mp

As U.S. Health Care System Sags under Strain of Pandemic, Immigrants and Refugees with Degrees in Health Care Could Serve as an Important Resource

WASHINGTON – Even as 1.5 million immigrants and refugees are already employed in the U.S. health care system as doctors, registered nurses and pharmacists, another 263,000 foreign-born health care graduates are on the sidelines during the COVID-19 pandemic—many of them because of difficulties getting their credentials accepted by employers and licensing bodies.




mp

As Millions Are Pushed from Jobs amid Pandemic, the Loss of Employer Health Coverage & Limited Access to Public Coverage for Many Immigrants Hold Major Implications for Them – and U.S. Overall

WASHINGTON – As more than 33 million U.S. workers have lost their jobs since March amid the pandemic-induced economic crisis, immigrants are among the most vulnerable: They are more likely than the U.S. born to be laid off and to live in communities with high COVID-19 infection rates, and less likely to have health insurance coverage and access to a doctor or other usual source of health care.




mp

Integrating Refugees and Asylum Seekers into the German Economy and Society: Empirical Evidence and Policy Objectives

As the top destination in Europe for asylum seekers in recent years, Germany has rolled out a number of integration policy changes. Based on an early look at how newcomers’ integration is progressing, the report finds the policies have had ambiguous implications. The report also provides insights into the demographic and socioeconomic characteristics of the asylum seeker and refugee population.




mp

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

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




mp

Bbq barramundi, Jamon, minted peas, Dijon mustard dressing & Danish fetta

Delicious fish dish for a summer night.




mp

Tasha's simple no fuss Christmas cake

I absolutely adore a rich moist fruit cake laced with brandy. We love this cake in our house and will stay fresh in a airtight tin for months.




mp

WARM FIGS WITH HONEY, ORANGE & CINNAMON

It's rare for me to cook fresh figs as I think there is little that can better a squishy-ripe, jammy fig eaten just as is. However just sometimes when they are cheap (well, relatively speaking!) and plentiful, I make this dish; it makes a lovely, simple summer dessert. The thing to be mindful of when you're buying figs, is that they're often picked when they're under-ripe as they're easier to handle and store, however if they're like this they're rarely worth eating; look for figs that feel softly squishy when you gently cup them in your hand, and ideally have tiny splits in the tender flesh...your care will pay off in spades.





mp

Apricot & Vanilla Jam

This recipe features on Foodie Tuesday, a weekly segment with Raf Epstein on Drive , 774, 3.30pm, courtesy of Alice Zaslavsky.




mp

Pumpkin soup with roasted almond pesto

Pumpkin soup on it's own can be rather plain but with interesting garnishes, the ordinary becomes delicious. This variation on a classic pesto, which uses pine nuts, incorporates roasted almonds instead, giving this ubiquitous winter soup a greater depth of flavour and crunch.





mp

MY MUM'S PUMPKIN & DATE SCONES

I have clear memories of being about four year's old standing on a little stool next to my mum while she made batches of these golden scones. I always loved being in the kitchen with her and she was endlessly patient, letting me help mix, stir, roll and shape all manner of things (in this case turning a blind eye when I smuggled little nuggets raw dough and dates into my mouth.) We would chat away as we went and she would explain to me what she was doing. I remember to this day her telling me the secret to making good scones was to use the lightest touch possible when you're mixing the dough together...we had no food processor then so everything was mixed by hand and I loved rubbing the flour and butter together, lifting my hands high as she had taught me to help keep the scones light. Although I whiz these up in a processor now, every so often I make a batch by hand, and am immediately whisked back into that childhood kitchen and can almost feel and see Cooee, my mum, beside me in her wonderful cinch-waisted 60's polka dot dress...it's a wonderful image.




mp

Pumpkin lasagne

1.2kg butternut pumpkin, peeled, cut into 2cm pieces 2 tablespoons olive oil 1 tablespoon chopped fresh sage, plus 12 whole leaves to serve 1/4 teaspoon freshly grated nutmeg 350g ricotta 1 egg 1 cup grated parmesan, plus extra to serve 8 fresh lasagne sheets 100g unsalted butter 2 tablespoons chopped walnuts




mp

Local Pecan & Carrot Cake with cheats Caramelised Fig Vanilla Ice Cream

I love a carrot cake . Usually walnuts are used however who doesn't want to take advantage of the local new season pecans at our local markets . Happy baking!




mp

Six Simple Steps to Making Stock

This recipe was featured on Foodie Tuesday, a weekly segment on 774 Drive with Raf Epstein, 3.30PM, courtesy of Alice Zaslavsky.




