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Oral Semaglutide Versus Empagliflozin in Patients With Type 2 Diabetes Uncontrolled on Metformin: The PIONEER 2 Trial

Helena W. Rodbard
Dec 1, 2019; 42:2272-2281
Emerging Therapies: Drugs and Regimens




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ADA, other organizations outline economic response needs to survive pandemic

The ADA and nearly 100 other organizations are asking Congress and the White House to help businesses survive the coronavirus crisis by reducing their costs and increasing their cash flow as much as possible in the coming weeks.




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ADA president: Reopening dental practices needs a team approach

As some dental practices begin plans to reopen and provide nonemergency care — as some states reopen following the direction of their state — the Association is urging dentists to have robust communication and engage their dental team members to address any concerns related to returning to work amid the COVID-19 pandemic.




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Analysis suggests states need to plan for second wave of COVID-19

Leaders across the United States should plan for a worst-case scenario, second wave to the COVID-19 pandemic, including no vaccine availability or herd immunity, say experts at the University of Minnesota.




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Patient portals need proxy options for better privacy protection, study finds

More patient portals and electronic health records should enable users to create "proxy" accounts for nurses and home aids to prevent unintentional sharing of personal health details, researchers said Monday.




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Angela's Tips for Handling Your Child's Special Education Needs

This guest post is written by Angela Peterson who writes on the topic of Online Psychology Degrees and can be emailed at angela_peterson@rediffmail.com

It’s not easy raising a child, and when he or she is affected by a severe disorder or disease, you have a greater challenge ahead of you. You have to put in extra effort, energy and thought into your child’s development and progress, one aspect of which includes their education. Some parents of children with special needs may be tempted to overprotect by keeping them in cloistered environments and limiting their interaction with the outside world. This usually only hampers the child instead of helping them. If you’re a parent with a child who has special needs, here’s some strategies:

* Understand your child: Some children may be able to express themselves while others are limited because of their disability. Whatever the case, understand your child and know that they have a mind of their own even if they are unable to speak it. Instead of forcing your will on them, get to know what they wish to do and cater to their needs as much as possible as long as it does not cause them any harm.

* Be patient: It’s a tough task, but you need to have an enormous amount of patience with your child. You need to condition yourself to be patient through practice and experience, otherwise you and your child will be subject to a great deal of stress.

* Decide on their education: There are many options for providing education to your special needs child, so look for what is available in your area. If you plan to homeschool, you will need to do some research before you’re up to the task. Many feel that it’s better to let the professionals handle this task who are trained and more experienced. Also, your child gets to mingle with other children and interact with them on a regular basis, which is very important to his or her social development.

*Think about inclusive classrooms: Parents often want their special needs children to attend regular schools. Learn about inclusive classrooms and determine if it is a good fit for your child. Consider if your child is up to the task of being educated with general education children and if he/she can cope with the curriculum in such classrooms. Although teachers in inclusive classrooms are trained to deal with children with special needs, there may be times when your child could be bullied or teased by the other kids for not being like them. Take all these facts into consideration before you decide on an inclusive classroom for your child.


Children with special needs need all the help and support they can get from parents and teachers, and it’s up to you to decide on the best form of education for them.




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What Parents Need to Know About the Special Education Evaluation


I spend most days of my life working with various students who are at different parts in the sped referral process. I attend Child Study Meetings where we decide if we are going to evaluate a student. I observe and screen children and talk with parents and teachers to help the committee make a good decision about whether we should do a special education evaluation.   I evaluate those students (this includes Psychological testing, observations, talking with student/teacher/parent, doing rating scales, etc.). I attend eligibility meetings where we determine if the student is eligible for for special education services. All of this is second nature to me and sometimes I need to stop and remember when a parent comes in, that this is NEW.

When I talk to parents, I find that many parents do not fully understand the special education referral process, even when they nod and act like they do. We as school staff need to do a better job of helping the parents understand the process. Parents also need to speak up and ask questions when there is not understanding.

This is a guide for parents to understand the process of special education testing, the testing components, and some of the test data. It is important to note that schools systems and states will vary to some degree. If you have any questions about the process in your school system, ask your school psychologist, teacher, or principal. Parents have every right to ask questions and usually school personnel are happy to help make this process less anxiety-provoking for you. It is important for parents to understand their rights during the special education process.


Special Education Process

After data shows that interventions have been attempted and if a student is suspected of having a disability, a referral is made to evaluate him or her for special education testing. Once the parents sign the Permission for Testing Forms, timelines begin and the schools have 65 business days to complete the assessments and hold the eligibility meeting. Some states may have a different timeline.

