Incidence trends for childhood type 1 diabetes in Europe during 1989-2003 and predicted new cases 2005-20: a multicentre prospective registration study

Background: The incidence of type 1 diabetes in children younger than 15 years is increasing. Prediction of future incidence of this disease will enable adequate fund allocation for delivery of care to be planned. We aimed to establish 15-year incidence trends for childhood type 1 diabetes in European centres, and thereby predict the future burden of childhood diabetes in Europe.
Methods: 20 population-based EURODIAB registers in 17 countries registered 29 311 new cases of type 1 diabetes, diagnosed in children before their 15th birthday during a 15-year period, 1989–2003. Age-specific log linear rates of increase were estimated in five geographical regions, and used in conjunction with published incidence rates and population projections to predict numbers of new cases throughout Europe in 2005, 2010, 2015, and 2020.
Findings: Ascertainment was better than 90% in most registers. All but two registers showed significant yearly increases in incidence, ranging from 0·6% to 9·3%. The overall annual increase was 3·9% (95% CI 3·6–4·2), and the increases in the age groups 0–4 years, 5–9 years, and 10–14 years were 5·4% (4·8–6·1), 4·3% (3·8–4·8), and 2·9% (2·5–3·3), respectively. The number of new cases in Europe in 2005, is estimated as 15 000, divided between the 0–4 year, 5–9 year, and 10–14 year age-groups in the ratio 24%, 35%, and 41%, respectively. In 2020, the predicted number of new cases is 24 000, with a doubling in numbers in children younger than 5 years and a more even distribution across age-groups than at present (29%, 37%, and 34%, respectively). Prevalence under age 15 years is predicted to rise from 94 000 in 2005, to 160 000 in 2020.
Interpretation: If present trends continue, doubling of new cases of type 1 diabetes in European children younger than 5 years is predicted between 2005 and 2020, and prevalent cases younger than 15 years will rise by 70%. Adequate health-care resources to meet these children’s needs should be made available.

Sex Offender Registration: Some Observations on ‘Megan’s Law’ and the Sex Offenders Act 1997

“Megan’s Law” in the United States and Part 1 of the Sex Offenders Act 1997 in the United Kingdom, make provision for the creation of a register which will record the names and addresses of all persons convicted or cautioned for a sexual offence. Arguments expounded in favour of the legislation include the supposedly high recidivism among sex offenders, the inadequacy of supervision provisions, and the resulting need to ‘track’ the dangerous offender for public protection. In practice, however, there are a plethora of obstacles, such as cost and inadequate policing resources, which may impede its effectiveness in aiding law enforcement and reduce it to symbolic significance only. In addition, there are an array of ethical objections to the legislation, such as it breaches civil liberties and constitutes ‘double jeopardy’, which may prevent meaningful imposition.

Sex Offender Registration: Implications and Difficulties for Ireland

The aim of this paper is to explore the implications and difficulties of a system of sex offender registration for Northern Ireland and the Republic of Ireland. From the orthodox perspective, registration appears justified. Sexual offending has increased and this is used by the media to generate a ‘moral panic’. However, sexual offenders in the community have also been socially constructed in Ireland, as a problem requiring specific action, through Blumer’s (1971) developmental perspective. It is this perspective which most adequately explains the formulation of the legislation. Arguments expounded in favour of registration include the supposedly high recidivism among sex offenders, the inadequacy of supervision provisions and the resulting need to ‘track’ the offender for public protection. Yet, in practice there are a plethora of obstacles such as cost and inadequate policing resources, not considered at the time the legislation was being formulated, which may impede its effectiveness in aiding law enforcement and reduce it to symbolic significance only. Given these difficulties, it is argued that registration is not an appropriate response to the problem of released sexual offenders in Ireland. Rather, from the social constructionist perspective, it is suggested that it is better to ‘treat’ the sex offender through less formal and stringent means in the community away from the criminal justice process.

Establishing a minimum dataset for prospective registration of systematic reviews: an international consultation

Background: In response to growing recognition of the value of prospective registration of systematic review protocols, we planned to develop a web-based open access international register. In order for the register to fulfil its aims of reducing unplanned duplication, reducing publication bias, and providing greater transparency, it was important to ensure the appropriate data were collected. We therefore undertook a consultation process with experts in the field to identify a minimum dataset for registration. Methods and Findings: A two-round electronic modified Delphi survey design was used. The international panel surveyed included experts from areas relevant to systematic review including commissioners, clinical and academic researchers, methodologists, statisticians, information specialists, journal editors and users of systematic reviews. Direct invitations to participate were sent out to 315 people in the first round and 322 in the second round. Responses to an open invitation to participate were collected separately. There were 194 (143 invited and 51 open) respondents with a 100% completion rate in the first round and 209 (169 invited and 40 open) respondents with a 91% completion rate in the second round. In the second round, 113 (54%) of the participants reported having previously taken part in the first round. Participants were asked to indicate whether a series of potential items should be designated as optional or required registration items, or should not be included in the register. After the second round, a 70% or greater agreement was reached on the designation of 30 of 36 items. Conclusions: The results of the Delphi exercise have established a dataset of 22 required items for the prospective registration of systematic reviews, and 18 optional items. The dataset captures the key attributes of review design as well as the administrative details necessary for registration.