Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Data Sources”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,135 records · Page 63Linked to original sources
PubMed2002

Cigarette advertising in magazines: the tobacco industry response to the Master Settlement Agreement and to public pressure.

OBJECTIVE: The Master Settlement Agreement (MSA) of November 1998 prohibited participating tobacco companies from directly or indirectly targeting youth in marketing. Widely publicised information in May 2000 showed increased cigarette advertising in magazines with substantial youth readership and companies were pressed to change their practices. The responses of the tobacco industry to the MSA and to the public pressure are examined. DESIGN: Expenditures on cigarette advertisements in national magazines in the USA are compared for three periods: January to November 1998, December 1998 to June 2000, and July 2000 to November 2001. Magazines in which at least 15% of readers are youth under age 18 are focused upon. Regression models test for the significance of period differences after controlling for seasonal and long term patterns. DATA SOURCES: Commercially maintained data on advertising in US magazines and on magazine readership by age. KEY MEASURES: Monthly cigarette ad expenditures in magazines with 15%+ youth readership, and monthly proportion of ad expenditures in 15%+ youth magazines. RESULTS: Cigarette advertising expenditures in magazines with 15%+ youth readership increased dramatically after MSA implementation and fell dramatically after public pressure. The percentage allocation of expenditures to 15%+ magazines fell significantly in both periods. Results differ somewhat by company. CONCLUSIONS: The tobacco industry response to the MSA was at best modest, reducing proportional allocations of advertising to youth magazines but increasing the absolute amount of such advertising. The value of public pressure was seen in substantial reductions in both absolute and proportional spending on youth magazines, although not by all companies.

Advertising↗
PubMed2006

Are patient falls and pressure ulcers sensitive to nurse staffing?

Research has demonstrated an association between more nurses and more qualified nursing staff in hospitals and better patient outcomes. Patient falls and pressure ulcers have been advanced as nursing-sensitive outcomes. This article evaluates the state of the science linking nurse staffing to falls and pressure ulcers. Studies that employed multivariate analysis to discern the effect of nurse staffing on patient falls and pressure ulcers in hospitals were evaluated. Eleven studies that met inclusion criteria were contrasted on their data sources and measures, data analysis, risk adjustment, and results. The evidence of an effect of nursing hours or skill mix on patient falls and pressure ulcers is equivocal. Substantial differences in research methods across studies may account for the mixed findings. Two study types were identified based on the level at which nurse staffing was measured, hospital or nursing unit, which exhibited systematic differences in measures and methods. Improvements in measurement and methods are suggested.

Accidental Falls↗
PubMed1993

Pharmacodynamic interpretation of adrenocorticotropin stimulation tests.

OBJECTIVE: To report a pharmacodynamic model that describes increases in cortisol concentrations during administration of an adrenocorticotropin (ACTH) infusion, taking into account both steroid secretion and elimination. DATA SOURCES: Previously published data. DATA SYNTHESIS: Using a population estimate of the elimination rate constant for cortisol and equations describing changes in cortisol concentration versus time, a value for the rate of cortisol secretion (Rcort) was derived. The Rcort value more directly represents the capacity for adrenal secretion of cortisol. CONCLUSIONS: Pharmacodynamic modeling techniques were used to successfully describe the rate of cortisol secretion during an ACTH infusion. This model can be applied to assess the extent of adrenal suppression after long-term corticosteroid therapy or in the presence of disease states.

Adrenal Glands↗
PubMed1994

Does ciprofloxacin interact with cyclosporine?

OBJECTIVE: To provide the reader with a review of the literature that evaluates whether a pharmacokinetic or pharmacodynamic drug interaction exists between ciprofloxacin and cyclosporine. DATA SOURCES: A MEDLINE search was used to identify pertinent review articles, pharmacokinetic studies, and case reports. STUDY SELECTION: As both pharmacokinetic trials and case reports were few in number, all available sources were reviewed. DATA EXTRACTION: A few case reports were reviewed; however, data were extracted primarily from prospective human studies involving cyclosporine pharmacokinetic profiles. DATA SYNTHESIS: Ciprofloxacin has been reported to interact with cyclosporine during concomitant use through an interaction with the cytochrome P-450 system or by additive nephrotoxicity. Because ciprofloxacin may be used to treat a variety of infections in transplant recipients who receive cyclosporine, it is important to determine whether an interaction exists. Although cyclosporine is known to cause nephrotoxicity, only a few reports of ciprofloxacin-induced acute renal failure exist, all involving an immune-mediated interstitial nephritis. Four case reports have suggested a possible pharmacokinetic or pharmacodynamic drug interaction between cyclosporine and ciprofloxacin; however, many pharmacokinetic studies have refuted these reports. Several studies performing cyclosporine pharmacokinetic profiles have documented no increased cyclosporine concentrations, thus supporting the premise that ciprofloxacin does not interact with cyclosporine. CONCLUSIONS: Controlled studies involving cyclosporine pharmacokinetic profiles do not support a pharmacokinetic or pharmacodynamic drug interaction between ciprofloxacin and cyclosporine. Although anecdotal case reports have suggested synergistic nephrotoxicity, no clear correlation can be made. Based on our review of the literature, it can be concluded that cyclosporine and ciprofloxacin may be used together safely at the recommended dosages without increased cyclosporine monitoring.

