A Randomized Controlled Trial Translating the Diabetes Prevention Program to a University Worksite, Ohio, 2012-2014

INTRODUCTION: Working adults spend much time at the workplace, an ideal setting for wellness programs targeting weight loss and disease prevention. Few randomized trials have evaluated the efficacy of worksite diabetes prevention programs. This study evaluated the efficacy of a worksite lifestyle intervention on metabolic and behavioral risk factors compared with usual care. METHODS: A pretest-posttest control group design with 3-month follow-up was used. Participants with prediabetes were recruited from a university worksite and randomized to receive a 16-week lifestyle intervention (n = 35) or usual care (n = 34). Participants were evaluated at baseline, postintervention, and 3-month follow-up. Dietary intake was measured by a food frequency questionnaire and level of physical activity by accelerometers. Repeated measures analysis of variance compared the change in outcomes between and within groups. RESULTS: Mean (standard error [SE]) weight loss was greater in the intervention (-5.5% [0.6%]) than in the control (-0.4% [0.5%]) group (P < .001) postintervention and was sustained at 3-month follow-up (P < .001). Mean (SE) reductions in fasting glucose were greater in the intervention (-8.6 [1.6] mg/dL) than in the control (-3.7 [1.6] mg/dL) group (P = .02) postintervention; both groups had significant glucose reductions at 3-month follow-up (P < .001). In the intervention group, the intake of total energy and the percentage of energy from all fats, saturated fats, and trans fats decreased, and the intake of dietary fiber increased (all P < .01) postintervention. CONCLUSION: The worksite intervention improved metabolic and behavioral risk factors among employees with prediabetes. The long-term impact on diabetes prevention and program sustainability warrant further investigation

The aggregation paradox for statistical rankings and nonparametric tests.

The relationship between social choice aggregation rules and non-parametric statistical tests has been established for several cases. An outstanding, general question at this intersection is whether there exists a non-parametric test that is consistent upon aggregation of data sets (not subject to Yule-Simpson Aggregation Paradox reversals for any ordinal data). Inconsistency has been shown for several non-parametric tests, where the property bears fundamentally upon robustness (ambiguity) of non-parametric test (social choice) results. Using the binomial(n, p = 0.5) random variable CDF, we prove that aggregation of r(≥2) constituent data sets-each rendering a qualitatively-equivalent sign test for matched pairs result-reinforces and strengthens constituent results (sign test consistency). Further, we prove that magnitude of sign test consistency strengthens in significance-level of constituent results (strong-form consistency). We then find preliminary evidence that sign test consistency is preserved for a generalized form of aggregation. Application data illustrate (in)consistency in non-parametric settings, and links with information aggregation mechanisms (as well as paradoxes thereof) are discussed

Tobacco product transition patterns in rural and urban cohorts: Where do dual users go?

Introduction: Understanding diverse tobacco product consumption represents a crucial area for tobacco regulatory science. With the increase in dual/poly use of tobacco products, transition patterns among exclusive and dual users are of considerable interest. We describe transition patterns of dual users over 18 months. Methods: A cohort of 145 adults in urban and rural Ohio who reported dual tobacco product use at least some days/week was enrolled during 2014–17. Participants completed follow-up interviews every six months where they were classified into one of five categories: 1) exclusive combustible, 2) exclusive smokeless, 3) exclusive e-cigarette, 4) dual (at least 2 of the previous 3 categories), and 5) less than some days/week. Participants categorized as exclusive and dual (1–4) used their products at least some days per week. Separately within the rural and urban cohorts, 6, 12, and 18 month transition probabilities between the categories were estimated. Results: The probability of remaining a dual user after 6 months is 43% in the rural and 37% in the urban cohort. The decline continues through 18 months with 24% of rural and 22% of urban dual users remaining in the category. The probability of a dual user consuming combustibles and e-cigarettes transitioning to exclusive combustible use in 6 months is over 50% in both the rural and urban cohorts. Conclusions: Dual use is an unstable state with users being more likely to transition to exclusive combustible use than to remain in the dual use category. Transitions are similar in the rural and urban cohorts. Keywords: Urban and rural differences, Longitudinal research, Trajectories, Multiple tobacco product us

Effects of a 21st-Century Curriculum on Students’ Information Technology and Transition Skills

A pretest—posttest control group experimental design was used to evaluate the effectiveness of EnvisionIT, a 10-unit web-based curriculum designed to teach secondary students information technology (IT) skills in the context of transition-planning activities. Fifteen high schools were stratified by socioeconomic status and randomly assigned to the EnvisionIT experimental condition or a control condition in which students received traditional instruction. Pre- and posttest data for 287 students—119 (41%) of whom had disabilities—were analyzed using hierarchical linear modeling. Findings indicated that students in the experimental group made significantly greater gains in IT literacy than students in the control group. Students in the experimental group also showed greater gains in several transition skills, including goal setting, knowledge of how to find jobs, and information about college. Results support the conclusion that the EnvisionIT curriculum produces improvements in students’ acquisition of the 21st-century skills needed for success in today’s high tech world

The effect of glycaemic control and glycaemic variability on mortality in patients hospitalized with congestive heart failure

Photograph of a scene in Riverside Park with the Tulsa Skyline in the background