Inequality of opportunity and growth

Theoretical and empirical studies exploring the effects of income inequality upon growth reach a disappointing inconclusive result. This paper postulates that one reason for this ambiguity is that income inequality is actually a composite measure of at least two different sorts of inequality: inequality of opportunity and inequality of returns to effort. These two types of inequality affect growth through opposite channels, so the relationship between income inequality and growth is positive or negative depending on which component is larger. We test this proposal using inequality-of-opportunity measures computed from the PSID database for 23 states of the U.S. in 1980 and 1990. We find robust support for a negative relationship between inequality of opportunity and growth, and a positive relationship between inequality of returns to effort and growth.income inequality; inequality of opportunity; economic growth.

Personalized Medicine for Diabetes: The Prevention of Type 2 Diabetes: An Overview

Type 2 diabetes mellitus is one of the major public health threats in the United States today, reaching epidemic rates. Epidemiological evidence suggests a strong link between obesity and the risk of developing diabetes. Increasing evidence demonstrates that lifestyle interventions can significantly delay or possibly prevent the onset of type 2 diabetes in persons with increased risk. Despite these findings, there remain important barriers to the translation of this research to the public health. These include identifying persons with an increased risk for developing the disease and the lack of easily accessible, cost-effective intervention programs. At least one study, however, has effectively implemented an evidenced-based intervention in community settings, suggesting that it may be possible to develop a model for the national scalability of primary prevention in the United States

Inequality of Opportunity and Inequality of Effort: a Canonical Growth Model

Theoretical and empirical studies exploring the effects of income inequality upon growth reach a disappointing inconclusive result. Some recent empirical papers have emphasized that one reason for this ambiguity could be that income inequality is actually a composite measure of inequality of opportunity (IO) and inequality of effort (IE). These types of inequality would affect growth through opposite channels, so the relationship between inequality and growth would depend on which component is larger. Based on this preliminary empirical result, we build an intergenerational model with human capital of inequality and development. The existence of a trap in the process of human capital accumulation generates multiplicity of equilibria and permits the inclusion of social mobility in the analysis. The model is able to explain how IO and IE affect human capital accumulation and hence ongoing long-run growth. The existence of social mobility in society makes the relationship between income inequality and growth to be non-linear, and the final sign of the in fluence of inequality on growth to be dependent on the degree of development and overall inequality of the economy. We find that IE is generally benefi cial to human capital accumulation and, therefore, to ongoing growth, while IO positively affects human capital (income) only for less developed economies

Psychometric Properties of the Healthful Eating Belief Scales for Persons at Risk of Diabetes

Objective: To examine the validity and reliability of Theory of Planned Behavior (TPB) scales for healthful eating for persons at risk for diabetes. Design: Cross-sectional, using a self-administered questionnaire. Setting: Community in the Midwest. Participants: 106 adults who self-identified based on one or more American Diabetes Association diabetes risks. Variables Measured: Behavioral, normative, and control beliefs; and attitude, subjective norm, perceived behavioral control, and intention to eat a healthful diet. Analysis: Construct validity was assessed with factor analyses and measurement and structural models using structural equation modeling. Reliability of the scales was assessed with Cronbach alpha and a 2-month test- retest. Results: Factor analysis loadings were greater than .37. Cronbach alphas for the behavioral, normative, and control belief scales were .80, .91, and .84, respectively. The measurement model revealed that the measures were significant estimates for the TPB constructs, and they fit well as indirect measures of attitude, subjective norm, and perceived behavioral control in predicting intention to eat a healthful diet. Test-retest revealed 2- month stability of the scales. Conclusions and Implications: Scales for measuring TPB behavioral, normative, and control beliefs were valid and reliable for use with adults at risk for diabetes. Further examination with minority persons is warranted

