bluuebunny/crossref_metadata_2025 huggingface dataset:
The computer as an aid to practical science—studying motion with a computer
Authors: Barton R. , Rogers L.
Published: April 2008

Abstract This paper describes the use of two types of physical sensor which enable the microcomputer to be used as a measuring instrument for practical experiments on motion. The systems enable a change of emphasis away from the routine activity of collecting results towards the use of interpreting skills, and are valuable for an investigative style of working in which pupils take a central role in planning and shaping their activity.
Information technology in art and design: visual sensitivity, learning and assessment
Authors: Genin T.
Published: April 2008

Abstract Current changes in the structure of British Art Education provide new opportunities for Information Technology to support the difficult task of teaching and evaluating. In the light of the 1988 Education Reform Act, this paper considers the use of microcomputers to develop visual sensitivity and skills. A test model is discussed which examines an experiential approach towards the teaching, evaluation and interpretation of colour theory.

This is an interim report, the work is ongoing and no overriding conclusions have yet been made.
Patterns of discussion between pupil pairs in computer and non‐computer environments
Authors: Hoyles C. , Healy L. , Sutherland R.
Published: April 2008

Abstract This paper presents some findings of research into the discussion between pupils in computer and non‐computer environments. The research was concerned with analysing the processes whereby pairs of pupils came to make mathematical generalizations in three environments, LOGO, spreadsheet and paper and pencil. Critical decisions in the generalization process were identified in order to allow comparisons to be made across environments. The analysis reveals differences in the effects of task environment on the negotiation of the mathematical generalization particularly in relation to the part played by formalization.
Logical sentences and searches
Authors: Bezanilla M.J. , Ogborn J.
Published: April 2008

Abstract  A study of 13–14 year‐old students' performance on two parallel logical reasoning tasks related to database searches is reported. In one task, given a logical sentence defining a search, students had to construct the equivalent data structure. In the other, given a data structure, they had to construct the equivalent logical sentence. Binary logical sentences including AND, OR and NOT were investigated, including tautology and contradiction. Students were more successful with sentences using AND than with sentences using OR. Negation generally produced difficulties, and essentially none could manage tautology and contradiction. Sentences using OR were more difficult, especially when they involved NOT. A common pattern was to treat OR as if it were AND. The two tasks, though formally parallel, were very different in difficulty, with the construction of sentences from a data structure being the more difficult. Both tasks were administered before and after training in the use of a database. A negligible difference in performance was seen.
Studying a complex knowledge domain by exploration or explanation
Authors: Beishuizen J. J.
Published: April 2008

Abstract  The teaching of complex knowledge domains should not be restricted to linear explanations but instead should allow the learner to travel through domains along different routes. Simulation programs provide a microworld in which the user has the freedom to explore the embedded concepts and relations by manipulating parameters and studying the resulting changes in the simulation environment. In this study two experiments were conducted to investigate the educational value of a simulation program modelling the relations between erosion and agriculture in a developing country as part of the secondary school geography curriculum. The hypothesis tested was that studying the complex domain through exploration with a simulation program decreases the retention of facts and concepts but increases performance on a problem solving test, compared with studying the same domain through traditional classroom explanation. The first experiment showed that the exploration group outperformed the explanation group on both factual knowledge and problem solving questions. A second experiment was run to control instruction time for both groups and to add a demonstration of the simulation program to the explanation condition. Under these conditions there were no post‐test differences between the explanation and the exploration group. It is hypothesized that training in how to use a simulation environment to study a domain is necessary to take full advantage of the facilities to explore the domain.
IT‐based open learning: a case study in management learning
Authors: Hodgson V. , McConnell D.
Published: April 2008

Abstract  This paper is concerned with the relationship between open learning and the use of computer mediated communications systems (CMCS) in supporting open learning. In order to illuminate this relationship, we report on a small scale trial of a model of open learning developed at Lancaster University: ITOL — Information Technology‐based Open Learning. The ITOL model has successfully been applied to an M.A. in Management Learning, and through a case study approach, we discuss an evaluation of this new computer mediated M.A. and point out some of the issues that emerge in introducing CMCS into professional learning situations.
Student‐teachers' experiences in using computers during teaching practice
Authors: Downes T.
Published: April 2008