During these 65 days, several testing components will be completed with you and your child. The evaluators will write reports and a copy will be given to parents at the eligibility meeting. However, schools are required to have a copy available for parents to pick up two days before the eligibility meeting. It is advised, that parents take advantage of this and read reports before the meeting to help get familiar with the information and to formulate questions. The reports hold a lot of information that can be overwhelming if you are not familiar with this type of testing. Read Understanding Test Scores to understand the types of tests used and what the scores mean.

Additionally, the meeting is likely to bring forth strong emotions as your child’s difficulties are discussed openly. It can be overwhelming for parents, especially when not prepared. When parents do not read the reports prior to the eligibility meeting, they are the only people at the table who come to the meeting not knowing what to expect.


What if My Child is Found ELIGIBLE for Special Education Services?

Once a child is eligible for special education services, the schools have 30 days to develop an Individualized Education Plan (IEP) for the student. This will consist of accommodations, goals, and describe the services offered. Parents are part of a committee to help create this document. Once it is signed, schools are legally required to follow it. It is reviewed once a year, unless parents or teachers feel that changes are necessary. Every three years, the committee will determine if the student should be reevaluated. This is called a triennial evaluation. Sometimes another full evaluation will be conducted, other times a review of records and updated teacher information is used.


What if My Child is Found INELIGIBLE for Special Education Services?

If your child was found ineligible for special education services and you agree with the eligibility findings, then your child will not receive special education. He or she was evaluated because of a problem that still needs to be addressed within regular education. Ask for a separate meeting with your teacher or a team to determine what accommodations or strategies can be used to help.

If you believe that your child requires special education services and has a disability, but was found ineligible for services, make an appointment to meet with the special education director. If an agreement cannot be reached, you may be able to have an Independent Evaluation at the expense of the school. The results of that testing will be brought back to an eligibility meeting. A child MUST have 2 things before they can receive special education services: They must have a disability and there must be a documented educational impact that the student requires special education services to be successful.






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[ Singles & Dating ] Open Question : WHAT TO DO, TO MAKE FRIENDS? I NEED ADVICE?




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[ Engineering ] Open Question : How can I determine data rate of wireless device given this information?

802.11n device 20 MHz band 32 QAM 1/2 coding rate What's formula?




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[ Religion & Spirituality ] Open Question : How come there are different writers attributed to the Gospel of Mark.... why would Mark need different people to write his Gospel.?




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A Race Against the Clock: Meeting Seasonal Labor Needs in the Age of COVID-19

As governments have reacted to the coronavirus pandemic by closing borders, seasonal workers have been kept out, raising a pressing question: who is going to produce the food amid agricultural labor shortages? Policymakers in the Asia Pacific, Europe, and North America have responded by seeking to recruit residents, lengthen stays for already present seasonal workers, and find ways to continue admitting foreign seasonal labor, as this commentary explores.




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A Needed Evidence Revolution: Using Cost-Benefit Analysis to Improve Refugee Integration Programming

European countries have ramped up their investments in helping refugees find work and integrate into society. Yet little hard evidence exists of what programs and policies work best. This report proposes a new framework for thinking smartly about integration programming, using cost-benefit analysis to look beyond short-term, economic outcomes to also measure indirect benefits through a social-value concept.




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Legal Migration for Work and Training: Mobility Options to Europe for Those Not in Need of Protection

As EU Member States struggle to deliver on the European Union's call to expand channels for foreign workers, they should focus more on attracting the middle- and low-skilled third-country nationals needed by the labor market yet for whom few opportunities for admission exist. They also would do well to consider their migration policies in light of labor market, foreign policy, and development objectives, rather than as a means to reduce irregular migration, this report cautions.




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Responding to Early Childhood Education and Care Needs of Children of Asylum Seekers and Refugees in Europe and North America

Marking the release of an MPI report, this webinar examines the challenges and successes major host countries in Europe and North America are experiencing in providing high-quality early childhood education and care (ECEC) services for children from refugee and asylum seeker families.




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Surviving vs. Thriving: The Need for a Paradigm Shift in Adult Education for Immigrants and Refugees

Marking the release of an MPI brief that articulates a new adult education program model, this webinar features a discussion among immigration and legal services, adult education, and digital learning experts. The webinar includes a discussion of strategies to implement the English Plus Integration model, which would maintain a central focus on English language acquisition while also building skills necessary for successful immigrant integration.