Ciprofloxacin↗
PubMed1995

Interactions between antipsychotic and antihypertensive drugs.

OBJECTIVE: To provide a comprehensive review of the pharmacokinetic and pharmacodynamic interactions between antipsychotics and antihypertensive and to provide recommendations for the selection of antihypertensive in patients receiving antipsychotic therapy. DATA SOURCES: A MEDLINE search of the English-language literature was used to identify pertinent human and animal studies, reviews, and case reports. STUDY SELECTION: All available sources were reviewed. DATA EXTRACTION: Background information was obtained from comprehensive reviews. Individual case reports were assimilated, and pertinent data were extracted. DATA SYNTHESIS: Because hypertension is common in patients with psychiatric illness and antihypertensive agents are used for a multiplicity of indications, significant numbers of patients receive concurrent therapy with antihypertensives and antipsychotics. Many antipsychotics may block the antihypertensive efficacy of guanethidine and related drugs. The interaction between clonidine and antipsychotics is defined less clearly. Limited data suggest possible additive hypotensive effects when chlorpromazine and methyldopa are given in combination. Increased plasma concentrations of thioridazine with a resultant increase in adverse effects have been reported when propranolol or pindolol are added to the regimen. A similar increase in chlorpromazine concentrations has been reported when propranolol was added. Although there are no reports documenting an interaction between a calcium-channel antagonist and an antipsychotic, the possible inhibition of oxidative metabolism of antipsychotics, additive calcium-blocking activity, and additive pharmacodynamic effects are theorized. Hypotension and postural syncope were reported in a patient given therapeutic dosages of chlorpromazine and captopril, and in 2 patients when clozapine was added to enalapril therapy. CONCLUSIONS: No antipsychotic-antihypertensive combination is absolutely contraindicated, but no combination should be considered to be completely without risk. Antihypertensives with no centrally acting activity, such as diuretics, may be the least likely to result in adverse reactions. The combination of the beta-antagonists propranolol or pindolol with thioridazine or chlorpromazine should be avoided if possible. Scrupulous patient monitoring for attenuated or enhanced activity of either agent is essential whenever antipsychotics and antihypertensives are given concurrently.

Adrenergic alpha-Agonists↗
PubMed2005

Gene expression analysis reveals that histone deacetylation sites may serve as partitions of chromatin gene expression domains.

BACKGROUND: It has been a long-term puzzle whether chromatin can be further divided into distinct gene expression domains. Because histone deacetylation affects chromatin structure, that in turn may affect the expression of nearby genes, histone deacetylation sites may act to partition chromatin into different gene expression domains. In this article, we explore the relationship between histone deacetylation sites and gene expression patterns on the genome scale using different data sources, including microarray data measuring gene expression levels, microarray data measuring histone deacetylation sites, and information on regulatory targets of transcription factors. RESULTS: Using 269 Saccharomyces cerevisiae microarray datasets, histone deacetylation datasets, and regulatory targets of transcription factors assembled from the Yeast Proteome Database and ChIP-chip data, we found that histone deacetylation sites can reduce the level of co-expression of neighboring genes. CONCLUSION: Histone deacetylation sites may serve as possible partition sites for chromatin domains and affect gene expression.

Binding Sites↗
PubMed2006

Estimating the cost of cervical cancer screening in five developing countries.