mp

Ginger Prawn Dumplings

This recipe features on Foodie Tuesday, a weekly segment on 774 Drive with Raf Epstein, 3.30PM, shared by Alice Zaslavsky.




mp

Simple Raspberry Sorbet

This recipe features on Foodie Tuesday, a weekly segment on 774 Drive with Raf Epstein, 3.30PM, shared by Alice Zaslavsky, author of Alice's Food A-Z.




mp

Tash's Passionfruit &Coconut �� Slice

Love this tasty slice with the combo of coconut and the passion fruit what's there not to like?




mp

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.




mp

Spring chicken & mushroom casserole

Easy weekend entertaining featuring another great recipe from Geoff Jansz




mp

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.




mp

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.




mp

The Prevalence and Determinants of Cognitive Deficits and Traditional Diabetic Complications in the Severely Obese

OBJECTIVE

To determine the prevalence of cognitive deficits and traditional diabetic complications and the association between metabolic factors and these outcomes.

RESEARCH DESIGN AND METHODS

We performed a cross-sectional study in severely obese individuals before bariatric surgery. Lean control subjects were recruited from a research website. Cognitive deficits were defined by the National Institutes of Health (NIH) Toolbox (<5th percentile for lean control subjects). Cardiovascular autonomic neuropathy (CAN) was defined by an expiration-to-inspiration (E-to-I) ratio of <5th percentile for lean control subjects. Retinopathy was based on retinal photographs and nephropathy on the estimated glomerular filtration rate (<60 mg/dL) and/or the albumin-to-creatinine ratio (ACR) (≥30 mg/g). NIH Toolbox, E-to-I ratio, mean deviation on frequency doubling technology testing, and ACR were used as sensitive measures of these outcomes. We used multivariable linear regression to explore associations between metabolic factors and these outcomes.

RESULTS

We recruited 138 severely obese individuals and 46 lean control subjects. The prevalence of cognitive deficits, CAN, retinopathy, and nephropathy were 6.5%, 4.4%, 0%, and 6.5% in lean control subjects; 22.2%, 18.2%, 0%, and 6.1% in obese participants with normoglycemia; 17.7%, 21.4%, 1.9%, and 17.9% in obese participants with prediabetes; and 25.6%, 31.9%, 6.1%, and 16.3% in obese participants with diabetes. Waist circumference was significantly associated with cognitive function (–1.48; 95% CI –2.38, –0.57) and E-to-I ratio (–0.007; 95% CI –0.012, –0.002). Prediabetes was significantly associated with retinal function (–1.78; 95% CI –3.56, –0.002).

CONCLUSIONS

Obesity alone is likely sufficient to cause cognitive deficits but not retinopathy or nephropathy. Central obesity is the key metabolic risk factor.




mp

Reduction in Global Myocardial Glucose Metabolism in Subjects With 1-Hour Postload Hyperglycemia and Impaired Glucose Tolerance

OBJECTIVE

Impaired insulin-stimulated myocardial glucose uptake has occurred in patients with type 2 diabetes with or without coronary artery disease. Whether cardiac insulin resistance is present remains uncertain in subjects at risk for type 2 diabetes, such as individuals with impaired glucose tolerance (IGT) or those with normal glucose tolerance (NGT) and 1-h postload glucose ≥155 mg/dL during an oral glucose tolerance test (NGT 1-h high). This issue was examined in this study.

RESEARCH DESIGN AND METHODS

The myocardial metabolic rate of glucose (MRGlu) was measured by using dynamic 18F-fluorodeoxyglucose positron emission tomography combined with a euglycemic-hyperinsulinemic clamp in 30 volunteers without coronary artery disease. Three groups were studied: 1) those with 1-h postload glucose <155 mg/dL (NGT 1-h low) (n = 10), 2) those with NGT 1-h high (n = 10), 3) and those with IGT (n = 10).

RESULTS

After adjusting for age, sex, and BMI, both subjects with NGT 1-h high (23.7 ± 6.4 mmol/min/100 mg; P = 0.024) and those with IGT (16.4 ± 6.0 mmol/min/100 mg; P < 0.0001) exhibited a significant reduction in global myocardial MRGlu; this value was 32.8 ± 9.7 mmol/min/100 mg in subjects with NGT 1-h low. Univariate correlations showed that MRGlu was positively correlated with insulin-stimulated whole-body glucose disposal (r = 0.441; P = 0.019) and negatively correlated with 1-h (r = –0.422; P = 0.025) and 2-h (r = –0.374; P = 0.05) postload glucose levels, but not with fasting glucose.

