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Cambridge, 1961. A group of students set off on the trip of a lifetime. Against the backdrop of the Cold War they travel through the Soviet Union to the Middle East, South Asia and on to Africa. Their mode of transport? The iconic VW Kombi. This book tells the story of that trip, not just the people they met and the places they saw, but the many experiences - sometimes nerve-wracking, sometimes bizarre - that they encountered along the way. It provides a fascinating insight into a world on the brink of change - seen through the eyes of nine young men fresh from university. The two VW Kombis doggedly traversed treacherous mountain passes, near-impossible roads, jungle tracks and river crossings on their journey through Anatolia, the Middle East, Asia and Africa. This book is an affectionate and highly entertaining re-creation of the relationship between the nine young travellers and their companions, the two VW Kombis which functioned as transport, shelter, canteen and home. It is also a tribute to the determined and rugged determination of the VW Kombi whose descendants still tackle the highways and the more daunting roads of the world.

Trends in the Diabetes Quality Improvement Project Measures in Maine From 1994 to 1999 Monica R. McClain , PHD 1 , David E. Wennberg , MD, MPH 1 2 , Roger W. Sherwin , MD 3 , William C. Steinmann , MD, MSC 4 and Janet C. Rice , PHD 5 1 Maine Medical Assessment Foundation, Manchester, Maine 2 Center for Outcomes Research and Evaluation, Maine Medical Center, Portland, Maine 3 Department of Epidemiology, Tulane University Graduate School, New Orleans, Louisiana 4 Tulane Center for Clinical Effectiveness and Prevention, Tulane University Medical Center, New Orleans, Louisiana 5 Department of Biostatistics, Tulane University Graduate School, New Orleans, Louisiana Abstract OBJECTIVE —To examine changes in the management of patients with diabetes from 1994 to 1999 using the claims-based Diabetes Quality Improvement Project (DQIP) accountability measures. RESEARCH DESIGN AND METHODS —Administrative claims from an employer-based health insurance cohort in Maine were used to describe the prevalence of claims-based DQIP accountability measures—HbA 1c testing, dilated eye examination, lipid profile, and monitoring for diabetic nephropathy—from 1994 ( n = 1,151) to 1999 ( n = 2,221) in a 100% sample of adults (18–64 years of age) with diabetes. The Mantel-Haenszel χ 2 test for trend was performed on each measure. Prevalence estimates were also stratified by three insurance products: health maintenance organization (HMO), point of service, and indemnity. RESULTS —There was a positive trend for all outcome measures ( P < 0.001). The baseline and final frequencies (percent increase) for lipid testing, HbA 1c , dilated eye examination, and screening for diabetic nephropathy were as follows: 13–50% (257%), 37–69% (92%), 30–46% (53%), and 37–50% (36%), respectively. Individuals with diabetes and indemnity insurance were much less likely to receive these measures than individuals with other types of insurance, whereas people in HMOs were more likely to receive HbA 1c testing and lipid profiles. CONCLUSIONS —The proportion of patients with diabetes receiving DQIP accountability measures significantly increased from 1994 to 1999. There is large variation in prevalence among these measures and insurance products. It is urgent to identify effective mechanisms for delivering consistent preventive care that are congruent with defined standards of benefit. BRFSS, Behavioral Risk Factor Surveillance System DQIP, Diabetes Quality Improvement Project HMO, health maintenance organization MHMC, Maine Health Management Coalition POS, point of service Footnotes Address correspondence and reprint requests to Monica R. McClain, Foundation for Blood Research, PO Box 190, Scarborough, ME 04070. E-mail: mcclain{at}fbr.org . Received for publication 5 June 2002 and accepted in revised form 9 November 2002. A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances. DIABETES CARE

Cambridge, 1961. A group of students set off on the trip of a lifetime. Against the backdrop of the Cold War they travel through the Soviet Union to the Middle East, South Asia and on to Africa. Their mode of transport? The iconic VW Kombi. This book tells the story of that trip, not just the people they met and the places they saw, but the many experiences - sometimes nerve-wracking, sometimes bizarre - that they encountered along the way. It provides a fascinating insight into a world on the brink of change - seen through the eyes of nine young men fresh from university. The two VW Kombis doggedly traversed treacherous mountain passes, near-impossible roads, jungle tracks and river crossings on their journey through Anatolia, the Middle East, Asia and Africa. This book is an affectionate and highly entertaining re-creation of the relationship between the nine young travellers and their companions, the two VW Kombis which functioned as transport, shelter, canteen and home. It is also a tribute to the determined and rugged determination of the VW Kombi whose descendants still tackle the highways and the more daunting roads of the world.

THE AUTHORS OF THIS PAPER SUMMARIZED the major themes that emerged from a 2-day workshop entitled Epidemiology of Hypertension in Hispanic Americans, Native Americans, and Asian/Pacific Islander Americans, sponsored by the National Heart, Lung, and Blood Institute (NHLBI) in Washington, DC. Data from the papers were synthesized using seven points: similarities, variability within and between groups, lost prevention opportunities, emergence of explanatory variables, differences in types of data collected, missing or inconsistently reported data, and socioeconomic characteristics. Virtually all of the population groups demonstrated rises in blood pressure with age. These rises appear to be largely attributable to potentially modifiable risk factors, for example, high body mass index (BMI). Despite high levels of awareness, the levels of control of high blood pressure were poor in each population studied. Based on the themes that emerged from the data, we presented several recommendations to the workshop. One was that data be collected on these population groups repeatedly and in a standardized fashion. Another called for increased efforts aimed at control of high blood pressure in these groups. A third recommended major nationwide programmatic efforts aimed at the prevention and control of high blood pressure.

THE AUTHORS PRESENT DATA FROM 361,662 MEN ages 35 to 57, screened from 1973 to 1976 for possible participation in the Multiple Risk Factor Intervention Trial (MRFIT). Volunteers identified themselves as \"white,\" \"black,\" \"Oriental,\" \"Spanish American,\" \"American Indian,\" or \"other.\" They also noted if they were taking medication for diabetes. A trained technician measured blood pressure after participants had rested for 5 minutes, using the fifth Korotkoff sound to define diastolic pressure and averaging the second and third of three readings. Differences among the groups included the following: blacks had consistently higher systolic and diastolic blood pressure (SBP and DBP) than other groups; Orientals had slightly lower pressure than other nonblack groups; American Indians had somewhat higher pressure than other nonblack groups at ages 35 to 44 but lower at ages 45 to 54; Hispanics in Miami and Davis, California, had significantly higher SBP and DBP than whites in the same area; Orientals in California had significantly higher DBP (but not SBP) than whites in California.