Why Do Institutional Plan Sponsors Hire and Fire their Investment Managers?

This paper examines the investment allocation decisions of pension plans, endowments, foundations, and other institutional plan sponsors. The experience and education of plan sponsors and the environment (both regulatory and agency) of the institutional market suggests that institutional investors rely less on past performance and use diffe rent criteria when evaluating performance compared to mutual fund investors. Institutional investors are expected to be less concerned with total returns and more considerate of benchmark-adjusted excess returns, and the consistency with which they are delivered, over longer time horizons. An examination of asset and account flows for actively-managed U.S. equity products is largely consistent with these expectations. The consistency with which managers deliver positive or negative active returns relative to the S&P500 over multiple horizons, without regard to the magnitude of these returns, plays a key role in determining the flow of assets among investment products. Style benchmarks play a larger role in determining account movements, which is found to employ more criteria than asset moves. However, total return is also considered, as the magnitudes of a one-year loss and 3 and 5-year total returns are found to be incremental factors in plan sponsors’ allocation decisions. One explanation for this result is the principal-agent arrangement faced by plan sponsors. Although the sponsors may be more sophisticated than the typical retail investor, their clients, investors and the investment board, may not be. Plan sponsors may minimize job risk by hiring and firing managers based on excess returns with incremental allocations based on total returns, thereby satisfying both their mandate and their clients. It is also found that smaller and older products capture relatively greater flows.pension plans, endowments, foundations

A mobile phone-based program to promote healthy behaviors among adults with prediabetes: study protocol for a pilot randomized controlled trial

Abstract Background Rates of participation in Diabetes Prevention Programs (DPPs) are low. This may be due, in part, to low levels of autonomous motivation (i.e., motivation that arises from internal sources and sustains healthy behaviors over time) to prevent type 2 diabetes (T2DM) among many individuals with prediabetes. Mobile health (mHealth) technologies that incorporate principles from the Self-Determination Theory offer an effective and scalable approach to increase autonomous motivation levels. One promising mobile phone-based application is JOOL Health, which aims to help users connect certain health behaviors (e.g., sleep and diet) with personal values in specific life domains (e.g., family and work). The first aim of this study is to estimate whether JOOL Health can increase autonomous motivation to prevent T2DM among individuals with prediabetes who declined DPP participation. The second aim of this pilot study is to examine the intervention’s feasibility and acceptability. Methods This is a 12-week, three-arm pilot randomized controlled trial. We will recruit 105 individuals with prediabetes who did not engage in a DPP despite invitation from their health plan to participate in face-to-face or web-based programs at no out-of-pocket-cost. Participants will be randomized to one of three study arms: (1) a group that receives information on prediabetes, evidence-based strategies to decrease progression to T2DM, and a list of resources for mHealth tools for monitoring diet, physical activity, and weight (comparison group); (2) a group that receives the JOOL Health application; and (3) a group that receives the JOOL Health application as well as a Fitbit activity tracker and wireless-enabled scale. Our primary outcome is change in autonomous motivation to prevent T2DM (measured using the Treatment Self-Regulation Questionnaire). We will also collect data related to the intervention’s feasibility (recruitment and retention rates) and acceptability (adherence and qualitative experience) as well as changes in psychosocial outcomes, hemoglobin A1c, and weight. Discussion To our knowledge, this is the first study that aims to promote positive health behaviors among individuals with prediabetes who previously declined to participate in a DPP. Our results will inform a larger trial to test the effect of JOOL Health on clinically relevant outcomes, including weight loss, physical activity, and DPP engagement. Trial registration NCT03025607 . Registered February 2017.https://deepblue.lib.umich.edu/bitstream/2027.42/142382/1/40814_2018_Article_246.pd

Sioux Falls Renewable Project Final Report

Sioux Falls is the largest city in South Dakota with a population of over 171,000 residents. Sioux Falls is one of only two cities in South Dakota to have an Office of Sustainability. South Dakota is a national leader in the amount of renewable energy produced with large amounts of hydropower and wind energy produced, and the climactic conditions on South Dakota are conducive for additional wind and solar energy production. Therefore, Sioux Falls is well position to take a leadership role in mitigating climate change in South Dakota. One way for Sioux Falls to mitigate climate change – and model climate action for the state and region – is to transition the energy use in the city to 100% renewable energy. There are currently more than 175 cities in the United States that have completed, are in the process, or have pledged to transition to 100% renewable energy. Although Sioux Falls is not one of these cities, we believe that there is potential for Sioux Falls to transition to 100% renewable energy. The primary uses of energy in a city include electricity, heating, and transportation. Based on reviews of the existing cities who are or have transitioned to 100% renewable energy, we determined that many cities first focus on a transition to 100% renewable electricity. The purpose of this report is to explore the opportunities and constraints – and to provide recommendations – for engaged stakeholders to develop a campaign for Sioux Falls to transition to 100% renewable electricity by 2035.https://red.library.usd.edu/sustainability-projects/1006/thumbnail.jp

Activation of Central Melanocortin Pathways by Fenfluramlne

D-fenfluramine (d-FEN) was once widely prescribed and was among the most effective weight loss drugs, but was withdrawn from clinical use because of reports of cardiac complications in a subset of patients. Discerning the neurobiology underlying the anorexic action of d-FEN may facilitate the development of new drugs to prevent and treat obesity. Through a combination of functional neuroanatomy, feeding, and electrophysiology studies in rodents, we show that d-FEN-induced anorexia requires activation of central nervous system melanocortin pathways. These results provide a mechanistic explanation of d-FEN\u27s anorexic actions and indicate that drugs targeting these downstream melanocortin pathways may prove to be effective and more selective antiobesity treatments

Molecular reductions in glucokinase activity increase counter-regulatory responses to hypoglycemia in mice and humans with diabetes.

