bluuebunny/crossref_metadata_2025 huggingface dataset:
Pooling and Rescinded or Forgone Stock Repurchases
Authors: Moehrle Stephen R. , Reynolds-Moehrle Jennifer A. , Wallace James S.
Published: March 2008

Securities and Exchange Commission (SEC) Staff Accounting Bulletin (SAB) No. 96 requires that firms rescind stock repurchase plans to receive pooling treatment for a business acquisition. In this study, we document the additional opportunity cost to pooling imposed by SAB No. 96 and revisit the purchase vs. pooling question with the additional consideration. Specifically, we examine whether firms should rescind or forgo stock repurchase plans to qualify to pool or simply accept purchase accounting treatment for mergers. We begin by establishing why firms choose to pool. We find that, consistent with anecdotal evidence in the financial press, firms pool to avoid the decreased earnings caused by amortization of goodwill that is recorded in a purchase. Next, given this motivation for pooling, we examine the purchase vs. pooling decision with the additional consideration imposed by the prohibition of stock repurchases. Our results suggest that forgoing stock repurchases to pool may not be in the best interest of shareholders. These findings support the decision of the FASB to eliminate pooling as an alternative.
A Special-Purpose Taxonomy of Corporate Social Performance Concepts
Authors: Stone Brett A.
Published: March 2008

The first iteration of a nonstatic special-purpose taxonomy of corporate social performance concepts is developed from a mailed, self-administered survey completed by managers of U.S. socially responsible mutual funds. The study combines the traditionally disparate research areas of Corporate Social Performance and Socially Responsible Investing. As a partial update of Rockness and Williams (1988), a descriptive account is presented of what mutual fund managers regard as the social issues that constitute corporate social performance. The resulting taxonomy represents an empirically derived framework useful in considering social accounting in general and accounting standard setting in particular.
State Conformity with Provisions of the 1997 Uniform Accountancy Act: Theory and Evidence
Authors: Roberts Robin W. , Kurtenbach James M. , Seaton Lloyd “Pat”
Published: March 2008

In this study we use theories of professional regulation to examine state conformity with model provisions of the 1997 Uniform Accountancy Act (UAA). We posit that three of the 1997 UAA provisions restricted the licensing of certified public accountants (CPAs) because they increased educational requirements and that three provisions were economic-service-related because they enhanced interstate and international reciprocity. We contrast public interest, quality-demand, and capture theories to develop contemporaneous empirical measures to explain the degree to which a state's laws conformed to each set of provisions. We found that our three capture-theory variables—(1) the ratio of the number of CPAs to the number noncertified public accountants (NPA) in a given state, (2) the percentage of CPAs who belong to a state's Society of CPAs, and (3) the percent of a state's population over 25 years of age without a college education—were directly related to a state's conformity with restrictive provisions of the UAA. The overall model for economic-service-related provisions was marginally significant, however, we further argue that these latter results also may be evidence of regulatory capture.
Accounting and the Moral Order: Justice, Accounting, and Legitmate Moral Authority
Authors: Williams Paul F.
Published: March 2008

Relying upon the manner in which accountants speak about their practice, this paper provides an argument that accounting discourse suffers from incoherence. Arguing that accountants speak as if the institution of accounting is part of a moral order, it follows that for accounting to have moral standing it must be capable of providing good reasons for people to conform to accounting directives. Through the work of Baier (1995) and Habermas (1990), the paper describes the nature of a moral order and develops the conclusion that good reasons for accounting rules must be society anchored ones.

Two examples are provided that illustrate why considerations of accounting as a deeply moral discourse are important. The first example is the iron law of accountability—which acts to subject people to accounting intrusions that may be unnecessary. The second example is the case of SFAS No. 106. The post-retirement benefits standard is a recent example of the FASB establishing a supra-legal definition of liability by assuming technical capabilities that simply do not exist. The paper concludes with a discussion of how a view of accounting as a system of moral rules may lead to the consideration that the appropriate solution to an “accounting problem” may not always be to extend the technical scope of accounting.
Audit, Nonaudit, and Information Technology Fees: Some Empirical Evidence
Authors: Abbott Lawrence J. , Parker Susan , Peters Gary F. , Rama Dasaratha V.
Published: March 2008

This study examines the purchase of nonaudit services by SEC audit clients. Effective February 5, 2001, the SEC has required the disclosure and description of audit, nonaudit, and information technology fees paid to the incumbent auditor. The SEC enacted this rule due to concerns about auditor independence. Our study reviews these disclosed fees contained in the proxy statements of 2,795 firms since the effective date of the new SEC disclosure rules. The results indicate that the actual incidence and magnitude of nonaudit fees is much greater than the information relied upon during the SEC rule-making deliberations. Consequently, our study calls into question the data used during SEC rule-making process, as well as the clarity of the current audit and nonaudit service distinctions. Our results also suggest that the nonaudit service landscape has changed dramatically since the last period of publicly available fee data (1978–1981). Our results provide at least two public policy implications. First, the SEC should maintain, at a minimum, the current disclosure environment. Second, the SEC should strive to improve the clarity and granularity of the disclosures. Our results also indicate a clear need for additional research regarding the provision of nonaudit services.
User Primacy, Positive Accounting Theory, and Nonaudit Services: Evidence from the SEC's Independence Hearings
Authors: Thornton John M.
Published: March 2008