BACKGROUND: Cost-effectiveness analyses (CEAs) can provide useful information to policymakers concerned with the broad allocation of resources as well as to local decision makers choosing between different options for reducing the burden from a single disease. For the latter, it is important to use country-specific data when possible and to represent cost differences between countries that might make one strategy more or less attractive than another strategy locally. As part of a CEA of cervical cancer screening in five developing countries, we supplemented limited primary cost data by developing other estimation techniques for direct medical and non-medical costs associated with alternative screening approaches using one of three initial screening tests: simple visual screening, HPV DNA testing, and cervical cytology. Here, we report estimation methods and results for three cost areas in which data were lacking. METHODS: To supplement direct medical costs, including staff, supplies, and equipment depreciation using country-specific data, we used alternative techniques to quantify cervical cytology and HPV DNA laboratory sample processing costs. We used a detailed quantity and price approach whose face validity was compared to an adaptation of a US laboratory estimation methodology. This methodology was also used to project annual sample processing capacities for each laboratory type. The cost of sample transport from the clinic to the laboratory was estimated using spatial models. A plausible range of the cost of patient time spent seeking and receiving screening was estimated using only formal sector employment and wages as well as using both formal and informal sector participation and country-specific minimum wages. Data sources included primary data from country-specific studies, international databases, international prices, and expert opinion. Costs were standardized to year 2000 international dollars using inflation adjustment and purchasing power parity. RESULTS: Cervical cytology laboratory processing costs were I$1.57-3.37 using the quantity and price method compared to I$1.58-3.02 from the face validation method. HPV DNA processing costs were I$6.07-6.59. Rural laboratory transport costs for cytology were I$0.12-0.64 and I$0.14-0.74 for HPV DNA laboratories. Under assumptions of lower resource efficiency, these estimates increased to I$0.42-0.83 and I$0.54-1.06. Estimates of the value of an hour of patient time using only formal sector participation were I$0.07-4.16, increasing to I$0.30-4.80 when informal and unpaid labor was also included. The value of patient time for traveling, waiting, and attending a screening visit was I$0.68-17.74. With the total cost of screening for cytology and HPV DNA testing ranging from I$4.85-40.54 and I$11.30-48.77 respectively, the cost of the laboratory transport, processing, and patient time accounted for 26-66% and 33-65% of the total costs. From a payer perspective, laboratory transport and processing accounted for 18-48% and 25-60% of total direct medical costs of I$4.11-19.96 and I$10.57-28.18 respectively. CONCLUSION: Cost estimates of laboratory processing, sample transport, and patient time account for a significant proportion of total cervical cancer screening costs in five developing countries and provide important inputs for CEAs of alternative screening modalities.

Journal Article↗
PubMedDate not supplied

Informal caregiving dynamics with a case study in blood and marrow transplantation.

PURPOSE/OBJECTIVES: To develop a definition of informal caregiving dynamics through a selective literature review and explore the proposed definition in the context of blood and marrow transplantation using a case study. DATA SOURCES: Published articles. DATA SYNTHESIS: Informal caregiving dynamics are commitment, expectations, and negotiation that move a dyadic informal caregiving relationship along an illness trajectory. CONCLUSIONS: The proposed definition of informal caregiving dynamics is useful in explaining how an informal caregiving dyadic relationship develops and is sustained. IMPLICATIONS FOR NURSING: Understanding the dynamics underlying informal caregiving relationships enables nurses to intervene effectively to develop and sustain these vital relationships. Elements of the concept require further clarification. Research to validate the accuracy of the concept is needed.

Adult↗
PubMed2006

Expanded treatment options in the adjuvant therapy of colon cancer: implications for oncology nurses.

PURPOSE/OBJECTIVES: To review the role of adjuvant therapy in the treatment of patients with colon cancer. DATA SOURCES: Published articles, Internet sources, and books. DATA SYNTHESIS: Colon cancer is a very common cancer in men and women. Chemotherapy, consisting primarily of 5-fluorouracil, has been used to treat colon cancer since the 1950s, but additional effective agents against metastatic disease now are available. The options for adjuvant chemotherapy have increased dramatically. Ongoing studies are evaluating the role of biologics in adjuvant therapy of colon cancer. CONCLUSIONS: Use of oxaliplatin in the adjuvant setting has further defined exciting new therapy options for patients with colon cancer. IMPLICATIONS FOR NURSING: Oncology nurses caring for patients with colon cancer should be aware of new changes in therapy options. Although the addition of new therapies increases the tools in the drug arsenal for the common disease, management of toxicities of therapy is crucial as well. This article reviews changes in therapy options and toxicity management, including discussion of key issues for oncology nurses in the care of patients with colon cancer.