CONCLUSIONS

This study shows that myocardial insulin resistance is an early defect that is already detectable in individuals with dysglycemic conditions associated with an increased risk of type 2 diabetes, such as IGT and NGT 1-h high.




mp

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.




mp

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.




mp

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.…




mp

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.




mp

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. 




mp

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.




mp

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.




mp

Chilling Effects: The Expected Public Charge Rule and Its Impact on Legal Immigrant Families’ Public Benefits Use

According to leaked drafts, the Trump administration is considering a rule that could have sweeping effects on both legal immigration to the United States and the use of public benefits by legal immigrants and their families. This report examines the potential scale of the expected rule’s impact, including at national and state levels and among children, as well as Hispanic and Asian American/Pacific Islander immigrants.




mp

Chilling Effects: The Expected Public-Charge Rule and Its Impact on Immigrant Families

This webinar highlights findings from an MPI report examining the potential impacts of expected changes to the public charge rule by the Trump administration. Leaked draft versions suggest the rule could sharply expand the number of legally present noncitizens facing difficulty getting a green card or extending a visa as a result of their family's use of public benefits. The rule likely would discourage millions from accessing health, nutrition, and social services for which they or their U.S.-citizen dependents are eligible.




mp

The Public-Charge Rule: Broad Impacts, But Few Will Be Denied Green Cards Based on Actual Benefits Use

While the Trump administration public-charge rule is likely to vastly reshape legal immigration based on its test to assess if a person might ever use public benefits in the future, the universe of noncitizens who could be denied a green card based on current benefits use is quite small. That's because very few benefit programs are open to noncitizens who do not hold a green card. This commentary offers estimates of who might be affected.




mp

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.




mp

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 […]




mp

Musculoskeletal Complications of Diabetes Mellitus

Rachel Peterson Kim
Jul 1, 2001; 19:
Practical Pointers




mp

Effects of Glycemic Control on Diabetes Complications and on the Prevention of Diabetes

Jay S. Skyler
Oct 1, 2004; 22:162-166
Feature Articles




mp

Integration of Clinical Psychology in the Comprehensive Diabetes Care Team

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




mp

Diabetes Self-Management in a Community Health Center: Improving Health Behaviors and Clinical Outcomes for Underserved Patients

Daren Anderson
Jan 1, 2008; 26:22-27
Bridges to Excellence




mp

The Disparate Impact of Diabetes on Racial/Ethnic Minority Populations

Edward A. Chow
Jul 1, 2012; 30:130-133
Diabetes Advocacy




mp

Improving Patient Adherence

Alan M. Delamater
Apr 1, 2006; 24:71-77
Feature Articles




mp

Empowerment and Self-Management of Diabetes

Martha M. Funnell
Jul 1, 2004; 22:123-127
Feature Articles




mp

Microvascular and Macrovascular Complications of Diabetes

Michael J. Fowler
Apr 1, 2008; 26:77-82
Diabetes Foundation




mp

The Heroic Leadership Imperative

Allison, S. T. & Goethals, G. R. (2020). The heroic leadership imperative: How leaders inspire and mobilize change. West Yorkshire: Emerald. Our next book describes a new principle that we call the heroic leadership imperative. We show how leaders who fulfill the imperative will inspire followers and initiate social change.   The imperative consists of … Continue reading The Heroic Leadership Imperative



  • Our latest books on HEROIC LEADERS

mp

10 Examples of Heroism Arising From the COVID-19 Pandemic

By Scott T. Allison In any tragedy or crisis, you will see many people standing out and stepping up to save lives and make the world a better place. These heroic individuals can range from leaders of nations to ordinary citizens who rise to the occasion to help others in need. During this COVID-19 pandemic, … Continue reading 10 Examples of Heroism Arising From the COVID-19 Pandemic




mp

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


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

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

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






mp

New Theory & Psychology: Early Critical Theory and Beck’s Cognitive Theory

Two articles in the most recent issue of Theory & Psychology may interest AHP readers. Full details below. “How lost and accomplished revolutions shaped psychology: Early Critical Theory (Frankfurt School), Wilhelm Reich, and Vygotsky,” by Gordana Jovanovi?. Abstract: On the occasion of recent centenaries of revolutions in Europe (1917, 1918–19), this article examines, within a … Continue reading New Theory & Psychology: Early Critical Theory and Beck’s Cognitive Theory