Changes in type 1 diabetes health indicators from high school to college

ABSTRACT

Objective: Evaluate trajectories of type 1 diabetes health indicators from high school through the first year of college. Participants: Seventy-four students with type 1 diabetes who maintained pediatric endocrinology care during the first year of college. Methods: Hemoglobin A_1c (HbA1c), blood glucose monitoring frequency, body mass index (BMI), and clinic attendance data were collected via retrospective medical chart review in spring 2012. Group-based trajectory models evaluated diabetes-related health indicators over time and identified distinct growth trajectory groups. Results: BMI increased and clinic attendance decreased in the first year of college. Trajectories for other health indicators were heterogeneous and stable over time; 69% of students were classified as having stable good glycemic control. Racial minority youth and youth on conventional insulin regimens were disproportionally represented in higher-risk groups. Conclusions: Diabetes health indicators are stable or decline upon college entrance. Results signal the need for targeted support for college students with type 1 diabetes.     

Book reviews

The Anthropology of Europe: Identity and Boundaries in Conflict. Victoria A. Goddard, Josep R. Llobera and Cris Shore, eds. Oxford: Berg Publishers Ltd, 1994. 310 pp. $45.95 (cloth), $19.95 (paper).

Inside European Identities: Ethnography in Western Europe. Sharon MacDonald, ed., Oxford: Berg Publishers Ltd, 1993. 247pp. $ 49.95 (cloth), $19.95 (paper).     

Book Reviews

In censuses and surveys in most African countries it has become the practice to estimate informants' age by the method of the historical calendar. This involves an attempt to relate a remembered historical event, occurring during the subject's childhood, with his age at the time.

This paper attempts a first evaluation of the method with particular reference to the 1961–63 multi-round survey in rural Morocco. It is shown that in practice the method is highly complex and easily misunderstood by interviewers and respondents. An attempt to lay down a precise procedure by means of a very detailed questionnaire appeared to yield at best only marginally more accurate results than the simpler procedure used in an earlier round. The more complex questionnaire did, however, introduce new patterns of misuse by the interviewer. There was evidence that the historical calendar gave somewhat better data than eye estimates, but results were highly defective for both methods.

It is clear that the method is far from perfect. Interviewer training and supervision remain the key to accurate age determination. If the potential benefits of the complex historical calendar method are to be realized, training and supervision need to be even more thorough than where simpler methods are used.     

Property testing for cyclic groups and beyond

This paper studies the problem of testing if an input (Γ,°), where Γ is a finite set of unknown size and ° is a binary operation over Γ given as an oracle, is close to a specified class of groups. Friedl et al. (Proc. of STOC, 2005) have constructed an efficient tester using poly(log|Γ|) queries for the class of abelian groups. We focus in this paper on subclasses of abelian groups, and show that these problems are much harder: Ω(|Γ|^1/6) queries are necessary to test if the input is close to a cyclic group, and Ω(|Γ| ^c ) queries for some constant c are necessary to test more generally if the input is close to an abelian group generated by k elements, for any fixed integer k≥1. We also show that knowledge of the size of the ground set Γ helps only for k=1, in which case we construct an efficient tester using poly(log|Γ|) queries; for any other value k≥2 the query complexity remains Ω(|Γ| ^c ). All our upper and lower bounds hold for both the edit distance and the Hamming distance. These are, to the best of our knowledge, the first nontrivial lower bounds for such group-theoretic problems in the property testing model and, in particular, they imply the first exponential separations between the classical and quantum query complexities of testing closeness to classes of groups.     

From counselling to community work: Developing a framework for social work practice with displaced persons

Abstract

This paper represents the outcome of a process of reflection during and following a practice experience with 400 displaced persons from Kosova who were accommodated in southern Tasmania in 1999. Engaged to provide counselling services, the authors experienced misgivings from the outset that this alone would be an effective and appropriate response to people in circumstances of continuing displacement and uncertainty. The paper describes the evolution of services from counselling to community work, discusses emergent practice issues and identifies key principles for future practice.     

The Impact of the Within My Reach Relationship Training on Relationship Skills and Outcomes for Low‐Income Individuals

A federal grant was awarded to provide the Within My Reach healthy relationships curriculum to low‐income, at‐risk individuals involved with various social service agencies. The effectiveness of this curriculum was evaluated for 202 participants through measures of training and relationship outcomes pre‐, immediately post‐ and 6 months posttraining. Participants experienced high levels of training satisfaction; significant increases in knowledge, communication/conflict resolution skills, and relationship quality; as well as a trend in the reduction of relationship violence. An important implication of this research is that MFTs may broaden their service delivery to at‐risk individuals by collaborating with community agencies to adapt established relationship enhancement programs, evidence‐based tools, and principles that complement traditional couples therapy.     

Defining estimands for efficacy assessment in single arm phase 1b or phase 2 clinical trials in oncology early development

The addendum of the ICH E9 guideline on the statistical principles for clinical trials introduced the estimand framework. The framework is designed to strengthen the dialog between different stakeholders, to introduce greater clarity in the clinical trial objectives and to provide alignment between the estimand and statistical analysis. Estimand framework related publications thus far have mainly focused on randomized clinical trials. The intention of the Early Development Estimand Nexus (EDEN), a task force of the cross-industry Oncology Estimand Working Group ( www.oncoestimand.org ), is to apply it to single arms Phase 1b or Phase 2 trials designed to detect a treatment-related efficacy signal, typically measured by objective response rate. Key recommendations regarding the estimand attributes include that in a single arm early clinical trial, the treatment attribute should start when the first dose is received by the participant. Focusing on the estimation of an absolute effect, the population-level summary measure should reflect only the property used for the estimation. Another major component introduced in the ICH E9 addendum is the definition of intercurrent events and the associated possible ways to handle them. Different strategies reflect different clinical questions of interest that can be answered based on the journeys an individual subject can take during a trial. We provide detailed strategy recommendations for intercurrent events typically seen in early-stage oncology. We highlight where implicit assumptions should be made transparent as whenever follow-up is suspended, a while-on-treatment strategy is implied.