STAR 3 randomized controlled trial to compare sensor-augmented insulin pump therapy with multiple daily injections in the treatment of type 1 diabetes: research design, methods, and baseline characteristics of enrolled subjects.

BACKGROUND: Sensor-augmented pump therapy (SAPT) integrates real-time continuous glucose monitoring (RT-CGM) with continuous subcutaneous insulin infusion (CSII) and offers an alternative to multiple daily injections (MDI). Previous studies provide evidence that SAPT may improve clinical outcomes among people with type 1 diabetes. Sensor-Augmented Pump Therapy for A1c Reduction (STAR) 3 is a multicenter randomized controlled trial comparing the efficacy of SAPT to that of MDI in subjects with type 1 diabetes. METHODS: Subjects were randomized to either continue with MDI or transition to SAPT for 1 year. Subjects in the MDI cohort were allowed to transition to SAPT for 6 months after completion of the study. SAPT subjects who completed the study were also allowed to continue for 6 months. The primary end point was the difference between treatment groups in change in hemoglobin A1c (HbA1c) percentage from baseline to 1 year of treatment. Secondary end points included percentage of subjects with HbA1c < or =7% and without severe hypoglycemia, as well as area under the curve of time spent in normal glycemic ranges. Tertiary end points include percentage of subjects with HbA1c < or =7%, key safety end points, user satisfaction, and responses on standardized assessments. RESULTS: A total of 495 subjects were enrolled, and the baseline characteristics similar between the SAPT and MDI groups. Study completion is anticipated in June 2010. CONCLUSIONS: Results of this randomized controlled trial should help establish whether an integrated RT-CGM and CSII system benefits patients with type 1 diabetes more than MDI.

Coevolution of capitalism and political representation: The choice of electoral systems

Protocorporatist West European countries in which economic interests were collectively organized adopted PR in the first quarter of the twentieth century, whereas liberal countries in which economic interests were not collectively organized did not. Political parties, as Marcus Kreuzer points out, choose electoral systems. So how do economic interests translate into party political incentives to adopt electoral reform? We argue that parties in protocorporatist countries were representative of and closely linked to economic interests. As electoral competition in single member districts increased sharply up to World War I, great difficulties resulted for the representative parties whose leaders were seen as interest committed. They could not credibly compete for votes outside their interest without leadership changes or reductions in interest influence. Proportional representation offered an obvious solution, allowing parties to target their own voters and their organized interest to continue effective influence in the legislature. In each respect, the opposite was true of liberal countries. Data on party preferences strongly confirm this model. (Kreuzer's historical criticisms are largely incorrect, as shown in detail in the online supplementary Appendix.). © 2010 American Political Science Association.

Hannah Arendt's Theory of Political Judgment

Hannah Arendt's theory of political judgment has been an ongoing perplexity among scholars who have written on her. As a result, her theory of judgment is often treated as a suggestive but unfinished aspect of her thought. Drawing on a wider array of sources than is commonly utilized, I argue that her theory of political judgment was in fact the heart of her work. Arendt's project, in other words, centered around reestablishing the possibility of political judgment in a modern world that historically has progressively undermined it. In the dissertation, I systematically develop an account of Arendt's fundamentally political and non-sovereign notion of judgment. We discover that individual judgment is not arbitrary, and that even in the complex circumstances of the modern world there are valid structures of judgment which can be developed and dependably relied upon. The result of this work articulates a theory of practical reason which is highly compelling: it provides orientation for human agency which does not rob it of its free and spontaneous character; shows how we can improve and cultivate our political judgment; and points the way toward the profoundly intersubjective form of political philosophy Arendt ultimately hoped to develop.