The Pittsburgh insulin-dependent diabetes mellitus (IDDM) registry. The incidence of insulin-dependent diabetes mellitus in Allegheny County, Pennsylvania (1965-1976).

An insulin-dependent Diabetes Mellitus Registry has been developed in Allegheny County, Pennsylvania, through hospital record review and surveillance of pediatric practices. The yearly incidence ranged from 10/100,000 for nonwhite males to 16/100,000 for white males. There were no temporal trends in incidence for 1965-1976 nor major sex differences. Nonwhites had a slightly lower incidence, primarily in the younger age groups.

Precipitants of hospitalization in insulin-dependent diabetes mellitus (IDDM): a statewide perspective.

A statewide insulin-dependent diabetes mellitus (IDDM) registry is used to identify and epidemiologically characterize patients admitted to Rhode Island's hospitals. Physician interviews and record reviews are obtained to ascertain reasons for hospitalization. Poor diabetes control (noncompliance with diet/medication) and infection accounted for 44-54% of hospital admissions among 691 known diabetic patients; these patients were readmitted more often (65%) compared with new-onset patients (46%) during a 3-yr follow-up of hospitalization patterns. An outpatient diabetic education program was successful in reducing the number of persons hospitalized (P = 0.04) and the number of hospitalizations for participants (P = 0.01) when comparisons of hospital admissions before and after the program were made. Potential cost savings for persons with IDDM over the 4 yr of the study are estimated at $674,400.00.

Incidence and hospitalization patterns of insulin-dependent diabetes mellitus.

Data from a statewide insulin-dependent diabetes mellitus (IDDM) registry in Rhode Island show that IDDM affects young adults (20-29 yr) as frequently as adolescents and teenagers (10-19 yr). Overall incidence less than 30 yr was 14/100,000 population. Peak incidence occurred at 10-14 yr (19/100,000 population). Poor diabetic control and infection accounted for 46-62% of hospitalizations among 275 known diabetic persons. Despite a 10-yr mean duration of diabetes, only 31% of hospitalized diabetic persons less than 30 yr of age reported ever having received outpatient diabetes education of two or more hours. Readmissions 1 yr after initial registration were more frequent for known (43%) than new-onset (18%) IDDM cases. Increased risk of readmission for both groups was associated with a poverty socioeconomic status. Total direct hospitalization costs for IDDM in persons under 30 yr of age in Rhode Island was $530,000 per year of $2,245 per patient.

Geographic differences in the risk of insulin-dependent diabetes mellitus: the importance of registries.

There are marked geographic differences in the incidence of insulin-dependent diabetes mellitus (IDDM); for example, children in countries such as Finland are over 35 times more likely to develop IDDM than children in Japan. An understanding of the reasons for the geographic differences is likely to be important for understanding and, hopefully, preventing IDDM. There are problems, however, because of the lack of registries with adequate standardization. The major needs for the future studies include (1) to clarify the definition of IDDM for epidemiologic study, (2) to establish a standardized approach for IDDM registries, (3) to use registries to evaluate viral, immunologic, and genetic differences in order to explain differential risks across populations, and (4) to encourage the development of new population-based registries worldwide.

Memory effects in visual spatial information processing.

Eight, ten and twelve year old children were tested on a novel procedure involving the successive presentation of the standard and comparison stimuli. Two hypotheses were evaluated, one dealing with memory effects, and the other with children's pre-testing of choice responses in spatial information processing. It was found, in general, for both spatial perception and coordination of perspectives tasks, that there was no short memory decay for spatial information, but that opportunities to pre-test choice responses improved performance. It was inferred from these data that the performance superiority under simultaneous than successive conditions is attributable to opportunities to pre-test responses and not to memory effects, as opposed to successive conditions is attributable to opportunities to pre-test responses and not to memory effects.

Cross-modality transfer of spatial information.