An analysis of the testimony given before the Securities and Exchange Commission (SEC) on auditors' independence requirements indicates that users of financial statements generally favored increased restrictions on the scope of nonaudit services provided by external auditors to their audit clients, while corporate management and public accounting (professional service) firms providing nonaudit services did not. Moreover, users of the financial statements generally favored the more extensive ban on nonaudit services over the SEC's proposed list of proscriptions. The principle of user primacy, a principle that has been espoused by regulatory and accounting standard-setting bodies, holds that the interests of the users of financial reports take precedence over the interests of the report preparers. However, the SEC's final ruling on auditor independence requirements was more closely aligned with the position taken by the preparers.

An analysis of the arguments presented in the transcripts and the regulations promulgated suggests that positive accounting theory predicated on instrumental economic and political power better explains the SEC's behavior than do considerations relative to the public interest reflected in the principle of user primacy. Positive accounting theory provides the theoretical model for the empirical research supporting nonregulation of nonaudit services and represents a theoretical model that explains the actions of the SEC as reflected in the final ruling on auditor independence requirements. Further, while positive accounting theory represents the underlying dogma upon which rhetorical arguments against increased regulation are grounded, the arguments themselves are framed and justified using the rhetoric of user primacy, which suggests either a nai¨ve belief in the ultimate generalized good of the neoclassical assumption of instrumental, self-interested behavior (ethical egoism), or a juxtaposition of incompatible theoretical frameworks. The discussion and analysis suggests, and subsequent events seem to confirm, the incompatibility of the two perspectives and, thus, the inability of positive accounting theory-based arguments to provide adequate grounds for acting in the public interest. The principle of user primacy affords legitimate grounds for evaluating regulatory alternatives and should provide the theoretical and empirical basis upon which to evaluate regulatory proposals.
Understanding the Socialization Strategies of the Major Accountancy Firms
Authors: Wilkinson Brett , Arnold Vicky , Sutton Steve G.
Published: March 2008

The Enron debacle, coupled with other high-profile frauds, has raised critical questions about the nature of firm environments and why firm members did not question faulty audit practices. Among these questions is the role of organizational culture in promoting a standard of blindly following team leaders. Evidence suggests that enculturation processes begin even before newly recruited accounting laborers become members. Prior studies note the need for research examining organizational socialization processes in accountancy firms (Fogarty 1992) and the general work conditions of contemporary accounting labor (Roslender 1996). This study expands upon these prior studies through additional examination of the socialization processes used by accountancy firms in the enculturation of new accounting laborers. Fogarty's (1992) application of institutional theory to socialization in audit firms is examined through an interpretivist study of accountancy firms' recruiting brochures, web pages, and human resources magazines. The results indicate a systemic application of enculturation behaviors by all of the Big 5 accountancy firms in their U.S. recruitment and retention processes in the period preceding the unveiling of the Enron fraud.
Intellectual Capital: Who Counts, Controls?
Authors: Roslender Robin , Fincham Robin
Published: March 2008

Intellectual capital and related topics including intangibles, innovation, and knowledge have rapidly climbed the management research agenda. Their significance lies in the contribution these assets make to sustained value creation, a central mantra within contemporary business strategy. A premium has been placed on the successful management of such assets, and within this program, the accountancy profession has found itself challenged to devise effective means of counting and controlling them. Driven by a distinctly managerial agenda, the majority of developments within intellectual capital accounting to date have exhibited the negative characteristics that critical accounting researchers associate with the extension of the prevailing accounting calculus into new fields. Nevertheless, in some recent contributions there are indications of how an alternative, more progressive approach, that of intellectual capital self-accounts, might be fashioned. As a consequence, the emergence of intellectual capital may yet provide an opportunity to return to the task of accounting for labor. This aspect of the critical accounting project has become less evident as researchers seeking to promote enabling accounting have directed their focus on a range of “other voices” to be encouraged to tell their own stories “from below.”
Dangerous, Dominant, Dependent, or Definitive: Stakeholder Identification When the Profession Faces Major Transgressions
Authors: Baskerville-Morley Rachel F.
Published: March 2008

This study examines how professional associations respond to crisis situations. The theoretical concepts presented in a model of stakeholder saliency, developed by Mitchell et al. (1997), are applied in examining how the New Zealand Society of Accountants responded to a significant transgression situation. The embezzlement by John Graham, a chartered accountant, gave rise to significant pressure being brought to bear on the profession by various stakeholder groups. The Graham scandal is described using landmark transgression analysis (Nichols 1997). The stakeholder model is applied in identifying salient stakeholder groups, in describing their activities, and in analyzing the profession's response. The analysis identifies an unprecedented level of activity among the professional body's stakeholder groups and provides a framework useful in making sense of the New Zealand Society's actions as it attempted both to protect its reputation of acting in the public interest as well as serving the interests of its members.
Accounting, Accountability, and Religion: Charles Taylor's Catholic Modernity and the Malaise of a Disenchanted World
Authors: Lehman Glen
Published: March 2008