The HealthPia GlucoPack™ Diabetes Phone: A Usability Study

This is a copy of an article published in Diabetes Technology & Therapeutics copyright Mary Ann Liebert, Inc.; Diabetes Technology & Therapeutics is available online at: http://online.liebertpub.com.Background: Type I diabetes is a common chronic disease of childhood. Both the growing influence of peers and the shifting away from parental influence have been implicated as prime elements contributing to poor glycemic outcomes in adolescents. Mobile technology that can be directed towards providing self-management support and modifying potentially negative child parent interaction holds promise to improve control in adolescents with diabetes. Methods: HealthPia, Inc. (Palisades Park, NJ) has developed a prototype system, the HealthPia GlucoPack™ Diabetes Monitoring System, which integrates a small blood glucose monitoring device into the battery pack of a cell phone. A pilot study used mixed quantitative and qualitative methods to evaluate user satisfaction with the integrated system, including the potential of the device to transmit self-monitoring data to a website for review and analysis by clinicians, parents, and patients. Results: Adolescents in our study liked the integration of the two technologies and agreed that the glucometer was easy to use and that the tool was useful in the management of their diabetes. Conclusions: Future work will focus on the utilization of the diabetes phone as a component of a care delivery system for adolescents with diabetes, including involvement of the health care team and enhancement of the web services that support the use of the phone

Center for Pediatric Obesity and Diabetes Prevention Research

poster abstractBackground To facilitate both research and treatment of obesity in youth who are at especially high risk for diabetes, we have created the Center for Pediatric Obesity and Diabetes Prevention Research. The mission of the center is to advance the health of vulnerable populations through obesity and diabetes prevention research focusing on mechanisms of progression from obesity to type 2 diabetes, defining best practices for obesity/diabetes prevention among youth, and cost-effective translation of the research to the community. Specific Aims 1. To promote the clinical investigation of pathophysiologic mechanisms, diagnosis, and primary prevention of type 2 diabetes among vulnerable youth 2. Foster collaboration and facilitate interdisciplinary research between investigators interested in childhood obesity and diabetes prevention 3. Participate in community-based diabetes prevention research Key Ongoing Collaborative Research Projects Youth Diabetes Prevention Clinic (YDPC) – Patient-Centered Outcomes Project This program is designed to evaluate and assess the needs of adolescents (ages 10 – 21) who have evidence of prediabetes. Our goal is to successfully intervene in the trajectory toward the development of diabetes, and to promote healthy weight-control and improved well-being through an individualized treatment plan. Not only has this allowed us to address a significant unmet clinical need, but also to advance pediatric obesity patient-centered outcomes research and comparative effectiveness research in adolescent obesity / diabetes prevention. Dietary Intervention for Glucose Intolerance in Teens (DIG-IT Study) The objective of this study is to determine the impact on glycemic control, in adolescents who have prediabetes, of an individually-tailored wellness coaching strategy used to modify lifestyle habits. Additionally, the study aims to identify lifestyle factors that drive glycemic control, independent of changes in weight. We are conducting this study in in the Youth Diabetes Prevention Clinic via a collaboration with Dr. Gletsu-Miller (Purdue University). ENCOURAGE Healthy Families Study This is a randomized trial evaluating the comparative effectiveness and costs of an adaptation of the Diabetes Prevention Program (DPP) directed at mothers and their children. The intervention is a group based lifestyle program which we developed and implemented in partnership with the YMCA. We are comparing the ENCOURAGE intervention targeted to 1) mothers who have had gestational diabetes or prediabetes, and 2) mothers who have had GDM or prediabetes along with their school-aged children

Physical Activity Belief Scales for Diabetes Risk: Development and Psychometric Testing

This article describes the development and psychometric evaluation of behavioral belief, normative belief, and control belief scales, derived from the theory of planned behavior to predict physical activity intentions of persons at risk for diabetes. In Study 1, belief statements from interviews were categorized, ranked, and evaluated for item construction. Content validity was established by 96. 1 % agreement among a five-member expert panel. In Study 2, items developed from the belief statements were administered to 106 adults at risk for diabetes. Psychometric analyses provided evidence of construct validity and reliability of the three scales. Internal consistency was sufficient (α = .76-.95), and test-retest evaluations indicated scale stability (r = .79- .91). Factor analyses and confirmatory factor analysis using structural equation modeling provided evidence that the items were appropriately grouped under each construct. Researchers and practitioners can use these measures to assess behavioral, normative, and control beliefs about physical activity among persons at risk for diabetes