Chemotherapy, Adjuvant↗
PubMed2006

An XML-based system for synthesis of data from disparate databases.

Diverse data sets have become key building blocks of translational biomedical research. Data types captured and referenced by sophisticated research studies include high throughput genomic and proteomic data, laboratory data, data from imagery, and outcome data. In this paper, the authors present the application of an XML-based data management system to support integration of data from disparate data sources and large data sets. This system facilitates management of XML schemas and on-demand creation and management of XML databases that conform to these schemas. They illustrate the use of this system in an application for genotype-phenotype correlation analyses. This application implements a method of phenotype-genotype correlation based on phylogenetic optimization of large data sets of mouse SNPs and phenotypic data. The application workflow requires the management and integration of genomic information and phenotypic data from external data repositories and from the results of phenotype-genotype correlation analyses. Our implementation supports the process of carrying out a complex workflow that includes large-scale phylogenetic tree optimizations and application of Maddison's concentrated changes test to large phylogenetic tree data sets. The data management system also allows collaborators to share data in a uniform way and supports complex queries that target data sets.

Animals↗
PubMed2005

Simulation analysis of the consequences of shifting the balance of health care: a system dynamics approach.

OBJECTIVES: The shift in the balance of health care, bringing services 'closer to home', is a well-established trend. This study sought to provide insight into the consequences of this trend, in particular the stimulation of demand, by exploring the underlying feedback structure. METHODS: We constructed a simulation model using the system dynamics method, which is specifically designed for the analysis of feedback structure. The model was calibrated to two cases of the shift in cardiac catheterization services in the UK. Data sources included archival data, observations and interviews with senior health care professionals. Key model outputs were the basic trends displayed by waiting lists, average waiting times, cumulative patient referrals, cumulative patient activity and cumulative overall costs. RESULTS: Demand was stimulated in both cases via several different mechanisms. We revealed the roles for clinical guidelines and capacity changes, and the typical responses to imbalances between supply and demand. Our analysis also demonstrated the potential benefits of changing the goals that drive activity by seeking a waiting list goal rather than a waiting time goal. CONCLUSIONS: Appreciating the wider consequences of shifting the balance of care is essential if services are to be improved overall. The underlying feedback mechanisms of both intended and unintended effects need to be understood. Using a systemic approach, more effective policies may be designed through coordinated programmes rather than isolated initiatives, which may have only a limited impact.

Cardiac Catheterization↗
PubMed2001

Depression, service utilization, and treatment costs among Medicare elderly: gender differences.

OBJECTIVE: To compare gender differences in mood disorders, service utilization, and health care costs among a random sample of Medicare elderly beneficiaries of Tennessee. DATA SOURCES: Medicare expenditure data from a 5% random sample of Tennessee Medicare beneficiaries (n = 35,673) were examined for 1991-1993. The physician reimbursement files provided data relative to ICD-9 diagnostic codes, physician visits, and the cost of physician services provided. Other service utilization and cost data were obtained for the sample from the outpatient, home health, skilled nursing, hospice and inpatient files. STUDY DESIGN: The dependent variables were: (i) patients with ICD-9 diagnosis for a mood disorder (major depression and other depression), (ii) service utilization (number of outpatient visits, skilled nursing visits, home health visits, physician visits, emergency visits, and inpatient days), and (iii) health care costs (dollar amount of physician cost, outpatient cost, inpatient cost, total mental health cost, total health cost, and other cost). The independent variable was gender. PRINCIPLE FINDINGS: Chi-square tests showed that among the patients with a mood disorder, females had a significantly higher incidence than males of major depression (1.3% vs. .4%, respectively, p < .001) and other depression (1.6% vs. .6%, respectively, p < .001). Further, t-test results indicated that females diagnosed with major depression utilized significantly more outpatient services than males (3.2 vs. 2.6, respectively, p < .04). Total health care costs for those with other depression were significantly higher for males than females ($15,060 vs. $10,240, respectively, p < .002). CONCLUSIONS: The results indicate that mood disorders, outpatient services, and total mental health costs are higher for females than males; however, total health care costs are higher for males than females.

Aged↗
PubMed1999

Physician over-the-counter drug prescribing patterns: an analysis of the National Ambulatory Medical Care Survey.