This paper introduces Charles Taylor's Varieties of Religion Today and A Catholic Modernity to an accounting audience. His work is used to examine the ethical and moral dilemmas that confront accounting. It is argued that modern accounting theory is infatuated by procedure and submerges shared and collective purposes that can be found in religion. The common purposes that are needed for societies to function are often neglected by modern ethical and accounting theories. According to Taylor, religion is a moral source for many people and must be given recognition if we are to discover the common purposes that bring people together. It is claimed that when religious values are ignored a moral forgetfulness is created and ethical problems emerge. One means to re-empower our moral sources is to examine the religious dimensions in society. Taylor's work is used to expose weaknesses and inconsistencies in modern accounting theory and offers a different way to think about the world.
The Image of the Accountant in a German Context
Authors: Hoffjan Andreas
Published: March 2008

This study introduces content analysis as a method of examining the accountant's role. The empirical study is based on 73 advertisements, which are directed primarily at employees who are affected by the management accountant's work. The findings of the study indicate that the subject of accountancy is used particularly in connection with promises of “cost reduction.” Consequently, the majority of advertisements use the accountant stereotype of “savings personified.” In a professional context, the work ethic of the management accountant is given particular emphasis in the advertisements. He/she identifies him/herself with his/her task to the maximum degree, is regarded as loyal to his/her company and, for the most part, is well organized in his/her work. However, the characterization of the management accountant as a well disciplined company-person conflicts with the negative portrayal of his/her professional qualities. In advertisements, the management accountant is portrayed as a rather inflexible, passive, and uncreative specialist who, as a result of these qualities, often demotivates others. The personal characteristics of the management accountant are shown in a negative light. This gives him/her the unappealing image of a humorless, envious, dissociated, and ascetic corporate-person.
Changing Our Questions: Reflections on the Corporate Scandals
Authors: Young Joni J.
Published: March 2008

In the aftermath of recent corporate scandals, several narrowly defined “problems” were quickly identified and readily classified into handy categories including independence, compensation, accounting, and disclosure. Various solutions were equally quickly developed. In this paper I attempt to slow down this search for quick and easy “solutions.” I begin by outlining the stories told in the press and various hearings that offered explanations of and solutions for the scandals. Drawing upon the work of Bauman, Fromm, and others, I then offer an alternative story line that provides a different perspective and examines the commonalities among the various scandals. This different perspective allows us to ask different questions about the significance of these scandals in the hope that these different questions may in turn suggest different solutions as possible responses. I close the paper by offering some alternative questions that could be asked in response to the scandals.
A Reexamination of the Factors Important to Selection of Accounting as a Major
Authors: Chen Clement , Jones Keith T. , McIntyre D. David
Published: March 2008

This study reexamines and extends the conclusions drawn from the Felton et al. (FBN) 1994 study that investigated a set of explanatory factors in the decision to choose a career as a chartered accountant (CA). The current study extends the findings of FBN in two primary ways. First, we improve upon their study by adding the students' overall experience in the first accounting course into the analysis. Second, we expand the analysis to include sophomores and juniors rather than seniors only. When we add the students' overall experience in the introductory accounting class into the analysis, it becomes the most important factor in distinguishing major choice between accounting and nonaccounting students. Consistent with FBN, we find that accounting majors place less importance on intrinsic factors and report a higher ratio of perceived benefits to costs of choosing accounting than nonaccounting majors. Unlike FBN, we find that initial earnings, long-term earnings, and job market considerations rank at or near the bottom in discriminating between accounting and nonaccounting majors. By shedding further light on the factors that attract students to the accounting profession, the results have recruiting, educational, and public interest implications.
The Impact of Accounting Education on Ethical Values: An Institutional Perspective
Authors: Mayper Alan G. , Pavur Robert J. , Merino Barbara D. , Hoops William
Published: March 2008

The accounting scandals at the beginning of the 21st century led to public distrust and demands for reform. Were these scandals unexpected? From an old institutional economics (OIE) perspective, which originated with the work of Thorstein Veblen in the 1890s, these failures and the moral lapses should not be a surprise. OIE theorists, like critical theorists, generally, contend that corporate hegemony, i.e., the domination of business values in all areas of human life, has eroded moral sensitivities. All institutions, including our once-autonomous educational institutions, have become mechanisms for promoting economic interests.

We first present a brief overview of institutional theory, to provide a theoretical framework for our subsequent experimental analysis. We discuss the concept of corporate hegemony and explain how hegemony impacts higher education, generally. We then examine efforts to commodify higher education and explain how that impacts all students in universities in the United States. Finally, we discuss the effect of commodification on accounting education to explain why we posit that our current accounting educational environment should be expected to desensitize students to the ethical aspects of their profession. This theoretical framework provides the basis for three hypotheses that we test in an experimental context to determine if accounting education desensitizes students to the moral aspects of their discipline.

