel postulate of Euclidean geometry.

Let's focus our question. Suppose you are looking for something, and so far you have only "negative" evidence: it's not here, it's not there, it's not anywhere you've looked. Why is it so difficult to decide, conclusively and confidently, that it simply does not exist?

This question is linked to a different question: how to make the decision that "it" (whatever it is) does not exist. We will focus on the "why" question, and leave the "how" question to students of decision theories such as statistics, fuzzy logic, possibility theory, Dempster-Shafer theory and info-gap theory. (If you're interested in an info-gap application to statistics, here is an example.)

Answers to the "why" question can be found in several domains.

Psychology provides some answers. People can be very goal oriented, stubborn, and persistent. Marco Polo didn't get to China on a 10-hour plane flight. The round trip took him 24 years, and he didn't travel business class.

Ideology is a very strong motivator. When people believe something strongly, it is easy for them to ignore evidence to the contrary. Furthermore, for some people, the search itself is valued more than the putative goal.

The answer to the "why" question that I will focus on is found by contemplating The Endless Unknown. It is so vast, so unstructured, so, well ..., unknown, that we cannot calibrate our negative evidence to decide that whatever we're looking for just ain't there.

I'll tell a true story.

I was born in the US and my wife was born in Israel, but our life-paths crossed, so to speak, before we were born. She had a friend whose father was from Europe and lived for a while - before the friend was born - with a cousin of his in my home town. This cousin was - years later - my 3rd grade teacher. My school teacher was my future wife's friend's father's cousin.

Amazing coincidence. This convoluted sequence of events is certainly rare. How many of you can tell the very same story? But wait a minute. This convoluted string of events could have evolved in many many different ways, each of which would have been an equally amazing coincidence. The number of similar possible paths is namelessly enormous, uncountably humongous. In other words, potential "rare" events are very numerous. Now that sounds like a contradiction (we're getting close to some of Zeno's paradoxes, and Aristotle thought Zeno was crazy). It is not a contradiction; it is only a "rareness illusion" (something like an optical illusion). The specific event sequence in my story is unique, which is the ultimate rarity. We view this sequence as an amazing coincidence because we cannot assess the number of similar sequences. Surprising strings of events occur not infrequently because the number of possible surprising strings is so unimaginably vast. The rareness illusion is the impression of rareness arising from our necessary ignorance of the vast unknown. "Necessary" because, by definition, we cannot know what is unknown. "Vast" because the world is so rich in possibilities.

The rareness illusion is a false impression, a mistake. For instance, it leads people to wrongly goggle at strings of events - rare in themselves - even though "rare events" are numerous and "amazing coincidences" occur all the time. An appreciation of the richness and boundlessness of the Unknown is an antidote for the rareness illusion.

Recognition of the rareness illusion is the key to understanding why it is so difficult to confidently decide, based on negative evidence, that what you're looking for simply does not exist.

One might be inclined to reason as follows. If you're looking for something, then look very thoroughly, and if you don't find it, then it's not there. That is usually sound and sensible advice, and often "looking thoroughly" will lead to discovery.

However, the number of ways that we could overlook something that really is there is enormous. It is thus very difficult to confidently conclude that the search was thorough and that the object cannot be found. Take the case of your missing house keys. They dropped from your pocket in the car, or on the sidewalk and somebody picked them up, or you left them in the lock when you left the house, or or or .... Familiarity with the rareness illusion makes it very difficult to decide that you have searched thoroughly. If you think that the only contingencies not yet explored are too exotic to be relevant (a raven snatched them while you were daydreaming about that enchanting new employee), then think again, because you've been blinded by a rareness illusion. The number of such possibilities is so vastly unfathomable that you cannot confidently say that all of them are collectively negligible. Recognition of the rareness illusion prevents you from confidently concluding that what you are seeking simply does not exist.

Many quantitative tools grapple with the rareness illusion. We mentioned some decision theories earlier. But because the rareness illusion derives from our necessary ignorance of the vast unknown, one must always beware.

Looking for an exciting vacation? The Endless Unknown is the place to go. 