Abstract The purposes of this study were to investigate student‐teachers' use of computers during teaching practice, differentiating between personal use and use with children, and to identify any relationships between these and a range of biographical, computer‐experience, and practicum factors. The results showed that less than half the final year students used computers with children during their teaching practice, that personal use does not need to precede use with children and that home usage and supervising teacher's usage were important factors in explaining differences in use. These results have significant implications for the design of courses for student‐teachers.
Information technology, informatics and pre‐service teacher training
Authors: Baron G‐L , Bruillard E.
Published: April 2008

Abstract  Over the past ten years, information technology (IT) has evolved considerably and computers in schools have become increasingly commonplace in France. However, technological subjects aside, any claim that their use has become integrated into every subject would be questionable. Limiting factors do exist, such as the place of IT in curricula. In order to advise their students to use technological devices, teachers must first be convinced that it is advantageous. Teacher training in IT is therefore essential. This paper reports the results of a quantitative study, undertaken in a French University institute for teacher training (IUFM), which was conducted to ascertain students' initial knowledge and opinions regarding IT. Overall, although their level of expectations was high, the initial level of their competency was low. The integration of IT into teacher‐training thus appears problematic.
Sixth form students' ability to engage in computational modelling
Authors: dos Santos A.C. Kurtz , Ogborn J.
Published: April 2008

Abstract The paper presents the main conclusions of an exploratory study of the ability of Sixth form students in England to use some different approaches to computational modelling. The research involves a questionnaire survey of causal diagraming and mathematical knowledge, which aims at characterizing students' model building capability. Also, it includes an intensive study with pairs of students doing exploratory and expressive tasks using two modelling systems:IQONandSTELLA.Data was gathered through written notes from observation, written answers given to questionnaires and data recorded in the computer. Overlapping questionnaires connected the survey and the intensive study, and comparisons between the use of causal diagrams andIQONwere carried out. Results suggest that Sixth form students can undertake valuable work with both computational systems.
Measuring the impact of IT on learning
Authors: Hammond M.
Published: April 2008

Abstract  This paper considers the impact of Information Technology on children's learning in schools with particular reference to the ImpacT report and the Plait report. The difficulties of evaluating the effectiveness of? are discussed as are some of the explanations given for the insignificant impact of IT in the two studies. In conclusion it is argued that the framework for evaluating the impact of Information Technology needs to consider the aims of the teacher, the principles of the software and an interpretation of what went on in the classroom.
Supporting professional learning: beyond technological support
Authors: Bonamy J. , Haugluslaine‐Charlier B.
Published: April 2008

Abstract Three main evolutions define the concept of professional learning support. The firstone could be as a result of the dynamic interaction between a new demand for professional learning coming both from the individual and the organisations and a new supply defined mainly by the new possibilities offered by the technologies. The second one could be presented as the adoption of a new paradigm of learning, which integrates the learner as the main actor and the process of knowledge building either by interactions with the environment or by human‐human interactions. The last one concerns the concept of professional itself. In this paper Jitol is analysed according to these three evolutions either bydefining the assumptions of this ‘professional learning support’ and by highlighting main results of the JITOL pilot studies. The main issue of this reflection, will lead to anunderstanding that Jitol becomes effective and meaningful through its diverse uses in real settings and that theses uses need to be driven by a collaborative research action.
Mental models and computer modelling
Authors: Wild M.
Published: April 2008

Abstract This paper is concerned with the place of mental models in the process of knowledge construction and in particular, the relationship between mental models and computer models in that process. It identifies what is meant by mental models and outlines why they might be seen to be central to the process of acquiring knowledge. In this context, the second part of the paper analyses and discusses children's use of a spreadsheet to build their own computer models. It is suggested that the process of building models on a computer may provide direct support to the cognitive processes of constructing mental models, although the relationship is not straight forward.
The clinical significance of surface antigen variants of hepatitis B virus
Authors: Carman W. F.
Published: April 2008