The experiment utilizes a capital budgeting context, which incorporates financial, social, and environmental factors. Subjects ranked and provided perceptions on eight alternatives as to their economic and moral content. Three groups of students, with differing levels of accounting knowledge, participated in the experiment. We develop hypotheses based on institutional theory and test those hypotheses in the latter part of this paper. Our results suggest that accounting education needs reform, so that accounting students become more aware of the ethical dimensions of our discipline.
The FASB and Accounting for Economic Reality
Authors: Lee Thomas A.
Published: March 2008

The proposal by the Financial Accounting Standards Board (FASB) in 2002 to produce principles-based accounting standards is an explicit commitment to use its conceptual framework to improve financial accounting. In effect, it is a proposal to assist accounting for economic reality. However, an evaluation of the proposal and related FASB communications reveals a global strategy more concerned with achieving comparability and consistency than identifying improved ways of recognizing and representing socially-constructed reality by accounting numbers. The paper examines the philosophical notions of social reality and truthful correspondence in light of principles-based accounting standards and suggests that the FASB's superficial use of its conceptual framework in this respect is consistent with a history of conceptual frameworks as means of legitimating standard setting activities. As such, the FASB proposal would be no more than a short-term palliative to the long-term ills of financial accounting world-wide. The paper recommends a better understanding of the construction and representation of social reality by all concerned with the world of financial accounting.
The Role of Culture and Accounting Education in Resolving Ethical Business Dilemmas by Chinese and Canadians
Authors: Dunn Paul
Published: March 2008

This paper examines the roles that culture and accounting education play in helping to resolve ethical dilemmas in business. Using a sample of Chinese and Canadian business students, the results show that the Chinese are more willing to sanction a variety of businesses and accounting policy choice decisions that the Canadians consider to be inappropriate and unethical. Furthermore, accounting students are better able to resolve accounting and business dilemmas regardless of their cultural background. Finally, this study finds that the social desirability bias, to present oneself as more ethical than is actually the case, is a cross-cultural phenomenon.
Comparing the Auditor Quality of Arthur Andersen to that of the Big 4
Authors: Fuerman Ross D.
Published: March 2008

This study compares the audit quality of Arthur Andersen with that of the Big 4 accounting firms. An expanded indicator of audit quality is developed based on the law of business misconduct literature and the legal process literature. A representation of audit quality is derived from an analysis of the legal actions initiated against these five large public accounting firms from 1996 to 2004. The legal action was partitioned into three year periods. In the first period, Arthur Andersen and the Big 4 evidenced no quality differential. In the second and third periods, the Big 4, in aggregate, rated higher on the audit quality indicator than did Andersen. The robustness of these findings is substantiated using multiple logistic regression and sensitivity analysis. When the individual firms are compared with Andersen, all four evidenced higher audit quality; three of the firms are significantly higher. This suggests that Andersen represents an outlier within the audit population. However, the analysis also indicates that overall audit quality declined in the period immediately following the passage of the Private Securities Litigation Reform Act of 1995. This suggests that the Sarbanes-Oxley Act provisions directed toward remedying auditing deficiencies is justified and not an overreaction to a “few bad apples.”
Accounting Science's Contribution to the Corporate Governance and Executive Accountability Problem
Authors: Shapiro Brian P.
Published: March 2008

Effective corporate governance and related accountability mechanisms are presumed to mitigate conflicts of interest and provide reasonable assurance that each party observes certain behavioral norms. Among the academic disciplines, one might expect that accounting would be well equipped to examine and prescribe improvements in accountability among agents in capitalist settings. But this article documents that the “top four” accounting journals in North America (The Accounting Review, Journal of Accounting Research, Journal of Accounting and Economics, and Contemporary Accounting Research; hereafter, “top” journals), which reputedly publish premier scientific articles and weigh most heavily in tenure and promotion decisions at U.S. universities, did not publish systematic critiques of ineffective corporate governance practices in the decade before Sarbanes-Oxley (2002). To explain this phenomenon, this article presents arguments and evidence that the top journals' editorial ideology of scientism, fact-value separation, methodological exclusivity, and active denigration of critical and historical reflection have obstructed rather than promoted timely awareness of corporate governance and executive accountability problems. The article then explores post-Sarbanes-Oxley opportunities for critical, institutional, and historical research on corporate accountability and governance, and identifies how they differ from as well as complement traditional positive accounting analyses. The concluding section considers the changes in institutional values that would be necessary for the top accounting journals to adopt a more methodologically inclusive and socially responsible research agenda.
The Influence of Disclosure Regulation on Selective Disclosure: Impact on Difficult-to-Measure Reporting Activities and the Importance of Assurance Services
Authors: Janvrin Diane J. , Kurtenbach James M.
Published: March 2008

The objective of recent disclosure regulation (e.g., Regulation Fair Disclosure [FD]) is to reduce selective disclosure, the practice of releasing financial information to selected users before publicly disclosing the information. Prior to FD, providers used narrow distribution reporting activities, such as phone calls and one-on-one meetings with analysts, reviews of analysts' earnings estimates, and analysts' contracts with suppliers and firm employees, to communicate private financial information to selected users at the expense of uninformed users. Public interest theorists view regulation as a means to protect the public. We predict that if FD is effective, providers will move away from narrow reporting activities and reduce the probability that selected users can achieve a competitive advantage over the general investing public. In addition, assuming that reducing selective disclosure increases the number of market participants receiving information, we argue that the importance of assurance services will increase since FD (1) reduces users' ability to evaluate the credibility of provider information based on personal relationships with providers, and (2) increases the pressure on provider investor relations personnel to monitor the amount and credibility of information disclosed to decrease the likelihood that market participants view the information released as unreliable.