OBJECTIVE: To describe the prevalence of physician over-the-counter (OTC) drug prescribing in relation to selected physician, patient, and drug characteristics. DATA SOURCE AND METHODS: Data from the 1990 National Ambulatory Medical Care Survey, a multistage probability clustered sample, were analyzed. Physician drug utilization was expressed in drug mentions defined as "the physician's entry of a pharmaceutical agent ordered or provided, by any route of administration, for prevention, diagnosis, or treatment." Sampling weights were used to obtain unbiased national estimates. Cross tabulations of the drug prescription status (OTC or prescription [Rx]) with independent variables were performed, overall and by therapeutic class. The overall OTC/Rx ratio (0.11) was used as the cutoff point for distinguishing high- from low-level OTC drug prescribing. RESULTS: In 1990, 9.7% of physician drug mentions were of OTC drugs. Women between 16 and 34 years, Asian/Pacific Islanders, white Hispanics, and African-Americans experienced high OTC drug mentions (OTC/Rx > or = 0.11). After stratification by drug therapeutic class, physicians in general practice, family practice, internal medicine, obstetrics/gynecology, and pediatrics highly mentioned OTC drugs. CONCLUSIONS: OTC drug prescribing by physicians is substantial, and primary care specialties, patient gender, age, and race should be considered by those interested in evaluating OTC drug utilization in the ambulatory care setting.

Age Factors↗
PubMed2003

Implications of SARS: medical geography and surveillance in disease detection.

OBJECTIVE: To expose pharmacy educators and practitioners to concepts of medical geography and medical surveillance. Severe acute respiratory syndrome (SARS) is used as a case example because it is an emerging infection and a prime example of the type of disease that pharmacists may encounter in daily practice (e.g., easily transmitted, resembles the common cold). DATA SOURCES: We retrieved data from publications related to medical geography, medical surveillance, and SARS. Data on current SARS cases in Hong Kong were obtained from the Hong Kong Department of Health Web site. STUDY SELECTION AND DATA EXTRACTION: Variables regarding new cases and deaths due to SARS were evaluated. DATA SYNTHESIS: Background information on medical geography and medical surveillance was reviewed. Descriptive statistics were calculated for incidence, prevalence, and the number of deaths due to SARS in Hong Kong from March 14 to May 31, 2003. CONCLUSIONS: Emerging infections are a serious concern for both the public and healthcare practitioners. The recent global diffusion of SARS highlights the ease in which diseases can diffuse from place to place. Understanding concepts related to medical geography and medical surveillance can help pharmacists be better prepared to anticipate disease diffusion and to evaluate signs of emerging infections. In turn, this can help pharmacists be better prepared to provide information and care to their patients. The long-term benefit of understanding how diseases spread and the specific activities related to disease detection is an opportunity for expanding the scope of pharmacy practice.

Canada↗
PubMed2005

Asthma-related health care resource use among patients starting fluticasone or montelukast therapy.

STUDY OBJECTIVES: To compare patterns of asthma-related health care resource use among patients prescribed fluticasone or montelukast as singlecontroller therapy for asthma, and to confirm patterns previously observed in retrospective analyses examining outcomes among patients receiving fluticasone or montelukast for asthma. DESIGN: Retrospective cohort study. DATA SOURCE: Administrative claims data drawn from United States health insurers in 35 states, covering 17 million privately insured patients. PATIENTS; A total of 4758 patients aged 2-55 years with asthma who were prescribed either fluticasone or montelukast from July 1, 1998-June 30, 1999, were continuously enrolled for at least 24 months, had no evidence of controller therapy for 6 months before the start of drug therapy, and had no evidence of chronic obstructive pulmonary disease or other respiratory illness. MEASUREMENTS AND MAIN RESULTS: Patients were identified using an algorithm based on medical and pharmacy insurance claims. Patients were matched between groups based on a propensity score of clinical characteristics and age; this resulted in 1512 patients/treatment group. Asthma-related health care claims incurred for 12 months before and after the start of controller therapy were analyzed. After adjustment, the fluticasone-treated group had greater risk than the montelukast-treated group of requiring therapy with a short-acting beta-agonist in the follow-up period (relative risk 1.12, 95% confidence interval [CI] 1.03-1.20). Odds were similar across treatment groups for needing an emergency department visit and/or hospitalization (odds ratio 1.08, 95% CI 0.74-1.58) and for needing therapy with an oral corticosteroid (odds ratio 1.02, 95% CI 0.84-1.26). CONCLUSION: The start of therapy with either fluticasone or montelukast as a single-controller for asthma was associated with similar asthma-related health care resource use in this matched population.

