Alcohol drinking, the metabolic syndrome and diabetes in a population with high mean alcohol consumption.

AIMS: To investigate the relationship of alcohol consumption with the metabolic syndrome and diabetes in a population-based study with high mean alcohol consumption. Few data exist on these conditions in high-risk drinkers. METHODS: In 6172 adults aged 35-75 years, alcohol consumption was categorized as 0, 1-6, 7-13, 14-20, 21-27, 28-34 and ≥ 35 drinks/week or as non-drinkers (0), low-risk (1-13), medium-to-high-risk (14-34) and very-high-risk (≥ 35) drinkers. Alcohol consumption was objectively confirmed by biochemical tests. In multivariate analysis, we assessed the relationship of alcohol consumption with adjusted prevalence of the metabolic syndrome, diabetes and insulin resistance, determined with the homeostasis model assessment of insulin resistance (HOMA-IR). RESULTS: Seventy-three per cent of participants consumed alcohol, 16% were medium-to-high-risk drinkers and 2% very-high-risk drinkers. In multivariate analysis, the prevalence of the metabolic syndrome, diabetes and mean HOMA-IR decreased with low-risk drinking and increased with high-risk drinking. Adjusted prevalence of the metabolic syndrome was 24% in non-drinkers, 19% in low-risk (P<0.001 vs. non-drinkers), 20% in medium-to-high-risk and 29% in very-high-risk drinkers (P=0.005 vs. low-risk). Adjusted prevalence of diabetes was 6.0% in non-drinkers, 3.6% in low-risk (P<0.001 vs. non-drinkers), 3.8% in medium-to-high-risk and 6.7% in very-high-risk drinkers (P=0.046 vs. low-risk). Adjusted HOMA-IR was 2.47 in non-drinkers, 2.14 in low-risk (P<0.001 vs. non-drinkers), 2.27 in medium-to-high-risk and 2.53 in very-high-risk drinkers (P=0.04 vs. low-risk). These relationships did not differ according to beverage types. CONCLUSIONS: Alcohol has a U-shaped relationship with the metabolic syndrome, diabetes and HOMA-IR, without differences between beverage types.

Juvenile Recidivism Report, December 2005

The following report contains district-level numbers for the percent of juveniles in Iowa’s Juvenile Court System and the number who re-offended (subsequent complaint/s). These numbers represent the data available in the ICIS system for initial complaints in 2002, an subsequent complaints. The report also includes recidivism numbers for those counties that had more than 180 initial complaints These numbers are representative, but are not state totals. All districts are represented, but no all counties. The 5th District only includes Polk County due to a data migration issue that, at this time, does not allow the remaining 5th District counties data to be analyzed.

State of Iowa Juvenile Delinquency Annual Statistical Report, 2006

The Iowa Juvenile Court Services Offices are issuing their fourth annual statewide report. The the Iowa Division of Criminal and Juvenile Justice Planning (CJJP). This report would not be possible without the dedication of, and assistance from, all of the above-mentioned people. The eight Chief Juvenile Court Officers would like to take this opportunity to thank their staff for their dedication and their ability to enter accurate information on every youth referred to Juvenile Court Services; the staff at the Iowa Court Information System, without whom this report would not be possible; and CJJP for their maintenance of the Iowa Justice Data Warehouse and their support in preparing this document.

State of Iowa Juvenile Delinquency Annual Statistical Report, 2007

The Iowa Juvenile Court Services Offices are issuing their fourth annual statewide report. The the Iowa Division of Criminal and Juvenile Justice Planning (CJJP). This report would not be possible without the dedication of, and assistance from, all of the above-mentioned people. The eight Chief Juvenile Court Officers would like to take this opportunity to thank their staff for their dedication and their ability to enter accurate information on every youth referred to Juvenile Court Services; the staff at the Iowa Court Information System, without whom this report would not be possible; and CJJP for their maintenance of the Iowa Justice Data Warehouse and their support in preparing this document.

DMC Section: 2008 State of Iowa Juvenile Justice and Delinquency Prevention Act Formula Grant Update, March 2009

This document is the DMC Section of Iowa’s 2009 federal Juvenile Justice and Delinquency Prevention Act (JJDP Act) formula grant three year plan update. The Division of Criminal and Juvenile Justice Planning (CJJP) wrote this update. CJJP is the state agency responsible for administering the JJDP Act in Iowa. Federal officials refer to state administering agencies as the state planning agency (SPA). The Plan was developed and approved by Iowa’s Juvenile Justice Advisory Council. That Council assists with administration of the JJDP Act, and also provides guidance and direction to the SPA, the Governor and the legislature regarding juvenile justice issues in Iowa. Federal officials refer to such state level groups as state advisory groups (SAG’s). The acronyms SPA and SAG are used through this report.