Summary. Hepatitis B surface antigen (HBsAg) is not only critical to the biology of hepatitis B virus (HBV), it is also the basis of the currently available vaccines, assays to detect it in serum are crucial for diagnosis of infection and antibodies against it are used clinically to suppress infection of transplanted livers. All of these rely on antigenic interactions between HBsAg and HBsAb. Thus, it should not be a surprise that changes in epitopes will affect all these situations. It is useful to classify such changes simplistically as variants, found in natural isolates, and mutants, which are observed to emerge, usually under immunological pressure, often medical in origin. The former tend to affect the sensitivity of diagnostic assays and the latter allow escape of viruses in vaccinees and those being treated with HBsAb. The majority of these changes cluster in the hydrophilic central core of HBsAg, from aa99 up to 169. They are gaining importance as causes of mistaken diagnosis and are associated with infection of vaccinees and transplanted livers. There is a danger that they will become the dominant strains as vaccination becomes universal. More data are required on the epidemiology and antigenicity of these changes.
Prolonged interferon‐alpha therapy of hepatitis B virus‐related decompensated cirrhosis
Authors: Marcellin P. , Giuily N. , Loriot M. A. , Durand F. , Samuel D. , Bettan L. , Degott C. , Bernuau J. , Benhamou J. P. , Erlinger S.
Published: April 2008

Summary. Interferon alpha therapy of hepatitis B virusrelated decompensated cirrhosis with the dose and the duration generally used is frequently associated with severe side‐effects and reactivations. Between 1989 and 1996, 15 patients with hepatitis B virus‐related decompensated cirrhosis received prolonged (3–48 months) low‐dose (3 million units) IFN‐α therapy. Ten patients (66%) had a sustained loss of serum hepatitis B virus DNA and hepatitis Be antigen (if present initially) associated with a decrease of aminotransferase levels into the normal range. During follow‐up of these 10 patients, seven had a marked clinical improvement and are alive and fully active. One has an hepatocellular carcinoma, and two died without reactivation. Among the five other patients, two had a transient loss of serum HBV DNA followed by reactivation and three did not respond to therapy. During follow‐up, one of these five patients died and one underwent liver transplantation. Severe complications, possibly related to interferon were uncommon and included bacterial infection in one case and variceal bleeding in two cases. Eleven of the 15 patients treated are alive after 1.5–7 years of follow‐up. Hence, in patients with hepatitis B‐related cirrhosis, prolonged low‐dose IFN‐α therapy is relatively well tolerated and may induce a sustained inhibition of hepatitis B virus replication with marked clinical improvement.
HCV cDNA transfection to HepG2 cells
Authors: Hiramatsu N. , Dash S. , Gerber M. A.
Published: April 2008

Summary. The establishment of an in vitro system for hepatitis C virus (HCV) propagation is essential to characterize virus replication, virus persistence and viral pathogenicity. The aim was to establish HCV replication in HepG2 cells by gene transfer of infectious HCV cDNA. First, several gene transfer methods were evaluated that employed cationic liposomes (lipofectin, lipofectamine. DOTAP), DEAE‐dextran and replication‐deficient adenovirus for transfection to HepG2 cells using a lacZ reporter gene. Highest transfection efficiency (20%) of cultured HepG2 cells was obtained by the combined use of lipofectamine and adenovirus. This method was used for transfection of HepG2 cells with HCV cDNA in a mammalian expression plasmid (pRC/CMV). The success and efficacy of HCV transfection to HepG2 cells was evaluated by testing for the presence of genomic and replicative (negative) strands of HCV RNA by strand‐specific reverse transcription (RT) followed by nested PCR. Expression of structural and non‐structural proteins of hepatitis C virus was detected using polyclonal antibodies to core, NS3, NS4 and NS5. Positive‐strand HCV RNA was detected by RT‐PCR for over 6 weeks in the HCV cDNA‐transfected HepG2 cells. Presence of HCV replication in these cells was confirmed by detecting HCV negative‐strand RNA by strand‐specific RT‐PCR and was observed to continue for over 4 weeks. HCV proteins (core. NS3, NS4 and NS5) were detected in the cytoplasm of the transfected cells by immunostaining. In summary, these findings suggest that replication and translation of HCV were achieved for a prolonged time in HepG2 cells after transfection with HCV cDNA and may provide an in vitro system for HCV studies.
Hepatitis B virus and liver transplantation: concepts in antiviral prophylaxis
Authors: Grellier L. , Dusheiko G. M.
Published: April 2008

