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Finance students today live in the midst of an enormous financial crisis. Institutions both large and small are failing or being rescued through government intervention. This environment presents a host of learning opportunities for instructors as well as students. This paper discusses financial autopsies as a form of experiential learning utilizing data on actual "real world" banks that have failed. The paper provides a framework whereby a student can systematically analyze data to determine the reason or reasons for bank failure. This stimulates student interest in the subject as well as honing their critical thinking skills.

Background Adherence to the type 1 diabetes ( T1D) regimen, while predictive of glycemic control, decreases during adolescence. For adolescents, attaining adequate sleep is an additional challenge. This study evaluates the impact of sleep on adherence in teens with T1D. Subjects Forty-five adolescents aged 12-18 yr, with T1D for at least 6 months while on insulin pump therapy. Methods Adolescents logged their sleep on a written diary for 2 wk. Corresponding insulin pump/glucometer downloads as well as sleep habit questionnaires were also obtained. Results Data from 20 girls and 25 boys, with a mean age of 15 ± 1.6 yr and mean glycated hemoglobin of 8.7 ± 1.1% (72 mmol/mol), were analyzed. Overall, average sleep was 8.6 ± 0.9 h per night. Sleep durations were compared to the next day's frequency of self-monitored blood glucose ( SMBG) and total daily insulin bolus frequency. Associations were found between sleep duration and youths' SMBG and insulin bolus frequencies (p < 0.03 and p < 0.001, respectively). Specifically, a 15- and 20-min increase in sleep was associated with one additional SMBG check and one additional insulin bolus, respectively. Conclusion Analyses suggest an associated increase in T1D self-management behaviors in youths with increased sleep duration. These findings highlight the importance of assessing sleep in clinical practice, and encourage further research to examine effective strategies to address sleep hygiene as part of routine diabetes management. [ABSTRACT FROM AUTHOR]

Objective To test the hypothesis that HbA1c variability, as measured by standard deviation ( SD), is associated with increased risk for incident microalbuminuria and persistent microalbuminuria in pediatric type 1 diabetes ( T1D). Methods A retrospective analysis using data from electronic health records was performed on 1195 patients from a pediatric diabetes clinic network in the Midwest USA from 1993 to 2009 with ≥1 yr of T1D, ≥4 total HbA1c values, ≥2 HbA1c values/yr, ≥1 urine microalbumin. Microalbuminuria, the main outcome was defined as albumin excretion rate ≥20 mcg/min or 2 of 3 consecutive urine microalbumin/creatinine ≥30 mg/gm. Patients who had persistently high microalbumin or who were treated with an angiotensin-converting-enzyme inhibitor within 1 yr were considered to have persistent microalbuminuria. Sex, race, age, diagnosis age, and duration were covariates. Results Median numbers of per-patient HbA1c and microalbumin results were 14 and 3, respectively. Median intrapersonal mean HbA1c and SD were 8.62% (70.72 mol/mol) and 1.47% (16.07 mmol/mol), respectively. The median interquartile range ( IQR) of diagnosis age was 9.4 yr (6.26-12.02) and diabetes duration was 4.97 yr (2.93-7.64). A total of 172 patients (14.4%) developed microalbuminuria; 55 (4.6%) had persistent microalbuminuria. Patients with higher SD of HbA1c had shorter time to microalbuminuria. In time-dependent Cox Proportional Hazard models, updated SD of HbA1c was significantly associated with microalbuminuria [univariate hazard ratio ( HR) 1.48 (1.25-1.76); multivariable HR 1.28 (1.04-1.58)], whereas updated mean HbA1c was not [univariate HR 1.08 (0.97-1.22); multivariable HR 1.05 (0.92-1.2)]. Patients with persistent microalbuminuria had similar HRs. Conclusions HbA1c variability is independently associated with development of microalbuminuria in children with T1D, highlighting the importance of maintaining stable glycemic control in pediatric patients. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to develop a measure of type 1 diabetes mellitus (T1DM) knowledge that is aimed at youth and is based on contemporary management standards. Methods: An 88-item test was derived from the American Association of Diabetes Educators 7 Self-Care Behaviors. Results: A multidisciplinary team selected the best 49 items which were piloted in a sample of 119 youths (59 males, aged 12-18, having a mean ± standard deviation glycated haemoglobin (A1C) of 9.9%±1.80 (84.7±19.7 mmol/mol). A minimum absolute point-biserial correlation coefficient of 0.250 was used to choose 49 items from the original 88 questions. Categorical principal component analysis was then used to identify the best factor analytical model that consisted of five factors composed of 19 items. These five factors explained 57% of item variances. Factors were associated with the latent variables: advanced problem-solving, hypoglycaemia prevention and management, taking insulin/medication administration, daily management and healthy active living. Conclusion: A new T1D knowledge test for youth was refined from 88 to 49 questions based on expert opinion and empirical test construction. The instrument was then refined to 19 items based on exploratory factor analysis. Future goals are to validate this factor model with another cohort and confirm concurrent validity based on youth's glycated haemoglobin and adherence behaviours. Our new T1DM knowledge measure initially appears valid and promising as a new clinical and research tool., Competing Interests: Disclosure: Melinda Storm works for Insulet, however, she did not work for this company during the development of this project or writing of the manuscript. Sarah Tsai, Susana Patton, Stephen DeLurgio, David D Williams, Kavitha Dileepan, Alexander Karmazin and Mark Clements have no conflicts of interest to disclose.

The costs of pediatric telemedicine services remain underreported and understudied; however, there is evidence that telepediatric services can be cost competitive with traditional ones. For 15 years, the University of Kansas Center for Telemedicine and Telehealth has been providing telemental health outreach from the University of Kansas Medical Center (KUMC). One service site is located in Crawford County, Kansas, which provides telepsychiatry services to children and adolescents. The purpose of this study was to examine the costs of operating the Crawford County site relative to accessing services at KUMC, the likely alternative service location. The cost of travel time to parents who accompanied a dependent to either location also was estimated. Patients and parents were examined over a 6-month period in 2006. One hundred thirty-two patients received 257 telemedicine psychiatric consultations during this period. Cost estimates for using the pediatric telemedicine service were assessed for all patients; however, travel and related costs were collected from a sample of 26 patient-parent dyads. The estimated costs of services were obtained using standard cost-accounting procedures. An average cost per consultation in Crawford County was $168.61. The cost savings in travel time and other expenses to parents and patients were substantial between use of the county site and KUMC. Subtracting average savings in travel costs to patients and parents produced an average cost of a telepsychiatry consult in Crawford County of only $30.99. This study was conducted over 6 months with a small number of observations; it should be replicated over a longer study period, with more patients, and with more data that might capture marginal costs of services.