Due to the lack of available empirical data related to narrow reporting activities and the importance of assurance services, we employ a field-based questionnaire of providers and users to address these issues. Results indicate that (1) providers and users perceive that narrow distribution reporting activities still exist, and (2) reducing users' personal access to providers may increase the importance of assurance services. The study increases our understanding of how regulation to reduce selective disclosure may protect the public by examining its impact on corporate disclosure activities and policies.
Career Self-Interest and Concern for Others—The Effects of Co-Worker Attitudes on Fraudulent Behavior
Authors: Collins Frank
Published: March 2008

The numerous corporate scandals in recent years raise questions as to why experienced business leaders would make unethical, and often illegal, decisions. Research (Collins et al. 2004a, 2004b; Shaub et al. 2005) has demonstrated that measures of self-interest and concern for others influence the likelihood that an individual will commit egregious acts of self-interest. The current study examines the moderating effects of co-worker attitudes on the relationship between career self-interest, concern for others, and the likelihood of committing egregious acts of self-interest. We find that co-worker attitudes do affect ethical decision making. The potential effect of peer opinion on individuals in the workplace highlights the importance of organizational culture in controlling incidents of unethical behavior, a matter of public interest (Harrison and Huntington 2000).
Arterial Hypertension Determined by Ambulatory Blood Pressure Profiles
Authors: Dost Axel , Klinkert Christoph , Kapellen Thomas , Lemmer Andreas , Naeke Andrea , Grabert Matthias , Kreuder Joachim , Holl Reinhard W. ,   for the DPV Science Initiative
Published: March 2008

OBJECTIVE—Arterial hypertension is a key player in the development of diabetes complications. We used a nationwide database to study risk factors for abnormal 24-h blood pressure regulation and microalbuminuria in children and adolescents with type 1 diabetes.

RESEARCH DESIGN AND METHODS—Ambulatory blood pressure monitoring was performed in 2,105 children and adolescents from 195 pediatric diabetes centers in Germany and Austria. Individual least median squares (LMS)-SD scores were calculated for diurnal and nocturnal systolic (SBP), diastolic (DBP), and mean arterial (MAP) blood pressure according to normalized values of a reference population of 949 healthy German children. The nocturnal blood pressure reduction (dipping) was calculated for SBP as well as DBP.

RESULTS—In diabetic children, nocturnal blood pressure in particular was significantly elevated (SBP +0.51, DBP +0.58, MAP +0.80 LMS-SD) and dipping of SBP DBP, and MAP was significantly reduced (P < 0.0001). Age, diabetes duration, sex BMI, A1C, and insulin dose were related to altered blood pressure profiles; dipping, however, was only affected by age, female sex, and A1C. The presence of microalbuminuria was associated with nocturnal DBP (P < 0.0001) and diastolic dipping (P < 0.01).

CONCLUSIONS—Our observations revealed a clear link between the quality of metabolic control and altered blood pressure regulation even in pediatric patients with short diabetes duration. Nocturnal blood pressure in particular seems to mainly contribute to diabetes complications such as microalbuminuria.
Effect of Lifestyle Intervention on the Occurrence of Metabolic Syndrome and its Components in the Finnish Diabetes Prevention Study
Authors: Ilanne-Parikka Pirjo , Eriksson Johan G. , Lindström Jaana , Peltonen Markku , Aunola Sirkka , Hämäläinen Helena , Keinänen-Kiukaanniemi Sirkka , Laakso Mauri , Valle Timo T. , Lahtela Jorma , Uusitupa Matti , Tuomilehto Jaakko ,   on behalf of the Finnish Diabetes Prevention Study Group
Published: March 2008

OBJECTIVE—The aim of this secondary analysis of the Finnish Diabetes Prevention Study was to assess the effects of lifestyle intervention on metabolic syndrome and its components.

RESEARCH DESIGN AND METHODS—A total of 522 middle-aged overweight men and women with impaired glucose tolerance were randomized into an individualized lifestyle intervention group or a standard care control group. National Cholesterol Education Program criteria were used for the definition of metabolic syndrome.

RESULTS—At the end of the study, with a mean follow-up of 3.9 years, we found a significant reduction in the prevalence of metabolic syndrome in the intervention group compared with the control group (odds ratio [OR] 0.62 [95% CI 0.40–0.95]) and in the prevalence of abdominal obesity (0.48 [0.28–0.81]).

CONCLUSIONS—The results suggest that lifestyle intervention may also reduce risk of cardiovascular disease in the long run.
Measurement of Insulin Sensitivity in Children
Authors: Schwartz Betsy , Jacobs David R. , Moran Antoinette , Steinberger Julia , Hong Ching-Ping , Sinaiko Alan R.
Published: March 2008

OBJECTIVE—In this study we compared fasting insulin and measures of insulin sensitivity (M) based on fasting insulin and glucose (i.e., homeostasis model assessment [HOMA], quantitative insulin sensitivity check index [QUICKI], and fasting glucose–to–insulin ratio [FGIR]) or triglycerides to the insulin clamp in a cohort of children/adolescents.

