Reform: School Choice • Allow families to choose beyond the what is assigned • Bring elements of the free market into education • Families can choose • Competition between schools improves quality • Problems with school choice • Who are the choosers? • Self selection: educated and wealthy families will exercise the choice • Access to information • Can afford to pay extra under a voucher • Those left behind • Choice based on proximity to residence or work or based on composition of student body • Introduces more divisions in society
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Building Dice # turn correct pips on if value == 1: self.pip4.setFill(self.foreground) elif value == 2: self.pip1.setFill(self.foreground) self.pip7.setFill(self.foreground) elif value == 3: self.pip1.setFill(self.foreground) self.pip7.setFill(self.foreground) self.pip4.setFill(self.foreground) elif value == 4: self.pip1.setFill(self.foreground) self.pip3.setFill(self.foreground) self.pip5.setFill(self.foreground) self.pip7.setFill(self.foreground) elif value == 5: self.pip1.setFill(self.foreground) self.pip3.setFill(self.foreground) self.pip4.setFill(self.foreground) self.pip5.setFill(self.foreground) self.pip7.setFill(self.foreground) else: self.pip1.setFill(self.foreground) self.pip2.setFill(self.foreground) self.pip3.setFill(self.foreground) self.pip5.setFill(self.foreground) self.pip6.setFill(self.foreground) self.pip7.setFill(self.foreground) Python Programming, 3/e 102
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Building Dice # turn correct pips on if value == 1: self.pip4.setFill(self.foreground) elif value == 2: self.pip1.setFill(self.foreground) self.pip7.setFill(self.foreground) elif value == 3: self.pip1.setFill(self.foreground) self.pip7.setFill(self.foreground) self.pip4.setFill(self.foreground) elif value == 4: self.pip1.setFill(self.foreground) self.pip3.setFill(self.foreground) self.pip5.setFill(self.foreground) self.pip7.setFill(self.foreground) elif value == 5: self.pip1.setFill(self.foreground) self.pip3.setFill(self.foreground) self.pip4.setFill(self.foreground) self.pip5.setFill(self.foreground) self.pip7.setFill(self.foreground) else: self.pip1.setFill(self.foreground) self.pip2.setFill(self.foreground) self.pip3.setFill(self.foreground) self.pip5.setFill(self.foreground) self.pip6.setFill(self.foreground) self.pip7.setFill(self.foreground) Python Programming, 2/e 101
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LETTER OF INTENT The effect of high intensity interval training versus moderate intensity training on anthropometric and cardiovascular health in children who are overweight or obese: A pilot study. PI Name: Ashwin Agrawal, DO, MA Stony Brook Children’s Hospital HSC T-11, Room 040 Stony Brook, NY 11794-8111 631-358-6106 [email protected] Funding Path Academic Pediatric Association Resident Investigator (RIA) Primary Mentor Name Peter Morelli, MD, FACC [email protected] Residency Program Director Name Robyn Blair, MD [email protected] Department Chair Name Margaret McGovern, MD [email protected] Participation Statement If funded, I agree to participate in any conference calls and/or in-person grantee meetings WORK IN PROGRESS…. PROBLEM, BACKGROUND AND SIGNIFICANCE: Approximately 30% of children in the United States are overweight/obese leading to a public health epidemic.[1] Pediatric obesity is linked to numerous acute and chronic health conditions including cardiovascular disease, diabetes, cancers, hypertension, and significant increase in all-cause mortality.[2, 3] Diet and exercise decrease the risk of obesity.[4] However, only 27% of children perform the recommended 60 minutes of daily exercise. [5] The American Academy of Pediatrics endorses that pediatricians assist children and their families with lifestyle modification such as diet and exercise to improve the physical, cognitive and mental state of children.[4] Fit Kids for Life (FKFL) is a 10 week lifestyle modification program developed and offered by Stony Brook Children’s since 1998 which incorporates nutritional guidance, wellness and a supervised exercise regimen for obese children in our community. Efficacy of pediatric obesity interventions is equivocal with many studies noting high attrition rates and poor long term adherence.[6-8] Factors that contribute to high attrition include: difficulty of exercise, repetitiveness/boredom from exercise routine or that weight loss was not visible. [6] Therefore, it is important to develop a novel, time efficient modality that will motivate, captivate and promote exercise and healthy nutrition for children to help reduce rates of pediatric obesity. Ideal intensity and duration of exercise programs for effective weight loss and improved health in pediatric populations is unclear.[6] Most pediatric obesity programs, including FKFL, have utilized moderate intensity training (MIT) which consists of exercise in 60 minute circuits.[6, 7] High intensity interval training programs (HIIT) have emerged and are effective at reducing weight and cardiovascular risk markers in adults.[9] Less is known abou the role of HIIT in the overweight/obese pediatric population. Early studies suggest that HIIT may have improved health benefits for children and adolescents. [10] Compared to MIT, HIIT programs employ short bursts of near maxim exercise intensity (HR ≥75% HR max) followed by brief rest periods and have a shorter duration (generally 30minutes). [10] HIIT programs have been found to be attractive to children and adolescents for several reasons including: 1) HIIT more closely mimics typical movements of children - short bouts (< 15 seconds) and high intensity, 2) HIIT can be delivered in a shorter timeframe, and 3) HIIT paradigms are more like playing a game which may decrease boredom, increase enjoyment and promote higher adherence.