High prevalence of retinopathy in young-onset type 2 diabetes and possible sex differences: insights from Norwegian general practice.

INTRODUCTION: People with young-onset type 2 diabetes (YOD), defined as diabetes diagnosis before age 40, have a high lifetime risk of vascular complications. We aimed to estimate the prevalence of YOD among adults with type 2 diabetes (T2D) in Norwegian general practice and explore associations between age at diabetes diagnosis and retinopathy overall and in men and women. RESEARCH DESIGN AND METHODS: We collected cross-sectional data from general practice electronic medical records of 10 241 adults with T2D in 2014, and repeated measurements of hemoglobin A1c (HbA1c) from 2012 to 2014. Using multivariate logistic regression, we assessed associations between YOD and later-onset T2D, sex and retinopathy. RESULTS: Of all individuals with T2D, 10% were diagnosed before 40 years of age in both sexes. Compared with later-onset T2D, HbA1c increased faster in YOD, and at the time of diagnosis HbA1c was higher in men, particularly in YOD. Retinopathy was found in 25% with YOD, twice as frequently as in later onset. After adjustments for confounders (age, country of origin, education, body mass index), OR of retinopathy was increased in both men with YOD (OR 2.6 (95% CI 2.0 to 3.5)) and women with YOD (OR 2.2 (1.5 to 3.0)). After further adjustments for potential mediators (diabetes duration and HbA1c), the higher OR persisted in men with YOD (OR 1.8 (1.3 to 2.4)) but was attenuated and no longer significant for women with YOD. CONCLUSIONS: Retinopathy prevalence was more than twice as high in YOD as in later-onset T2D. The increased likelihood of retinopathy in YOD was partly mediated by higher HbA1c and longer T2D duration, but after accounting for these factors it remained higher in men with YOD.

The Potential of Anti-Bullying Efforts to Prevent Academic Failure and Youth Crime. A Case Using the Olweus Bullying Prevention Program (OBPP).

The effectiveness of bullying prevention programs has led to expectations that these programs could have effects beyond their primary goals. By reducing the number of victims and perpetrators and the harm experienced by those affected, programs may have longer-term effects on individual school performance and prevent crime. In this paper, we use Norwegian register data to study the long-term impact of the Olweus Bullying Prevention Program (OBPP) on academic performance, high school dropout, and youth crime for the average student, which we call population-level effects. The OBPP program is widely acknowledged as one of the most successful programs reducing school-level bullying; yet, using a difference-in-difference design, no statistically significant population-level effects of the OBPP were found on any of the long-term outcomes in this study. When studied at the population level, as in the current project, the base rate prevalence of bullying is a major explanatory factor for these results. Earlier studies have shown that OBPP reduces bullying prevalence by 30-50%. This decrease translates into absolute reductions in bullying victimization and perpetration at the population level of "only" four and two percentage points, respectively. Our results suggest the average causal effects of school bullying involvement are too small to translate this reduction in bullying into a sizeable population-level impact on students' long-term outcomes. However, a limited potential of anti-bullying programs to prevent population-level adversity can very well be compatible with substantial program effects for individual bullies and victims. Further, our results do not speak to the main objective of anti-bullying programs of limiting childhood abuse and safeguarding children's human rights.

Impacts of school-wide positive behaviour support: Results from National Longitudinal Register Data.

Problem behaviour in schools may have detrimental effects both on students' well-being and academic achievement. A large literature has consistently found that school-wide positive behaviour support (SWPBS) successfully addresses social and behavioural problems. In this paper, we used population-wide longitudinal register data for all Norwegian primary schools and a difference-in-difference (DiD) design to evaluate effects of SWPBS on a number of primary and secondary outcomes, including indicators of externalising behaviour, school well-being, pull-out instruction, and academic achievement. Indications of reduced classroom noise were found. No other effects were detected. Analyses revealed important differences in outcomes between the intervention and control schools, independent of the implementation of SWPBS, and that a credible design like DiD is essential to handle such school differences.