RESEARCH DESIGN AND METHODS—The subjects were Minneapolis fifth- to eighth-grade students. Euglycemic-hyperinsulinemic clamps were performed on 323 adolescents at mean age 13 and were repeated on 300 of these subjects at mean age 15. Insulin sensitivity was determined by glucose uptake (milligrams per kilogram per minute) adjusted for lean body mass (MLBM) and steady-state insulin (MLBM/ln SSI). Comparisons were made for the whole cohort and by body size (BMI <85th percentile vs. BMI ≥85th percentile). Receiver operating characteristic (ROC) curves were used to test whether specific fasting insulin cut points separated true-positive from false-positive approximations of insulin resistance.

RESULTS—Fasting insulin was significantly correlated with HOMA (r = 0.99), QUICKI (r = 0.79), FGIR (r = −0.62), and (ln fasting insulin + ln triglycerides) (r = 0.88). Correlations of the surrogates with MLBM were significantly lower than those with M for the total cohort and ≥85th percentile group. In general, correlations in the ≥85th percentile group were higher than those in the <85th percentile group. Correlations with MLBM and MLBM/ln SSI decreased in the total cohort and ≥85th percentile group from age 13 to 15. ROC curves showed only a modest capability to separate true- from false-positive values.

CONCLUSIONS—Surrogate measures are only modestly correlated with the clamp measures of insulin sensitivity and do not offer any advantage over fasting insulin. In general, lower correlations are seen with MLBM than with M and with thinner than with heavier individuals.
Can Self-Rated Health Scores Be Used for Risk Prediction in Patients With Type 2 Diabetes?
Authors: Hayes Alison J. , Clarke Philip M. , Glasziou Paul G. , Simes R. John , Drury Paul L. , Keech Anthony C.
Published: March 2008

OBJECTIVE—To investigate whether self-rated health profiles compiled using the EuroQol group’s visual analog scale (EQ VAS) are independent predictors of vascular events and major complications in people with type 2 diabetes after controlling for standard clinical risk factors.

RESEARCH DESIGN AND METHODS—The study is based on 7,348 individuals with a mean follow-up of 2.4 years after completing the EQ-5D questionnaire. We used Cox proportional hazards modeling to estimate hazard ratios associated with EQ VAS scores after controlling for baseline covariates: age, sex, smoking status, diabetes duration, A1C, systolic blood pressure, BMI, plasma lipids, and prior clinical history.

RESULTS—A 10-point higher EQ VAS score was associated with a 6% (95% CI 1–11) lower risk of vascular events and a 22% (95% CI 15–28) lower risk of diabetesc complications.

CONCLUSIONS—Self-rated health profiles compiled using the EQ VAS provide valuable information on patient risk in addition to that determined from clinical risk factors alone.
Tracking and Prediction of Arterial Blood Pressure From Childhood to Young Adulthood in 868 Patients With Type 1 Diabetes
Authors: Knerr Ina , Dost Axel , Lepler Rudolf , Raile Klemens , Schober Edith , Rascher Wolfgang , Holl Reinhard W. ,   On behalf of the Diabetes Data Acquisition System for Prospective Surveillance (DPV) Scientific Initiative Germany and Austria
Published: March 2008

OBJECTIVE—Arterial blood pressure was followed in 868 patients with type 1 diabetes aged 6.0–19.9 years in 95 centers in Germany and Austria.

RESEARCH DESIGN AND METHODS—European blood pressure reference data for 28,043 children and adolescents were used with respect to age and sex. Data were stratified into three groups: prepubertal, pubertal, and postpubertal.

RESULTS—Up to 4% of the participants in the younger age-groups and 13.9% of the postpubertal patients exhibited blood pressure values >97th centile. Blood pressure levels correlated with A1C level and BMI Z score. Tracking of blood pressure revealed that children with elevated blood pressure had higher blood pressure in adolescence and young adulthood.

CONCLUSIONS—Patients with higher blood pressure in childhood showed elevated blood pressure later in life. We need to focus on the diagnosis of hypertension in children with type 1 diabetes and to study the efficacy of early intervention.
Individualized, Non–Age-Based Glycemic Control in Elderly Veterans With Diabetes
Authors: Helmer Drew A. , Sambamoorthi Usha , Rajan Mangala , Tseng Chin-Lin , Pogach Leonard M.
Published: March 2008

OBJECTIVE—To examine the role of age and endocrinology care in glycemic testing and control in elderly veterans with diabetes.

RESEARCH DESIGN AND METHODS—In this retrospective study of Veterans Health Administration clinic users aged ≥65 years with diabetes, we compared glycemic testing and poor glycemic control (A1C >9%) between older (≥75 years) and younger (65–74 years) veterans in the year 2000.