Summary. Liver transplantation remains problematic in patients with end‐stage liver disease secondary to chronic hepatitis B virus (HBV) infection. Recurrent hepatitis is almost universal in those patients who are HBV DNA‐positive prior to transplantation. Prophylactic hepatitis B immune globulin can be given to reduce the rate of hepatitis B recurrence in patients who are HBV DNA‐negative prior to transplantation. More recently novel antiviral drugs such as lamivudine or famciclovir have been used specifically to inhibit hepatitis B viral replication. However, the development of drug‐resistant viral mutants have been observed. Further studies are needed to investigate these drugs more extensively, particularly to assess whether combination therapy may be a more effective means of controlling viral recurrence in patients transplanted for chronic HBV infection.
Mechanisms of peripheral T‐cell tolerance
Authors: Lechler R. , Marelli‐Berg F. M.
Published: April 2008

Summary. It is becoming increasingly clear that the control of self‐reactivity involves peripheral mechanisms that supplement thymic negative selection. It is now generally accepted that T‐cell activation depends upon both T‐cell receptor engagement and the delivery of B7‐mediated costimulation by specialized antigen presenting cells (APC). In contrast, failure to deliver B7‐mediated costimulation can result in the induction of antigen‐specific non‐responsiveness. In physiological terms, costimulation‐deficient antigen presentation is the prerogative of those cells that do not express B7 molecules, even during inflammatory conditions, such as tissue parenchymal cells. The consequences of such costimulation‐deficient antigen presentation are illustrated by the allospecific tolerance that is observed in animal models of transplantation following the depletion of bone marrow‐derived APC from an allograft. In this paper the possible role of antigen presentation by tissue parenchymal cells in the induction and maintenance of peripheral tolerance is discussed, with particular attention to the important contribution that the liver may make to these events.
Cause of death in individuals with chronic HBV and/or HCV infection, a nationwide community‐based register study
Authors: Duberg Ann‐Sofi , Törner Anna , Daviðsdóttir Lóa , Aleman Soo , Blaxhult Anders , Svensson Åke , Hultcrantz Rolf , Bäck Erik , Ekdahl Karl
Published: April 2008

Summary.  Studies on chronic viral hepatitis and mortality have often been made on selected populations or in high‐endemic countries. The aim of this study was to investigate the causes of death and the mortality rates in the nationwide cohorts of people chronically infected with hepatitis B virus (HBV) and/or hepatitis C virus (HCV) in Sweden, a low‐endemic country. All notifications on chronic HBV infection and HCV infection 1990–2003 were linked to the Cause of Death Register. A total of 9517 people with chronic HBV infection, 34 235 people with HCV infection and 1601 with chronic HBV–HCV co‐infection were included, and the mean observation times were 6.4, 6.3 and 7.9 years, respectively. The mortality in the cohorts was compared with age‐ and gender‐specific mortality in the general population and standardized mortality ratios (SMR) were calculated. All‐cause mortality was significantly increased, SMR 2.3 (HBV), 5.8 (HCV) and 8.5 (HBV–HCV), with a great excess liver‐related mortality in all cohorts, SMR 21.7, 35.5 and 46.2, respectively. In HCV and HBV–HCV infected there was an increased mortality due to drug‐related psychiatric diagnoses (SMR: 20.7 and 27.6) and external causes (SMR: 12.4 and 11.4), predominantly at younger age. To conclude, this study demonstrated an increased all‐cause mortality, with a great excess mortality from liver disease, in all cohorts. In people with HCV infection the highest excess mortality in younger ages was from drug‐related and external reasons.
The St. Thomas's Hospital maternity case notes study: A randomised controlled. trial to assess the effects of giving expectant mothers their own maternity case notes
Authors: Lovell Alice , Zander Luke I. , James Catherine E. , Foot Sarah , Swan Anthony V. , Reynolds Angela
Published: April 2008