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Forthcoming in JHBS: Quêtelet on Deviance, McClelland on Leadership, Psychological Warfare, and More

A number of articles now in press at the Journal of the History of the Behavioral Sciences will be of interest to AHP readers. Full details below. “Uncovering the metaphysics of psychological warfare: The social science behind the Psychological Strategy Board’s operations planning, 1951–1953,” Gabrielle Kemmis. Abstract: In April 1951 president Harry S. Truman established … Continue reading Forthcoming in JHBS: Quêtelet on Deviance, McClelland on Leadership, Psychological Warfare, and More




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How to Mentally Prepare for a Synchro Swimming Competition

Some people have the misguided belief that synchronized swimming is just an easy sport performed in beautiful swim team suits. That it’s merely dancing in the water that you can tune in to watch during the Olympic Games. But that is far from true; there is much more to the sport.  Synchro is a dominant […]




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Women Who Buy Sex: Why They Do It, And What Their Experiences Are Like

Most research on people who patronize sex workers has focused on men. In some ways, this isn’t surprising because men are much more likely to report having paid for sex than are women. For example, in a recent YouGov survey of 1,000 adult Americans, 12% of men reported having paid for sex before compared to just 1% of women. Similarly, in a nationally representative survey of more than 20,000 Australians aged 16-69, researchers found that 17% of men said they had paid for sex, while only 0.3% of women said the same [1]. However, these figures may significantly underreport the actual number of women who have ever engaged the services of a sex worker.




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What are the Most Effective Pick-Up Lines? Here’s What the Science Says

For decades, researchers have been studying the effectiveness of different kinds of pick-up lines in order to better understand the psychology of attraction. What they’ve found is that certain types of lines definitely seem to work better than others—and the results have been surprisingly consistent over the years.




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How women are revolutionizing Rwanda | Agnes Binagwaho

In 1996, Agnes Binagwaho returned home to Rwanda in the aftermath of its genocide. She considered leaving amid the overwhelming devastation, but women in her community motivated her to stay and help rebuild -- and she's glad she did. In an inspiring talk, Binagwaho reflects on her work as Rwanda's former Minister of Health and discusses her new women's education initiative for the country, which strives to create one of the greatest levels of gender equality worldwide.




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Why COVID-19 is hitting us now -- and how to prepare for the next outbreak | Alanna Shaikh

Where did the new coronavirus originate, how did it spread so fast -- and what's next? Sharing insights from the outbreak, global health expert and TED Fellow Alanna Shaikh traces the spread of COVID-19, discusses why travel restrictions aren't effective and highlights the medical changes needed worldwide to prepare for the next pandemic. "We need to make sure that every country in the world has the capacity to identify new diseases and treat them," she says. (Recorded March 5, 2020. Update: the CDC is now calling for everyone to wear face coverings in public.)




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A fascinating time capsule of human feelings toward AI | Lucy Farey-Jones

How comfortable are you with robots taking over your life? Covering a wide range of potential applications -- from the mundane (robot house cleaner) to the mischievous (robot sex partner) to the downright macabre (uploading your brain to live on after death) -- technology strategist Lucy Farey-Jones shares data-backed evidence of how our willingness to accept AI may be radically changing.




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2 questions to uncover your passion -- and turn it into a career | Noeline Kirabo

What's your passion? Social entrepreneur Noeline Kirabo reflects on her work helping out-of-school young people in Uganda turn their passions into profitable businesses -- and shares the two questions you can ask yourself to begin doing the same.




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How health workers are responding to the COVID-19 pandemic | Esther Choo

The coronavirus pandemic is unlike anything we've ever seen in health care, says emergency physician Esther Choo. Sharing insights into how health workers are responding to the outbreak, she explains what makes this public health emergency different from others -- and provides a few simple things you can do to help. Watch to the end to hear about Choo's work deploying mobile ICUs across the United States as hospitals start to reach capacity. (This virtual conversation is part of the TED Connects series, hosted by current affairs curator Whitney Pennington Rodgers and head of curation Helen Walters. Recorded April 7, 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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How to co-parent as allies, not adversaries | Ebony Roberts and Shaka Senghor

When Shaka Senghor and Ebony Roberts ended their relationship, they made a pact to protect their son from its fallout. What resulted was a poetic meditation on what it means to raise a child together, yet apart. In this moving and deeply personal talk, Senghor and Roberts share their approach to co-parenting -- an equal, active partnership that rolls with the punches and revels in the delights of guiding their child through the world with thought and intention.




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The mental health benefits of storytelling for health care workers | Laurel Braitman

Health care workers are under more stress than ever before. How can they protect their mental health while handling new and complex pressures? TED Fellow Laurel Braitman shows how writing and sharing personal stories helps physicians, nurses, medical students and other health professionals connect more meaningfully with themselves and others -- and make their emotional well-being a priority.