RESULTS—Without adjustment, rates for glycemic testing were 70.2% in older and 71.1% in younger veterans, and those for poor control were 9.4% in older and 12.8% in younger veterans. After adjustment, older veterans had 1.8% lower probability of glycemic testing and 2.9% lower probability of poor control than younger veterans. Endocrinology care was associated with a higher probability of both glycemic testing (9.7%) and poor control (1.0%), regardless of age.

CONCLUSIONS—Glycemic testing and control and effect of endocrinology care were comparable in older and younger veterans with diabetes.
Racial Disparity in Glucagon-Like Peptide 1 and Inflammation Markers Among Severely Obese Adolescents
Authors: Velásquez-Mieyer Pedro A. , Cowan Patricia A. , Pérez-Faustinelli Sylvia , Nieto-Martínez Ramfis , Villegas-Barreto Cesar , Tolley Elizabeth A. , Lustig Robert H. , Alpert Bruce S.
Published: March 2008

OBJECTIVE—Compared with Caucasians, obese African-American adolescents have a higher risk for type 2 diabetes. Subclinical inflammation and reduced glucagon-like peptide 1 (GLP-1) concentration are linked to the pathogenesis of the disease. We determined the relationship between insulin resistance, β-cell activity, and subclinical inflammation with GLP-1 concentrations and whether racial disparities in GLP-1 response were present in 49 obese adolescents (14 ± 3 years; 76% African American; 71% female).

RESEARCH DESIGN AND METHODS—Subjects underwent physical examination and an oral glucose tolerance test. We measured levels of high-sensitivity CRP (CRPhs), fibrinogen, glucose, GLP-1total, GLP-1active, and insulin. Insulin and glucose area under the curve (AUC), insulinogenic index (ΔI30/ΔG30), and composite insulin sensitivity index (CISI) were computed. Subjects were categorized by race and as inflammation positive (INF+) if CRPhs or fibrinogen were elevated.

RESULTS—No racial differences were seen in mean or relative BMI. Thirty-five percent of subjects had altered fasting or 2-h glucose levels (African American vs. Caucasian, NS), and 75% were INF+ (African American vs. Caucasian, P = 0.046). Glucose and insulin, CISI, and ΔI30/ΔG30 values were similar; African Americans had lower GLP-1total AUC (P = 0.01), GLP-1active at 15 min (P = 0.03), and GLP-1active AUC (P = 0.06) and higher fibrinogen (P = 0.01) and CRPhs (NS) compared with Caucasians.

CONCLUSIONS—African Americans exhibited lower GLP-1 concentrations and increased inflammatory response. Both mechanisms may act synergistically to enhance the predisposition of obese African Americans to type 2 diabetes. Our findings might be relevant to effective deployment of emerging GLP-1–based treatments across ethnicities.
Nuclear Factor-κB Induction by Visfatin in Human Vascular Endothelial Cells
Authors: Adya Raghu , Tan Bee K. , Chen Jing , Randeva Harpal S.
Published: March 2008

OBJECTIVE—Visfatin is elevated in obesity and type 2 diabetes and is thought to be an inflammatory mediator within atherosclerotic lesions and to induce gelatinase activity. We investigated the activation of nuclear factor-κB (NF-κB), a well-known proinflammatory transcription factor, by visfatin in endothelial cells.

RESEARCH DESIGN AND METHODS—Human endothelial cells were transfected with pNF-κB-Luc plasmid. Using quantitative PCR, Western blot analysis, and gelatin zymography, we studied NF-κB signaling in gelatinase-mediated vascular inflammation by visfatin using the NF-κB inhibitor BAY 11-7085.

RESULTS—Visfatin significantly increased NF-κB transcriptional activity (P < 0.001). We also found a significant inhibition of tumor necrosis factor-α (TNF-α)-induced NF-κB activity by visfatin (P < 0.001). Furthermore, the NF-κB inhibitor significantly negated visfatin-induced matrix metalloproteinase (MMP)-2/9 mRNA expression, protein levels, and gelatinolytic activity (P < 0.001).

CONCLUSIONS—Visfatin-induced NF-κB signaling in human endothelial cells affects the activation of gelatinases MMP-2 and -9, suggesting an important role of visfatin in the pathogenesis of vascular inflammation in obesity and type 2 diabetes.
Association Between Acculturation Modes and Type 2 Diabetes Among Native Hawaiians
Authors: Kaholokula Joseph Keawe‘aimoku , Nacapoy Andrea H. , Grandinetti Andrew , Chang Healani K.
Published: March 2008

OBJECTIVE—To examine the association between acculturation modes (integrated, assimilated, traditional, and marginalized) and type 2 diabetes prevalence in Native Hawaiians.

RESEARCH DESIGN AND METHODS—Cross-sectional data were analyzed from 495 Native Hawaiians, including acculturation modes, diabetes status, triglycerides, fasting insulin, BMI, age, and education level. Acculturation modes were assessed using an eight-item cultural affiliation questionnaire.

RESULTS—Native Hawaiians in a traditional mode of acculturation were more likely to have type 2 diabetes (27.9%) than those in integrated (15.4%), assimilated (12.5%), or marginalized (10.5%) modes.