Summary. At an antenatal clinic in St. Thomas's Hospital, London, 246 expectant mothers were randomly allocated to hold either their own maternity case notes or the standard co‐operation card. Information was collected on three occasions during their care on attitudes and health behaviour. Clinical outcomes were recorded and the effects of the two systems on clinic administration were observed. More of the notes group expressed satisfaction with most aspects of their care and delivery and significantly more of the notes group felt well informed and satisfied with their companion during labour.

There were no differences in clinical outcomes between the two groups except that, for no identifiable systematic reason, there were more assisted deliveries among the notes group.

A number of administrative advantages resulted from mothers holding their own notes and although initial reservations were found amongst professional staff interviewed at the start of the study, the results proved persuasive and the practice of giving mothers their own notes is now to be extended throughout the department.
Parity specific perinatal mortality. A longitudinal study based on sibships
Authors: Skjærven Rolv , Irgens Lorentz M. , Lie Rolv Terje , Bjerkedal Tor
Published: April 2008

Summary. Perinatal mortality in sibships has been examined using the Medical Birth Registry of Norway. Using linear logistic regression, parity specific perinatal mortality in the period 1967–1981 has been analysed, controlling simultaneously for maternal age, year of birth and survival of earlier births. The risk of a perinatal loss was increased by a factor of up to 6.0 following one earlier perinatal loss, and with three earlier losses the increase was 17.0. The general reduction in mortality between the different five year periods varied according to parity and maternal age. No secular reduction in risk, however, was demonstrated in sibships where the first birth died perinatally; for some subgroups of women the risk actually increased between the first and the second five year period. The effect of maternal age changed with parity, being strong in the first birth order, but of no effect either for the third or the fourth birth orders once the perinatal survival of earlier births was controlled for. This study shows the need to take heterogeneity of risk between women into account in studies of perinatal loss; the overall improvement in perinatal mortality does not apply to every woman. As care improves, perinatal losses become less and less random, demonstrated by increased risks of recurrence.
Management of pregnancy and childbirth in England and Wales and in France
Authors: Kaminski Monique , Blondel BÉATRICE , Bréart GÉRARD
Published: April 2008

Summary. This paper reviews national data on obstetric and neonatal practices in England and Wales, and in France between 1970 and 1980. The data have been derived from national statistics and surveys on national samples of births in 1970, 1975 and 1980 in England and Wales, and 1972,1976 and 1981 in France. The analysis shows that there was no major difference in pregnancy outcome, but wide variations in medical practices, and their trend over time. The main differences were: in England and Wales a higher number of antenatal visits, a higher percentage of inpatient admissions during pregnancy, a higher rate of induction, more episiotomies, a higher rate of resuscitation at birth, and admission to neonatal special care units; in France, a higher rate of caesarean sections before and during labour, some evidence of a more active management of labour, and a longer hospital post‐natal stay. These differences in practice reflect differences in objectives and assessment of the effectiveness of care between the two countries: they point out the need forbetter monitoring and evaluation of obstetric and neonatal practices.
High incidence of neural tube defects in Bursa, Turkey
Authors: Akar Nejat , Cavdar AYHAN O. , Arcasoy Ayten
Published: April 2008

Summary. A radiological survey of 1204 members of the population of Bursa revealed a high prevalence of spina bifida occulta (16.3%). Hospital deliveries in the area also showed a high incidence of anencephalus and spina bifida aperta (5.8 per 1000 total births) in the years 1983 to 1986. In the first 6 months of 1987, however, there was an increase in incidence to 20 per 1000 births (P<0.01). The possibility is raised that the Chernobyl disaster of May 1986 might have resulted in the elevation of the rate in an already susceptible population.
The perinatal morbidity and mortality survey of Jamaica 1986–1987
Authors: Ashley Deanna , McCaw‐Binns Affette , Foster‐Williams Karen
Published: April 2008