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Surviving vs. Thriving: The Need for a Paradigm Shift in Adult Education for Immigrants and Refugees

Taking stock of weaknesses in the WIOA-driven design of most adult basic education programming, MPI analysts draw on research from the integration, adult education, and postsecondary success fields in arguing for the adoption of an “English Plus Integration” (EPI) adult education program model, and discuss strategies for implementation. 




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Thoughtful Investments Are Needed to Effectively Engage Volunteers in Refugee Integration

WASHINGTON — Rapid arrivals of humanitarian migrants in Europe and North America have been matched by an equally unprecedented outpouring of public support. As offers to volunteer and donate pour in, many have asked whether this generosity can be harnessed to ease pressures on overburdened receiving communities and service providers. But using volunteers to meet the longer-term integration needs of resettled refugees and recognized asylum seekers is not an automatic salve: it requires thoughtful training and investment to be effective.




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Governments in Europe & North America Need a New Social Contract for the Age of Spontaneous Migration

WASHINGTON — A new age of migration has been ushered in by large-scale spontaneous migration flows on both sides of the Atlantic, which have upended asylum adjudications systems and placed enormous stress on reception, housing and social services, particularly in Europe.




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

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




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Immigrant Families and Child Welfare Systems: Emerging Needs and Promising Policies

With the children of immigrants a growing share of all U.S. children, and federal immigration enforcement and other policies undergoing significant change, some state and local child welfare agencies are developing new ways to improve how they work with immigrant families. This report examines key cultural, linguistic, and legal challenges, and how agencies are adjusting staffing, training, placement, and other policies to tackle them.




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The Diabetes Attitudes, Wishes and Needs Second Study

Martha M. Funnell
Jan 1, 2015; 33:32-36
Translating Research to Practice




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Genesis for Engineers

Technology has come a long way since Australopithecus first bruised their fingers chipping flint to make knives and scrapers. We are blessed to fruitfully multiply, to fill the world and to master it (Genesis 1:28). And indeed the trend of technological history is towards increasing mastery over our world. Inventors deliberately invent, but many inventions are useless or even harmful. Why is there progress and how certain is the process? Part of the answer is that good ideas catch on and bad ones get weeded out. Reality, however, is more complicated: what is 'good' or 'bad' is not always clear; unintended consequences cannot be predicted; and some ideas get lost while others get entrenched. Mastering the darkness and chaos of creation is a huge engineering challenge. But more than that, progress is painful and uncertain and the challenge is not only technological.

An example of the weeding-out process, by which our mastery improves, comes to us in Hammurabi's code of law from 38 centuries ago:

"If a builder build a house for some one, and does not construct it properly, and the house which he built fall in and kill its owner, then that builder shall be put to death. If it kill the son of the owner the son of that builder shall be put to death." (Articles 229-230)

Builders who use inferior techniques, or who act irresponsibly, will be ruthlessly removed. Hammurabi's law doesn't say what techniques to use; it is a mechanism for selecting among techniques. As the level of competence rises and the rate of building collapse decreases, the law remains the same, implicitly demanding better performance after each improvement.

Hammurabi's law establishes negative incentives that weed out faulty technologies. In contrast, positive incentives can induce beneficial invention. John Harrison (1693-1776) worked for years developing a clock for accurate navigation at sea, motivated by the Royal Society's 20,000 pound prize.

Organizations, mores, laws and other institutions explain a major part of how good ideas catch on and how bad ones are abandoned. But good ideas can get lost as well. Jared Diamond relates that bow and arrow technologies emerged and then disappeared from pre-historic Australian cultures. Aboriginal mastery of the environment went up and then down. The mechanisms or institutions for selecting better tools do not always exist or operate.

Valuable technologies can be "side-lined" as well, despite apparent advantages. The CANDU nuclear reactor technology, for instance, uses natural Uranium. No isotope enrichment is needed, so its fuel cycle is disconnected from Uranium enrichment for military applications (atom bombs use highly enriched Uranium or Plutonium). CANDU's two main technological competitors - pressurized and boiling water reactors - use isotope-enriched fuel. Nuclear experts argue long (and loud) about the merits of various technologies, but no "major" or "serious" accidents (INES levels 6 or 7) have occurred with CANDU reactors but have with PWRs or BWRs. Nonetheless, the CANDU is a minor contributor to world nuclear power.

The long-run improvement of technology depends on incentives created by attitudes, organizations and institutions, like the Royal Society and the law. Technology modifies those attitudes and institutions, creating an interactive process whereby society influences technological development, and technology alters society. The main uncertainty in technological progress arises from unintended impacts of technology on mores, values and society as a whole. An example will make the point.