CONCLUSIONS—The higher prevalence of type 2 diabetes among Native Hawaiians in a traditional mode of acculturation could not be attributed to any of the sociodemographic or biological factors included in this study. We discuss the role of psychosocial factors as possible mediators in the relationship between acculturation modes and type 2 diabetes.
Physician Recommendations About Maternal Involvement in Adolescent Diabetes Management
Authors: Wiebe Deborah J. , Berg Cynthia A. , Fortenberry Katherine T. , Sirstins Janet , Lindsay Rob , Donaldson David , Murray Mary
Published: March 2008

OBJECTIVE—The purpose of this study was to examine whether perceptions of physician recommendations about maternal involvement in adolescent diabetes management are associated with children's reports of mothers’ involvement during the subsequent week.

RESEARCH DESIGN AND METHODS—Youth with type 1 diabetes (aged 10–15 years) and mothers completed scales measuring perceptions of physician recommendations about maternal involvement. At their appointment, and again 1 week later, children reported mothers’ involvement in diabetes over the preceding week.

RESULTS—A total of 53 dyads provided usable data at both time points. Perceived recommendations to increase involvement were associated with children's reports of increased maternal collaboration during the subsequent week (B = 0.81, P < 0.05), an effect that was stronger among boys (B = −1.21, P < 0.005). Increased maternal collaboration correlated with better A1C (r = −0.39, P < 0.005).

CONCLUSIONS—Physicians may facilitate adaptive forms of maternal involvement during adolescence by conveying messages about involvement to patients and families.
Alternative Methods of Insulin Sensitivity Assessment in Obese Children and Adolescents
Authors: Rössner Sophia M. , Neovius Martin , Montgomery Scott M. , Marcus Claude , Norgren Svante
Published: March 2008

OBJECTIVE—To validate fasting indexes against minimal model analysis (MMOD) of the frequently sampled intravenous glucose tolerance test (FSIVGTT) in an obese pediatric population.

RESEARCH DESIGN AND METHODS—FSIVGTT-MMOD results were compared with homeostasis model assessment of insulin resistance (HOMA-IR) and fasting insulin with the sample stratified by sex, puberty, and sensitivity index (Si) median in 191 children (82 males and 109 females, 13.9 ± 2.9 years of age, BMI 36.9 ± 6.2 kg/m2, BMI SD score 6.1 ± 1.6).

RESULTS—Across pubertal groups, correlation coefficients between Si and HOMA-IR ranged from −0.43 to −0.78 in males and from −0.53 to −0.57 in females (age and BMI adjusted, P < 0.05 in all instances). Similar results were seen for fasting insulin. In females, the relationship was significantly weaker in more-insulin-resistant subjects.

CONCLUSIONS—The validity of fasting indexes in explaining Si was sex dependent, varied with pubertal stage, and in females was influenced by degree of insulin sensitivity. In obese pediatric populations, we generally discourage the use of fasting indexes, although the validity varies within subgroups.
Retinal Vascular Lesions in Patients of Caucasian and Asian Origin With Type 2 Diabetes
Authors: Stolk Ronald P. , van Schooneveld Mary J. , Cruickshank J. Kennedy , Hughes Alun D. , Stanton Alice , Lu Juming , Patel Anushka , Thom Simon A. McG. , Grobbee Diederick E. , Vingerling Johannes R. ,   on behalf of the AdRem Project Team and ADVANCE Management Committee
Published: March 2008

OBJECTIVE—The objective of this study was to describe prevalent vascular retinal lesions among patients with type 2 diabetes enrolled in the ADVANCE Retinal Measurements (AdRem) study, a substudy of the Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation (ADVANCE) trial.

RESEARCH DESIGN AND METHODS—Seven-field stereoscopic photographs of both eyes were obtained at the baseline assessment of the ADVANCE trial. All photographs were graded in a central reading center. Gradable retinal images were received from 1,605 patients.

RESULTS—The number of patients with any retinopathy (Early Treatment of Diabetic Retinopathy Study [ETDRS] score ≥20) was 645 (40.2% [95% CI 37.8–42.6]); of these, 35 (2.2% [1.6–3.0]) had severe diabetic retinopathy (ETDRS score ≥50). Focal arterial narrowing, venous beading, and arteriovenous nicking were present in 3.8, 5.1, and 9.8% of participants, respectively. Among participants included in this study, Chinese and South-Asian patients had more retinopathy than Caucasians, as defined both by ETDRS score (49.4, 46.0, and 31.3%, respectively; P < 0.001, adjusted for age, sex, A1C, systolic blood pressure, and duration of diabetes) and specific vascular lesions (e.g., arteriovenous nicking 12.3, 8.5, and 7.5%, respectively; adjusted P < 0.005). A1C, duration of diabetes, and systolic blood pressure were similarly associated with increased retinal lesions in Chinese, South-Asian, and Caucasian patients.

CONCLUSIONS—Using a sensitive diagnostic procedure, more than one-third of patients with type 2 diabetes enrolled in the AdRem study had retinal lesions at baseline. Despite differences in prevalence and severity of retinopathy among Chinese, South-Asian, and Caucasian patients included in this study, the cross-sectional associations among established risk factors for retinopathy and retinal lesions were similar across ethnic groups.