The purpose of this research was to evaluate the impact of glycemic measures, and changes in identified risk factors (BMI, waist circumference, lipids, blood pressure) on follow-up glycemia, in Pima children at high risk for type two diabetes (type 2 DM).I computed incidence and cumulative incidence of type 2 DM in Pima children 5-19 years of age between 1983 and 2004. Cox proportional hazards rates for development of type 2 DM were calculated by glycemic measure (HbA1C, 20PG, FPG) controlling for confounding factors (age, sex, BMI, blood pressure, and cholesterol). Diabetes was defined by the presence of at least one of four criteria: 1) 20PG of >200 mg/dl, 2) FPG of >126 mg/dl, 3) HbA1C > 8.0%, or 4) hypoglycemic treatment. Linear regression models were computed to identify the impact of changes in risk factors on changes in HbA1C. Only exams performed in non-diabetic children during childhood were included in the regression models.Among 2658 non-diabetic children, 258 cases of diabetes occurred during mean 9.1 years of follow-up (1.5 - 21.7). The age-sex adjusted incident rate of diabetes was 19.0 cases per 1000 person-years, and cumulative incidence was 54% by age 40. Incidence rates increased with increasing baseline values of 20PG, and FPG, but not for HbA1C. For HbA1C the relationship was u-shaped with the lowest and highest quartiles having the highest DM rates. After adjustment for confounding risk factors using Cox proportional hazards analysis, the risk for diabetes increased 2-fold for every 10 mg/dl increase in FPG. Changes in waist circumference best predicted changes in HbA1C (R2 = 0.48, Ï <0.001). However, the ability of waist circumference to predict change is limited due to the powerful effect of regression to the mean, suggesting that these risk factors contribute very little to changes in HbA1C, at least in childhood.Childhood levels of glycemia predict development of type 2 DM later in life. While changes in waist circumference are associated with only moderate changes in HbA1C, this does not refute the significant contribution of adiposity in childhood to the development of type 2 DM.

abstract: Indian water rights and Indian water settlements have emerged as a means for resolving long-standing despites and water rights claims. Working with and understanding water rights demands a genuine knowledge of water issues that are specific to each indigenous community as there are cultural aspects and perspectives towards water that are involved. The Gila River Indian Community is an indigenous community in south central Arizona, whose cultural and historic origins span over two millennia. Their foundation as a people was tied to the presence of the Gila and Salt Rivers, from which they freely diverted its waters through hundreds of miles of hand-dug canals, to transform the Sonoran desert into a desert oasis. There is a historical progression of this Community's water rights from when water was abundant to the time it was scarce, leading to an outright denial of a livelihood where water and farming was central to their way of life. A water rights settlement was an option that was pursued because it offered a chance for the Community to see the return of their water. The 2004 Gila River Indian Community Water Rights Settlement has been recognized as the largest Indian water rights settlement in United States history and serves as a model for future water settlements. The success of Indian water settlements in the United States has the potential, under the right political and legal conditions, to be replicated in other areas of the world where water resources are under dispute and water rights have come into conflict between indigenous and non-indigenous users. / Dissertation/Thesis / M.A. Social Justice and Human Rights 2012