Early mechanical clocks summoned the faithful to prayer in medieval monasteries. But technological innovations may be used for generations without anyone realizing their full implications, and so it was with the clock. The long-range influence of the mechanical clock on western civilization was the idea of "time discipline as opposed to time obedience. One can ... use public clocks to summon people for one purpose or another; but that is not punctuality. Punctuality comes from within, not from without. It is the mechanical clock that made possible, for better or for worse, a civilization attentive to the passage of time, hence to productivity and performance." (Landes, p.7)

Unintended consequences of technology - what economists called "externalities" - can be beneficial or harmful. The unintended internalization of punctuality is beneficial (maybe). The clock example illustrates how our values gradually and unexpectedly change as a result of technological innovation. Environmental pollution and adverse climate change are harmful, even when they result from manufacturing beneficial consumer goods. Attitudes towards technological progress are beginning to change in response to perceptions of technologically-induced climate change. Pollution and climate change may someday seriously disrupt the technology-using societies that produced them. This disruption may occur either by altering social values, or by adverse material impacts, or both.

Progress occurs in historical and institutional context. Hammurabi's Code created incentives for technological change; monastic life created needs for technological solutions. Progress is uncertain because we cannot know what will be invented, and whether it will be beneficial or harmful. Moreover, inventions will change our attitudes and institutions, and thus change the process of invention itself, in ways that we cannot anticipate. The scientific engineer must dispel the "darkness over the deep" (Genesis 1:2) because mastery comes from enlightenment. But in doing so we change both the world and ourselves. The unknown is not only over "the waters" but also in ourselves.




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Why We Need Libraries, Or, Memory and Knowledge


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

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

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

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

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

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

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

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

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

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

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





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

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




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Schools Struggle to Meet Students' Mounting Mental-Health Needs

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




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Public Schools Get Creative to Meet Military Children's Needs (Video)

There are more than 1 million children in the U.S. whose parents are active duty military. This video explores some of the ways school leaders can work to meet these students' needs.




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Indiana teachers meet challenges for special needs students




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Murphy tells Trump at White House NJ will need billions




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Schools Struggle to Meet Students' Mounting Mental-Health Needs

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




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Special-needs children facing challenges amid virus outbreak




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Smart Scheduling Puts Students' Needs First

The principal of a school in Kentucky went back to the drawing board on his school's schedule after hearing author Daniel Pink talk about what children really need.




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John Hickenlooper, Who Helped Start a Scholarship Program For Needy High School Students, Announces Presidential Run

Former Colorado Gov. John Hickenlooper, who helped initiate a shakeup of Denver Public Schools, has announced that he's running for president as a Democrat in 2020.




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Superintendent: Immigrant Students Need a Safe Harbor in School

In the wake of anti-immigrant violence, we must help make sure that all students feel welcomed, writes Susana Cordova.




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Will Academia Give Rural Schools the Attention They Need?

A push to open a center devoted to research and professional development for rural K-12 holds promise for educators who work in small, isolated communities.




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Indiana teachers meet challenges for special needs students




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Murphy tells Trump at White House NJ will need billions




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Schools Struggle to Meet Students' Mounting Mental-Health Needs

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




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Special-needs children facing challenges amid virus outbreak




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Schools Struggle to Meet Students' Mounting Mental-Health Needs

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




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Murphy tells Trump at White House NJ will need billions




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School Named for Andrew Jackson Changes Name to Honor Famed NASA Engineer

Mary Jackson's story is among those depicted in the book "Hidden Figures," which focused on the lives of black women who worked as mathematicians and engineers for NASA during the Space Race. Before landing there, Jackson worked as a math teacher in Maryland.




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Utah to reconsider bill funding special needs scholarships




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Schools Struggle to Meet Students' Mounting Mental-Health Needs

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




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Mindful cricket : how to create the mindset you need to be the best cricketer you can be.




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Designing for resilient energy systems : choices in future engineering / edited by Paul Barnes and Neil Greet.




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Why we need religion / Stephen T. Asma.

Emotions -- Religious aspects.




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Honourable healers : pioneering women doctors : Elizabeth Blackwell, Elizabeth Garrett Anderson and Constance Stone / Merrilyn Murnane.

Stone, E. Constance (Emma Constance), 1856-1902.




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Autism spectrum disorder : what every parent needs to know / Alan I. Rosenblatt, MD, FAAP, Paul S. Carbone, MD, FAAP.

Autism spectrum disorders in children.




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The Royal School of Needlework book of embroidery : a guide to essential stitches, techniques and projects.

Embroidery.