Statewide Process and Comparative Outcomes Study of 2003 Iowa Adult and Juvenile Drug Courts, August 2009

A statewide evaluation of the six adult and three juvenile drug courts in operation during calendar year 2003 was conducted. Completion rates, recidivism, substance abuse treatment, and supervision and placement (juveniles only) costs were examined by model (Judge and Community Panel) and by Judicial District. In addition, adult drug court participants were compared with a group of offenders who were screened and declined or were rejected by drug court in 2003 (referred) and a sample of offenders starting probation in 2003 (probationer). The adult participant and comparison groups were tracked from their entry into drug court, or the study, through December 31, 2007. This yielded an average post-program follow-up time of almost 3 years (2.9) for drug court participants. For the juvenile portion, drug court participants were compared with a group matched on several demographic and offense variables (Matched Comparison group) and juveniles referred to drug court who did not enter the program (Referred Comparison group). The juvenile participant and comparison groups were tracked from their entry into drug court, or the study, through approximately 16 quarters after program discharge with an end date of December 31, 2007.

Juvenile Crime Prevention Community Grand Fund Outcomes Report and FY2002 Juvenile Justice Youth Development Program Summary, January 2002

This document contains two related, but separate reports. The Juvenile Crime Prevention Community Grant Fund Outcomes Report is a summary of outcomes from services and activities funded through the Juvenile Crime Prevention Community Grant Fund in FY2001. The Juvenile Justice Youth Development Program Summary describes Iowa communities’ current prevention and sanction programs supported with funding from the Division of Criminal and Juvenile Justice Planning (CJJP) during FY2002. The material in Juvenile Crime Prevention Community Grant Fund Outcomes Report is presented in response to a legislative mandate to report specific prevention outcomes for the community Grant Fund. It includes a brief description of a Youth Development Results Framework established by the Iowa Collaboration for Youth Development. Outcomes are reported using this results framework, which was developed by a number of state agencies as a common tool for various state programs involving youth development related planning and funding processes. Included in this report is a description of outcomes from the prevention activities funded, all or in part, by the Community Grant Fund, as reported by local communities. The program summaries presented in the Juvenile Justice Youth Development Program Summary provide an overview of local efforts to implement their 2002 Juvenile Justice Youth Development plans and include prevention and sanction programs funded through the combined resources of the State Community Grant Fund and the Federal Title V Prevention, Juvenile Justice & Delinquency Prevention Act Formula Grant and Juvenile Accountability Incentive Block Grant programs. These combined funds are referred to in this document as the Juvenile Justice Youth Development (JJYD) funds. To administer the JJYD funds, including funds from the Community Grant Fund, CJJP partners with local officials to facilitate a community planning process that determines the communities’ priorities for the use of the funds. The local planning is coordinated by the Iowa’s Decategorization Boards (Decats). These local officials and/or their staff have been leaders in providing oversight or staff support to a variety of local planning initiatives (e.g. child welfare, Comprehensive Strategy Pilot Projects, Empowerment, other) and bring child welfare and community planning experience to the table for the creation of comprehensive community longterm planning efforts. The allocation of these combined funds and the technical assistance received by the Decats from CJJP is believed to have helped enhance both child welfare and juvenile justice efforts locally and has provided for the recognition and establishment of connections for joint child welfare/juvenile justice planning. The allocation and local planning approach has allowed funding from CJJP to be “blended” or “braided” with other local, state, and federal dollars that flow to communities as a result of their local planning responsibilities. The program descriptions provided in this document reflect services and activities supported with JJYD funds. In many cases, however, additional funding sources have been used to fully fund the programs. Most of the information in this document’s two reports was submitted to CJJP by the communities through an on- line planning and reporting process established jointly by the DHS and CJJP.

Juvenile Recidivism Report, June 2007

The following report contains district-level numbers for the percent of juveniles in Iowa’s Juvenile Court System and the number who re-offended (subsequent complaint/s). These numbers represent the data available in the ICIS system for initial complaints in 2004, and subsequent complaints in 2004, 2005, and 2006. The report also includes recidivism numbers for those counties that had more than 180 initial complaints during 2004.

Long-Range Goals for Iowa's Criminal & Juvenile Justice Systems, February 2005

Iowa Code Section 216A.135 requires the Criminal and Juvenile Justice Planning Advisory Council (CJJPAC) to submit a long-range plan for Iowa's justice system to the Governor and General Assembly every five years. The Criminal and Juvenile Justice Advisory Council directed that the 2005 plan be developed with input from the public. A public hearing was held in September 2004, utilizing the Iowa Communications Network at 5 sites across Iowa. Using the information gained, the Council developed new goals and strategies and modified others from the 2000 plan. The 2005 Long Range Goals for Iowa’s Criminal and Juvenile Justice Systems, organized as follows, are meant to facilitate analyses and directions for justice system issues and concerns in Iowa.

