RESUMEN
Relatively little research has addressed whether conceptual frameworks of early learning generalize across different national contexts. This article reports on a cross-country measurement invariance analysis of the International Development and Early Learning Assessment (IDELA). The IDELA is a direct assessment tool for 3- to 6-year-old children, intended to measure Early Literacy, Early Numeracy, Motor, and Social-Emotional development. Its generalizability is evaluated using samples from 5 countries: Afghanistan (N = 2,629); Bolivia (N = 480); Ethiopia (N = 682); Uganda (N = 504); and Vietnam (N = 675). The 4-domain model of the IDELA was supported in each country, although the domains were highly correlated. Measurement invariance analysis revealed that most IDELA items do not provide a basis for comparing children's development over the 5 countries. This research supports the use of the IDELA for program evaluation and within-country monitoring purposes, but cautions against its use for international comparisons. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
Asunto(s)
Desarrollo Infantil/fisiología , Comparación Transcultural , Aprendizaje/fisiología , Pruebas Neuropsicológicas/normas , Afganistán , Bolivia , Niño , Preescolar , Etiopía , Femenino , Humanos , Pruebas del Lenguaje/normas , Masculino , Reproducibilidad de los Resultados , Uganda , VietnamRESUMEN
Oxyntomodulin (OXM), an enteroendocrine hormone, causes appetite suppression, increased energy expenditure, and weight loss in obese humans via activation of GLP-1 and glucagon receptors. However, the effects of OXM on glucose homeostasis remain ill defined. To address this gap, we evaluated the effects of an i.v. infusion of native OXM on insulin secretion rates (ISRs) and glycemic excursion in a graded glucose infusion (GGI) procedure in two separate randomized, placebo (PBO)-controlled, single-dose crossover trials in 12 overweight and obese subjects without diabetes and in 12 obese subjects with type 2 diabetes mellitus (T2DM), using the GLP-1 analog liraglutide (LIRA) as a comparator in T2DM. In both groups, in the GGI, 3.0 pmol/kg/min of OXM significantly increased ISR and blunted glycemic excursion relative to PBO. In T2DM, the effects of OXM were comparable to those of LIRA, including restoration of ß-cell glucose responsiveness to that of nonobese subjects without diabetes. Our findings indicate that native OXM significantly augments glucose-dependent insulin secretion acutely in obese subjects with and without diabetes, with effects comparable to pharmacologic GLP-1 receptor activation and independent of weight loss. Native OXM has potential to improve hyperglycemia via complementary and independent induction of insulin secretion and weight loss.
Asunto(s)
Fármacos Antiobesidad/uso terapéutico , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Hiperglucemia/prevención & control , Hipoglucemiantes/uso terapéutico , Obesidad/tratamiento farmacológico , Sobrepeso/tratamiento farmacológico , Oxintomodulina/uso terapéutico , Adulto , Fármacos Antiobesidad/administración & dosificación , Fármacos Antiobesidad/efectos adversos , Índice de Masa Corporal , Estudios de Cohortes , Estudios Cruzados , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/complicaciones , Relación Dosis-Respuesta a Droga , Método Doble Ciego , Receptor del Péptido 1 Similar al Glucagón/agonistas , Receptor del Péptido 1 Similar al Glucagón/metabolismo , Glucosa/administración & dosificación , Glucosa/efectos adversos , Humanos , Hiperglucemia/inducido químicamente , Hipoglucemiantes/administración & dosificación , Hipoglucemiantes/efectos adversos , Infusiones Intravenosas , Insulina/sangre , Insulina/metabolismo , Secreción de Insulina , Células Secretoras de Insulina/efectos de los fármacos , Células Secretoras de Insulina/metabolismo , Masculino , Obesidad/sangre , Obesidad/complicaciones , Sobrepeso/sangre , Sobrepeso/complicaciones , Oxintomodulina/administración & dosificación , Oxintomodulina/efectos adversos , Receptores de Glucagón/agonistas , Receptores de Glucagón/metabolismo , Adulto JovenRESUMEN
BACKGROUND: Postprandial hyperglycemia poses a challenge to closed-loop systems. Dipeptidyl peptidase-4 (DPP-4) inhibitors, like sitagliptin, reduce postprandial glucose concentrations in patients with type 2 diabetes. The objective of this study was to assess sitagliptin's role in type 1 diabetes (T1DM) as an adjunct therapy in reducing postprandial blood glucose with an insulin-only closed-loop system. METHODS: This was a randomized, double-blinded, placebo controlled, crossover design trial. The participants were18-35 years old, had T1DM, and an HbA1c of ≤ 8.5%. A dose determination study included eight subjects with T1DM. There were three study visits. Four hours after receiving study drug (placebo, sitagliptin 50 mg, sitagliptin 100 mg), subjects underwent a mixed meal tolerance test with assessment of hormone concentrations. In a second study, 15 subjects underwent two visits receiving either placebo or 100 mg of sitagliptin plus an insulin only closed-loop system for 25 hours with timed meals. Blood glucose and other hormone concentrations were analyzed using repeated measures ANOVA. RESULTS: For the dose determination study, sitagliptin 100 mg resulted in reduced postprandial blood glucose ( P = .006). For the closed-loop study, glucose concentrations were lower in the treatment group, most prominently during the first two study meals ( P = .03). There was no difference in glucagon concentrations, but insulin concentrations and insulin delivery were lower in the treatment group. CONCLUSIONS: Sitagliptin may be considered as an adjunct therapy in a closed-loop setting. Larger studies are needed to determine the role of oral agents like sitagliptin to lower postprandial hyperglycemia with closed loop.
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Glucemia/efectos de los fármacos , Diabetes Mellitus Tipo 1/tratamiento farmacológico , Hiperglucemia/prevención & control , Hipoglucemiantes/uso terapéutico , Fosfato de Sitagliptina/uso terapéutico , Adolescente , Adulto , Estudios Cruzados , Diabetes Mellitus Tipo 1/sangre , Método Doble Ciego , Quimioterapia Combinada/métodos , Femenino , Humanos , Insulina/administración & dosificación , Sistemas de Infusión de Insulina , Masculino , Periodo Posprandial/efectos de los fármacos , Adulto JovenRESUMEN
The authors examine the relationships between children's reading abilities and the enabling environment for learning in the context of Save the Children's Literacy Boost program. They conceptualize the enabling environment at a micro level, with two components: the home literacy environment, represented by reading materials/habits at home, and the community learning environment (community reading activities). Using longitudinal reading scores of 6,874 students in 424 schools in 12 sites across Africa and Asia, there was 1) a modest but consistent relationship between students' home literacy environments and reading scores, and 2) a strong relationship between reading gains and participation in community reading activities, suggesting that interventions should consider both home and community learning environments and their differential influences on interventions across different low-resource settings.