OBJECTIVE: Appropriate glucose levels are essential for survival; thus, the detection and correction of low blood glucose is of paramount importance. Hypoglycemia prompts an integrated response involving reduction in insulin release and secretion of key counter-regulatory hormones glucagon and epinephrine that together promote endogenous glucose production to restore normoglycemia. However, specifically how this response is orchestrated remains to be fully clarified. The low affinity hexokinase glucokinase is found in glucose-sensing cells involved in glucose homeostasis including pancreatic β-cells and in certain brain areas. Here, we aimed to examine the role of glucokinase in triggering counter-regulatory hormonal responses to hypoglycemia, hypothesizing that reduced glucokinase activity would lead to increased and/or earlier triggering of responses. METHODS: Hyperinsulinemic glucose clamps were performed to examine counter-regulatory responses to controlled hypoglycemic challenges created in humans with monogenic diabetes resulting from heterozygous glucokinase mutations (GCK-MODY). To examine the relative importance of glucokinase in different sensing areas, we then examined responses to clamped hypoglycemia in mice with molecularly defined disruption of whole body and/or brain glucokinase. RESULTS: GCK-MODY patients displayed increased and earlier glucagon responses during hypoglycemia compared with a group of glycemia-matched patients with type 2 diabetes. Consistent with this, glucagon responses to hypoglycemia were also increased in I366F mice with mutated glucokinase and in streptozotocin-treated β-cell ablated diabetic I366F mice. Glucagon responses were normal in conditional brain glucokinase-knockout mice, suggesting that glucagon release during hypoglycemia is controlled by glucokinase-mediated glucose sensing outside the brain but not in β-cells. For epinephrine, we found increased responses in GCK-MODY patients, in β-cell ablated diabetic I366F mice and in conditional (nestin lineage) brain glucokinase-knockout mice, supporting a role for brain glucokinase in triggering epinephrine release. CONCLUSIONS: Our data suggest that glucokinase in brain and other non β-cell peripheral hypoglycemia sensors is important in glucose homeostasis, allowing the body to detect and respond to a falling blood glucose.Yousef Jameel Fund Sir Jukes Thorn Trust Elmore Fund Chang Gung University College of Medicin

Leptin Does Not Directly Affect CNS Serotonin Neurons to Influence Appetite

Serotonin (5-HT) and leptin play important roles in the modulation of energy balance. Here we investigated mechanisms by which leptin might interact with CNS 5-HT pathways to influence appetite. Although some leptin receptor (LepRb) neurons lie close to 5-HT neurons in the dorsal raphe (DR), 5-HT neurons do not express LepRb. Indeed, while leptin hyperpolarizes some non-5-HT DR neurons, leptin does not alter the activity of DR 5-HT neurons. Furthermore, 5-HT depletion does not impair the anorectic effects of leptin. The serotonin transporter-cre allele (Sert(cre)) is expressed in 5-HT (and developmentally in some non-5-HT) neurons. While Sert(cre) promotes LepRb excision in a few LepRb neurons in the hypothalamus, it is not active in DR LepRb neurons, and neuron-specific Sert(cre)-mediated LepRb inactivation in mice does not alter body weight or adiposity. Thus, leptin does not directly influence 5-HT neurons and does not meaningfully modulate important appetite-related determinants via 5-HT neuron function

The Shared Health Appointments and Reciprocal Enhanced Support (SHARES) study: study protocol for a randomized trial

Abstract Background Diabetes shared medical appointments (SMAs) and reciprocal peer support programs have been found in efficacy trials to help adults with diabetes improve their self-management and achieve short-term gains in clinical and patient-centered outcomes. In order to translate this evidence to system-level interventions, there is a need for large-scale, pragmatic trials that examine the effectiveness, implementation, and costs of SMAs and reciprocal peer support across diverse settings. Methods The Shared Health Appointments and Reciprocal Enhanced Support (SHARES) study is a multisite, cluster randomized trial that is evaluating the effectiveness and implementation of SMAs with and without an additional reciprocal Peer-to-Peer (P2P) support program, when compared to usual care. The P2P program comprises periodic peer support group sessions and telephone contact between SMA participant pairs to promote more effective diabetes self-management. We will examine outcomes across three different treatment groups: (1) SMAs, (2) SMAs plus P2P, and (3) usual care. We will collect and analyze data over a 2.5-year implementation period at five geographically diverse Veterans Affairs (VA) health systems. The primary outcome is the relative change in hemoglobin A1c over time. Secondary outcomes are changes in systolic blood pressure, antihypertensive medication use, statin use, and insulin initiation over the study period. The unit of analysis is the individual, adjusted by the individual’s SMA group (the cluster). We will use mixed methods to rigorously evaluate processes and costs of implementing these programs in each of the clinic settings. Discussion We hypothesize that patients will experience improved outcomes immediately following participation in SMAs and that augmenting SMAs with reciprocal peer support will help to maintain these gains over time. The results of this study will be among the first to examine the effects of diabetes SMAs alone and in conjunction with P2P in a range of real-life clinical settings. In addition, the study will provide important information on contextual factors associated with successful program implementation. Trial registration ClinicalTrials.gov, ID: NCT02132676 . Registered on 21 August 2013.https://deepblue.lib.umich.edu/bitstream/2027.42/136794/1/13063_2017_Article_1959.pd