Iowa Medicaid Pharmaceutical and Therapeutics Committee and Diabetes Treatment Preferred Drug List, December 16, 2008

This document was produced to help the state and citizens of Iowa with the price list of preferred drug list of medicines that diabetics can use.

Two randomized trials of canakinumab in systemic juvenile idiopathic arthritis.

BACKGROUND: Interleukin-1 is pivotal in the pathogenesis of systemic juvenile idiopathic arthritis (JIA). We assessed the efficacy and safety of canakinumab, a selective, fully human, anti-interleukin-1β monoclonal antibody, in two trials. METHODS: In trial 1, we randomly assigned patients, 2 to 19 years of age, with systemic JIA and active systemic features (fever; ≥2 active joints; C-reactive protein, >30 mg per liter; and glucocorticoid dose, ≤1.0 mg per kilogram of body weight per day), in a double-blind fashion, to a single subcutaneous dose of canakinumab (4 mg per kilogram) or placebo. The primary outcome, termed adapted JIA ACR 30 response, was defined as improvement of 30% or more in at least three of the six core criteria for JIA, worsening of more than 30% in no more than one of the criteria, and resolution of fever. In trial 2, after 32 weeks of open-label treatment with canakinumab, patients who had a response and underwent glucocorticoid tapering were randomly assigned to continued treatment with canakinumab or to placebo. The primary outcome was time to flare of systemic JIA. RESULTS: At day 15 in trial 1, more patients in the canakinumab group had an adapted JIA ACR 30 response (36 of 43 [84%], vs. 4 of 41 [10%] in the placebo group; P<0.001). In trial 2, among the 100 patients (of 177 in the open-label phase) who underwent randomization in the withdrawal phase, the risk of flare was lower among patients who continued to receive canakinumab than among those who were switched to placebo (74% of patients in the canakinumab group had no flare, vs. 25% in the placebo group, according to Kaplan-Meier estimates; hazard ratio, 0.36; P=0.003). The average glucocorticoid dose was reduced from 0.34 to 0.05 mg per kilogram per day, and glucocorticoids were discontinued in 42 of 128 patients (33%). The macrophage activation syndrome occurred in 7 patients; infections were more frequent with canakinumab than with placebo. CONCLUSIONS: These two phase 3 studies show the efficacy of canakinumab in systemic JIA with active systemic features. (Funded by Novartis Pharma; ClinicalTrials.gov numbers, NCT00889863 and NCT00886769.).

Genome-wide association identifies nine common variants associated with fasting proinsulin levels and provides new insights into the pathophysiology of type 2 diabetes.

OBJECTIVE: Proinsulin is a precursor of mature insulin and C-peptide. Higher circulating proinsulin levels are associated with impaired β-cell function, raised glucose levels, insulin resistance, and type 2 diabetes (T2D). Studies of the insulin processing pathway could provide new insights about T2D pathophysiology. RESEARCH DESIGN AND METHODS: We have conducted a meta-analysis of genome-wide association tests of ∼2.5 million genotyped or imputed single nucleotide polymorphisms (SNPs) and fasting proinsulin levels in 10,701 nondiabetic adults of European ancestry, with follow-up of 23 loci in up to 16,378 individuals, using additive genetic models adjusted for age, sex, fasting insulin, and study-specific covariates. RESULTS: Nine SNPs at eight loci were associated with proinsulin levels (P < 5 × 10(-8)). Two loci (LARP6 and SGSM2) have not been previously related to metabolic traits, one (MADD) has been associated with fasting glucose, one (PCSK1) has been implicated in obesity, and four (TCF7L2, SLC30A8, VPS13C/C2CD4A/B, and ARAP1, formerly CENTD2) increase T2D risk. The proinsulin-raising allele of ARAP1 was associated with a lower fasting glucose (P = 1.7 × 10(-4)), improved β-cell function (P = 1.1 × 10(-5)), and lower risk of T2D (odds ratio 0.88; P = 7.8 × 10(-6)). Notably, PCSK1 encodes the protein prohormone convertase 1/3, the first enzyme in the insulin processing pathway. A genotype score composed of the nine proinsulin-raising alleles was not associated with coronary disease in two large case-control datasets. CONCLUSIONS: We have identified nine genetic variants associated with fasting proinsulin. Our findings illuminate the biology underlying glucose homeostasis and T2D development in humans and argue against a direct role of proinsulin in coronary artery disease pathogenesis.