Analytical Comparison of the Effectiveness of the Diabetes Prevention Program and Weight Watchers as media to prevent Type II Diabetes via Weight Loss in Different Age Categories

poster abstractType II Diabetes is a condition in which the body does not utilize insulin properly and causes detrimental symptoms such as glucose build up in the blood, overflown into the urine and passed out of the body without fulfilling the body’s main source of fuel. The Diabetes Prevention Program (DPP) is a multi-center clinical research study aimed to discover modest weight loss methods compared to oral medication (Glucophage) which prevents diabetes. Subsequently, the Health Information and Translational Sciences department at Indiana University School of Medicine uses Weight Watchers, a weight loss program, for participants at risk for Type II Diabetes (pre-diabetic) to monitor their weight and glucose levels. Both programs are investigating ways to justify the same hypothesis using different methods. Both studies aspire to determine the most affective ways for people to lose weight in order to prevent Type II Diabetes. The DPP was an efficacy trial to establish a correlation between weight loss and the risk of Type II Diabetes. Although the DPP successfully proved their hypothesis, the Weight Watchers study provides another approach in the mission of diabetes prevention. By analyzing six months of archived physical measurements data for the Diabetes Prevention Program study and the Weight Watchers study, one can determine how affective each program is in preventing weight loss depending on the age classification. The age groups are compared in fifteen-year intervals for both programs. Although both programs are successful in their mission, the conclusion of which program is more affective is still under continued study

mu-Opioid inhibition of Ca2+ currents and secretion in isolated terminals of the neurohypophysis occurs via ryanodine-sensitive Ca2+ stores

mu-Opioid agonists have no effect on calcium currents (I(Ca)) in neurohypophysial terminals when recorded using the classic whole-cell patch-clamp configuration. However, mu-opioid receptor (MOR)-mediated inhibition of I(Ca) is reliably demonstrated using the perforated-patch configuration. This suggests that the MOR-signaling pathway is sensitive to intraterminal dialysis and is therefore mediated by a readily diffusible second messenger. Using the perforated patch-clamp technique and ratio-calcium-imaging methods, we describe a diffusible second messenger pathway stimulated by the MOR that inhibits voltage-gated calcium channels in isolated terminals from the rat neurohypophysis (NH). Our results show a rise in basal intracellular calcium ([Ca(2+)]i) in response to application of [D-Ala(2)-N-Me-Phe(4),Gly5-ol]-Enkephalin (DAMGO), a MOR agonist, that is blocked by D-Phe-Cys-Tyr-D-Trp-Orn-Thr-Pen-Thr-NH2 (CTOP), a MOR antagonist. Buffering DAMGO-induced changes in [Ca(2+)]i with BAPTA-AM completely blocked the inhibition of both I(Ca) and high-K(+)-induced rises in [Ca(2+)]i due to MOR activation, but had no effect on kappa-opioid receptor (KOR)-mediated inhibition. Given the presence of ryanodine-sensitive stores in isolated terminals, we tested 8-bromo-cyclic adenosine diphosphate ribose (8Br-cADPr), a competitive inhibitor of cyclic ADP-ribose (cADPr) signaling that partially relieves DAMGO inhibition of I(Ca) and completely relieves MOR-mediated inhibition of high-K(+)-induced and DAMGO-induced rises in [Ca(2+)]i. Furthermore, antagonist concentrations of ryanodine completely blocked MOR-induced increases in [Ca(2+)]i and inhibition of I(Ca) and high-K(+)-induced rises in [Ca(2+)]i while not affecting KOR-mediated inhibition. Antagonist concentrations of ryanodine also blocked MOR-mediated inhibition of electrically-evoked increases in capacitance. These results strongly suggest that a key diffusible second messenger mediating the MOR-signaling pathway in NH terminals is [Ca(2+)]i released by cADPr from ryanodine-sensitive stores