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Teenagers Who Believe They Are Particularly Intelligent Tend To Be More Narcissistic And Happier With Life

By Emily Reynolds. But self-assessed intelligence was not actually related to objective measures of intelligence




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We’re Drawn To Fictional Villains Who Are Similar To Us

By Emma Young. Fans of fictional villains share both positive and negative personality traits with them.




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Helping Prepare Teachers in Massachusetts for Day One

Massachusetts' new performance assessment for teacher candidates helps boost readiness.




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How States and Schools Are Working to Grow Young Voters

States are tweaking voter registration laws for teenage voters and schools are busing students to the polls. Will these efforts help young people get in the habit of voting?




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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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North Carolina Teachers Say Conditions in Schools Are 'Unacceptable'

North Carolina teachers had press conferences in seven locations across the state to criticize education spending levels.




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Two More Statewide Teacher Protests Are on the Horizon

Teachers in North Carolina and Oregon plan to walk out of their classrooms in protest in May.




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West Virginia Teachers Are Going on Strike Again

Teachers across the state will walk out of their classrooms on Tuesday to protest an education bill going through the state legislature.




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Where They Are: The Nation's Small But Growing Population of Black English-Learners

In five northern U.S. states, black students comprise more than a fifth of ELL enrollment.




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Lion's Share of Ohio Districts Rank No Teachers as 'Ineffective'

About 94 percent of Ohio school districts did not rate a single teacher as "ineffective," the lowest rating on the state's four-rung teacher-evaluation scale, according to the 2016-17 state report card.




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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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Will Child-Care Services Help Recruit Teachers? Oklahoma District Aims to Find Out

A small school district in Oklahoma plans to offer low-cost daycare services to its employees next year in an effort to better compete with larger districts when it comes to recruiting and retaining teachers.




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Are Math Coaches the Answer to Lagging Achievement?

A sizable body of research shows that intensive, one-on-one coaching can improve instructional practice and student achievement more than other professional development offerings for teachers.




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How Schools Are Putting Equity First in Math Instruction

Educators are changing instructional priorities, altering lessons, and working on ways to help teachers grow professionally, all in an effort to raise math achievement.




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Alabama lawmakers advance pared down budgets amid COVID-19




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How 4 Communities Are Struggling to Prepare Kids for an Uncertain Future

Schools are slowly figuring out how to balance thinking globally with acting locally, and recognizing that some key skills are valuable no matter where students end up living.




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Why Troubles Are Mounting for Online Charter Schools in Three States

Officials in Illinois, Nevada, and Pennsylvania are proposing to close online charter schools over concerns that they're producing subpar academic results for students.




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New Public Data Tool Lets You See What Curricula Schools in Nebraska Are Using

Nebraska's education department released an interactive instructional materials map last week, showing what curricula districts have adopted for English-language arts, math, and K-8 science.




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Nebraska Education Department accused of software-pirating




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Alabama lawmakers advance pared down budgets amid COVID-19




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New York Leap-Frogs ESSA With Its Own Financial Transparency Rule

New York will require some districts next year to have their school-by-school spending amounts approved by the state, an effort to assure that state funds are being distributed as intended.




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Schools Are Required to Teach Mental-Health Lessons This Fall in Two States. And That's a First.

Students returning to schools in Virginia and New York this fall will be required to participate in mental-health education as part of their health and physical education courses.




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Memphis Superintendent Dorsey Hopson Leaving to Join Healthcare Company

Hopson became the interim superintendent in Shelby County, Tenn., in 2013 after the Memphis City School system merged with Shelby County schools. That merger then led six suburban communities to break away from the merged school system to form their own school districts.




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Will Colorado Teachers Go on Strike? Lawmakers Are Worried

Two Republican legislators in Colorado have introduced a bill that would enact harsh consequences, including jail time, for teachers and teachers' unions who go on strike.




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Dual-Language Learning: How Schools Can Empower Students and Parents

In this fifth installment on the growth in dual-language learning, the executive director of the BUENO Center for Multicultural Education at the University of Colorado, Boulder., says districts should focus on the what students and their families need, not what educators want.




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Colorado Teachers Are the Latest to Rally for Better Pay, More School Funding

Teachers in Colorado forced at least one school district to close as they rallied at the capitol to call for more education funding.