First, second, and fourth grade boys and girls were tested on a spatial task requiring perception of the location of a group of three geometrical objects. The initial sensory input was either visual or tactual/kinaesthetic, and the choice stimuli, which were presented either simultaneously with the objects, or after the objects were removed (successively) were photographs of different configurations of the objects. There was no performance difference between th intramodal and cross-modal conditions, although older children performed better than younger ones, and performance was better under the simultaneous than successive conditions. It was concluded that in making complex visual spatial judgements, visual perceptual representations mediate performance under both tactual/kinaesthetic and visual sensory inputs.

Basic money-counting skills of children with mental retardation.

The thought processes involved in counting and comparing small amounts of money among children and adolescents with Down syndrome (n = 17), other children and adolescents with mental retardation of unknown etiologies (n = 17), and normally developing first graders (n = 15) were examined. Three different tasks that progressively reduced the cognitive demands placed on the children were used. Although not generally different from each other, the two groups of children with mental retardation had far greater difficulties with the tasks than normals. Also, as the complexity of the counting task increased, the number of comparison errors made by the children with mental retardation increased. Based on the findings, a program for teaching money principles to children with mental retardation was proposed.

The development of prejudice towards gays and lesbians by adolescents.

The authors studied the development of gay and lesbian prejudice in white, suburban adolescents in grades 7, 9, and 11. Results parallel several major findings with adults: males were more prejudiced than females; this difference was greater towards gay males than lesbians; and same-sex prejudice was greater than opposite-sex prejudice. For males and females prejudice increased between grades 7 and 9, but from grades 9 to 11 it decreased for females and increased for males. These differences were explained by the increased vulnerability of males to defensive reactions in response to the prospect of intimate relationships. None of the personality measures were significantly correlated with prejudice.

Sibling set configuration and family dysfunction.

The relationships between sex and birth order of the sibling set, number of parents in the primary family unit, and family dysfunction were assessed. The sample was restricted to two-child and three-child families, all of school age, and all living with one or both natural parents only, i.e., no one else was in the household. Chi-square analyses indicated that the likelihood of a family seeking treatment for one of their children was lowest with all girl sibling sets, intermediate with all boy sibling sets and with sibling sets in which all the girls were older than all the boys, and highest with sibling sets in which at least one boy was older than one girl. The patterns were stronger for two-parent than single-parent families. The results were interpreted in terms of two factors: (a) the relative commitment of boys and girls to supporting family norms, and (b) the relative stability of a family culture in same gender versus mixed gender sibling sets.

The epidemiology of diabetic acidosis: a population-based study.

A 12-month epidemiologic study in 1979 and 1980 of all diabetic acidosis admissions to all acute care hospitals in Rhode Island detected 152 episodes occurring in 137 persons. Eleven per cent of diabetic acidosis admissions presented in coma and the overall death-to-case ratio was 9%. Newly diagnosed diabetes accounted for 20% of these episodes, while persons having multiple episodes during the year accounted for 15% of the admissions. The annual rate of diabetic acidosis was 46 per 10,000 diabetics. Highest rates of diabetic acidosis were found for the elderly, those admitted from nursing homes and those residing in one geographic area of the state. For known diabetics with an admission for acidosis, 87% were on insulin prior to admission and 81% were nonobese. Patients seldom contacted physicians prior to admission. Insulin dose or frequency was often (40%) changed in the two weeks prior to admission. Most of the known diabetic cases of acidosis had emergency admissions for diabetes in the three-year period prior to admission and few had any structured diabetic outpatient education. Infection and noncompliance were the most frequently identified precipitants of diabetic acidosis occurring in known diabetics.

The Pittsburgh Insulin Dependent Diabetes Mellitus Registry: the relationship of insulin dependent diabetes mellitus incidence to social class.

The incidence of insulin dependent diabetes mellitus, as determined from the Pittsburgh Insulin Dependent Diabetes Mellitus Registry, was examined in relationship to social class. The registry consists of all Allegheny County, Pennsylvania, cases of insulin dependent diabetes diagnosed under age 20 years in 1965-1976. Analyses of the registry data revealed little relationship between incidence, age at onset and social class. The lack of a strong relationship to social class indicates that the epidemiology of insulin dependent diabetes is not similar to those of polio or Hodgkin's disease, in which social class is strongly related to incidence and age at onset.