Acetates↗
PubMed2003

Declining trends in work-related morbidity and disability, 1993-1998: a comparison of survey estimates and compensation insurance claims.

OBJECTIVES: This study compared trends in the incidence of work-related morbidity and disability across 3 sources of surveillance data in a Canadian province. METHODS: Time series estimates of workplace injuries and work-related disability based on 2 panel surveys in the province of Ontario, Canada, for the period 1993-1998 were compared with rates of work-related injury and illness compensation claims during the same period. RESULTS: Lost-time compensation claims declined by 28.8% over this 6-year period. The incidence of self-reported work-related injury declined by 28.2%, and the self-reported incidence of work absence for work-related causes declined by 32.2%. CONCLUSIONS: Parallel reductions in work-related morbidity were seen in 3 independent data sources. These results support an interpretation that there has been an important reduction in injury risk in Ontario workplaces over the past decade.

Absenteeism↗
PubMed2004

Do interventions to increase income improve the health of the poor in developed economies and are such policies cost effective?

Health policy has shifted towards placing a greater emphasis on the role of lifestyle and life circumstances in improving health. The factors that are associated with poor health status are known, but the comparative effectiveness of specific policy interventions in improving health and reducing inequalities in health is unclear. For example, there is little evidence that specific policies aimed at providing income support or poverty eradication have any measurable impact on health. Two previous reviews have addressed the evidence in this area but in a fairly restrictive way. One considered only randomised trials and the other excluded non-cash benefits. This article builds on the previous reviews in three ways: a broader scope of study designs and types of intervention is considered; more recent literature is reviewed; and it considers the extent to which an economic evaluation framework has been applied. A systematic search of electronic databases was carried out for literature published since 1980 and in the English language. Each study was appraised in terms of its relevance to the question of interest, and the quality of the study design was appraised in terms of its capacity to provide robust answers. Few studies were found with health outcomes as their main focus. Most of the studies that used secondary data sources or survey data were of poor quality. Where economic evaluations were reported, these tended to be restricted to financial assessments. Different types of interventions were evaluated. In studies of cash benefits, there was limited evidence that they had a positive effect on some health domains, mainly psychosocial. Studies in welfare-to-work interventions produced mixed results in terms of impact on either income or health; there was no consistent relationship between income gains and health improvements. Five welfare-to-work studies included 'benefit-cost analysis', but these were essentially financial assessments. Studies of benefits in kind did not meet the quality criteria for inclusion in this article. Overall, we found no evidence of the potential cost effectiveness of income support or anti-poverty initiatives in improving health, nor is there a strong effectiveness literature on which to build such analysis. However, the hypothesis that increased income may improve health cannot be said to have been properly tested. Studies generally analyse the incremental effect of changes to the welfare system and do not estimate the health effects of current provisions. The production function for good health is complex. Increasing income may be a necessary, but not a sufficient, condition for the creation of better health in those with low incomes.

Cost-Benefit Analysis↗
PubMed1993

Sex differences in incidence of IDDM in age-group 15-29 yr. Higher risk in males in Province of Turin, Italy.

OBJECTIVE: To report the incidence of IDDM in the age-group 0-29 yr in the Province of Turin, Italy (951, 445 inhabitants 0-29 yr of age), over a 5-yr period (1984-1988) according to age, sex, and geographical region within the area and to identify any temporal trend. RESEARCH DESIGN AND METHODS: The survey used as the primary data source the list of all patients attending diabetic clinics, and as secondary data source, used the list of hospital discharges for diabetes. RESULTS: We identified 298 incident cases of IDDM in people 0-29 yr of age. Estimated completeness of ascertainment of the registry was 97%. Age-adjusted (world-standard) incidence rates were 7.40/100,000 (95% CI 6.28-8.71), 5.83 (4.95-6.86), and 6.70 (5.97-7.51), respectively, in the age-groups 0-14, 15-29, and 0-29 yr. Incidence was significantly higher in males than in females in the age-group 15-29 yr (7.36, 6.02-8.98, vs. 4.21, 3.12-5.56). An increasing incidence from rural areas to the greater Turin area (city and its industrial belt) was evident. No significant temporal trend during the study period was found, although year-to-year variability was evident, with the highest incidence in 1984. CONCLUSIONS: This study suggests a high male-to-female ratio of incidence of IDDM after 14 yr; either sex hormones or different exposure to environmental determinants could be involved.

Adolescent↗