[11-13] Currently used outcome measures in pediatric obesity studies (such as height, weight, waist to hip ratio, Body mass Index [BMI], heart rate [HR] and blood pressure [BP]) may not be ideal. For example, BMI is influenced by linear growth and ineffective at quantifying body composition; waist circumference, while promoted by the WHO as a valid predictor of cardiovascular disease, is fraught with measurement reliability issues; and vascular health may not be reflected by BP and HR changes alone. Three dimensional (3D) body imaging is a new technique which may offer greater reliability in measuring body circumferences and inferring body composition. In addition, bio-electrical impedance has shown to evaluate fat content and muscle mass fairly accurately. In terms of cardiovascular health, brachial artery flow-mediated dilatation (FMD) is a safe, non-invasive technique which correlates strongly with coronary endothelial function and predicts cardiovascular disease.[14, 15] In the adult literature, FMD has revealed improved vascular health following exercise and diet, even in the absence of weight loss. Therefore, FMD may be a strong indicator of cardiovascular improvement following the FKFL program, and this outcome may reflect program success despite lack of change in anthropometric measures. Studies show improved vascular health (FMD) in adults even when body composition and weight have not changed, thus FMD may potentially be a more sensitive measure of exercise (and overall program) effect.[15] SPECIFIC AIMS: Specific Aim 1: To determine if high intensity interval training (HIIT) is a better alternative to moderate intensity training (MIT) for improvements in a) BMI and weight loss, b) body composition by a novel 3D body scanning method and bioelectric impedance and and, c) cardiovascular health measured by FMD and heart rate variability in children and adolescents who are overweight and obese. Specific Aim 2a: To determine if children/adolescents who complete HIIT program have better attendance and long term adherence to lifestyle changes compared to the MIT group. Specific Aim 2b: To determine if children in the HIIT program report higher enjoyment and satisfaction compared to the MIT group. HYPOTHESES: Hypothesis 1: Children who complete the FKFL HIIT protocol will have greater improvements in CV health (as measured by BMI, body composition, vital signs, and FMD) as compared Commented [1]: I would remove this line. BIA is not
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Academic Excellence -- Accreditation School School of of Education Education School School of of Pharmacy Pharmacy Accreditation Accreditation Council Council for for Pharmacy Pharmacy Education Education School of Dental Medicine National National Council Council for for the the Accreditation Accreditation of of Teacher Teacher Education (NCATE) Education (NCATE) National National Association Association of of School School Psychologists Psychologists American American Speech-Language-and-Hearing Speech-Language-and-Hearing Assn. Assn. American American Dental Dental Association Association School School of of Engineering Engineering (ABET) (ABET) Accreditation Accreditation Board Board for for Engineering Engineering Technology Technology American American Council Council for for Construction Construction Education Education 44 44 Baccalaureate Baccalaureate Degree Degree Options Options The The Graduate Graduate School School 45 45 Masters Masters Degrees Degrees Doctoral/Professional Doctoral/Professional Degrees Degrees Pharmacy Pharmacy and and Dental Dental Medicine Medicine Nursing and Education Engineering Nursing and Education Engineering School School of of Nursing Nursing CCNE CCNE Commission Commission on on Collegiate Collegiate Nursing Nursing Education Education College College of ofArts Arts and and Sciences Sciences National NationalAssociation Association of of Schools Schools of of Music, Music, Voice, Voice, and and Piano; Piano; National NationalAssociation Association of of Schools Schools of ofArt Art and and Design; Design; School of Business (AACSB) –Association Association to to American American Chemical Chemical Society; Society; Advance Collegiate Schools of Business Advance Collegiate Schools of Business American AmericanArt Art Therapy; Therapy; Association AssociationAccrediting Accrediting Council Council in in Journalism Journalism and and Mass Mass Communication; Communication; Council Council on on Social Social Work Work Education Education National National Association Association of of Schools Schools of of Public PublicAffairs Affairs and andAdministration; Administration; National NationalAssociation Association of of Schools Schools of of Theatre Theatre
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Level II Placements 1st Rotation 2nd Rotation FW Site 1 1 Student 1- 1st Choice 1 Student 2- 1st Choice FW Site 1 1 Student 1- 1st 0 Student 2- 1st FW Site 2 1 Student 2- 1st Choice Student 3- 2nd Choice Student 4- 3rd Choice 1 Student A- 1st Student B- 2nd choice Student C- 3rd Choice FW Site 3 1 Student 4- 1st Choice Student 5- 1st Choice Student 6- 1st Choice Student 7-2nd Choice Student 8- 2nd Choice Student 9- 3rd Choice 1 Student 2- 1st Student 3- 1st Student 4- 1st Student 5- 1st Student 6- 1st Student 7- 1st FW Site 4 0 Student 10- 1st 0 Student 11- 1st Choice FW Site 5 1 No Student 1 No Student FW Site 6 1 No Student 1 Student 11- 1st Student 12- 1st Lake Charles MC with free housing
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