Summary. The Jamaican Perinatal Morbidity and Mortality Survey was conducted between September 1986 and August 1987. A total of 10310 consecutive births were identified and mothers interviewed in the first 2 months (main cohort study), 1405 neonatal admissions were evaluated over a 6‐month period (morbidity study), and 1855 perinatal deaths and 73 late neonatal deaths identified over 12 months (mortality study)‐55% of the deaths were given a postmortem examination. The perinatal mortality rate for the cohort study was 38.1 per 1000 births. This was 36.6 percent higher than the 1982 estimate of 27.9/1000 based on deliveries at the Victoria Jubilee Hospital, a specialist maternity institution which has at least 13 000 deliveries per annum.
A prospective survey of necrotising enterocolitis in very low birthweight infants
Authors: Walther Frans J. , Verloove‐Vanhorick S. Pauline , Brand Ronald , Ruys Jan H.
Published: April 2008

Summary. Necrotising enterocolitis is the most common gastrointestinal complication of pre‐term infants. In order to determine the strength of the association of hypoxia/ischaemia and infection as causative factors in necrotising enterocolitis, we evaluated all liveborn pre‐term infants with a birthweight<1500 g and/or gestational age <32 weeks in The Netherlands in 1983. The factors related to hypoxia/ischaemia included: asphyxia, respiratory distress syndrome, ventilatory assistance, persistent fetal circulation, persistent ductus arteriosus, apnoea, bradycardia, exchange transfusion and peri/intraventricular haemorrhage; those related to infection were: congenital infections, pneumonia, sepsis and meningitis. Of the 1338 infants enrolled, 1187 survived for more than 24 hours and had complete data. Mean (pLs.d.) birthweight was 1278 (pL297) g and mean (pLs.d.) gestational age 30.7 (pL2.6) weeks. Seventy‐three (6.1%) infants developed necrotising enterocolitis: 46 (63.0%) stage I disease (clinically very suspect), 11 (15.1%) stage II (pneumatosis intestinalis) and 16 (21.9%) stage III (intestinal perforation). Mean pL s.d. birthweight of the infants with necrotising enterocolitis (1197 pL 284 g) was lower (P<0.02) than in those without necrotising enterocolitis (1283 pL 297 g). Gestational ages were comparable. Mortality in the group with necrotising enterocolitis was 21.9% versus 15.8% in the non‐necrotising enterocolitis group (NS). Stepwise logistic regression analysis indicated that among those factors studied, only sepsis and birthweight were truly associated with the occurrence of necrotising enterocolitis.
What matters in developmental assessment?*
Authors: Illingworth Ronald
Published: April 2008

Many feel the urge to calculate a score or figure for a child's development by submitting him to some objective test of readily scorable items, without regard to the child as a whole. I suggest that instead of merely determining a score for a child's development we should try to understand development, and particularly the purpose of developmental tests, their limitations and the reasons for those limitations. We should continue to learn about development by following up all those many children in which for a variety of reasons the assessment was unusual or difficult.
Postneonatal mortality, sudden infant death syndrome: factors preventing the decline of infant mortality in France from 1979 to 1985
Authors: Bouvier‐Colle M.H. , Inizan J. , Michel E.
Published: April 2008

The sudden infant death syndrome (SIDS) is known to be associated with a peak in mortality rates at 3 months of age, and a seasonal peak in winter. The aim of this study was to analyse the relationship between the month of death, month of birth and age at death for cohorts of monthly births in France between 1979 and 1985. Statistics concerning the causes of death were collected and used to calculate life‐tables firstly from SIDS and secondly from all other causes. They show that the specific age distribution at death was not the same for babies born in late summer or autumn as for other newborns. Total infant death rates were higher for cohorts born in the autumn, because of the peak in deaths from SIDS at about three months of age.
Reflex anal dilatation: a clinical epidemiological evaluation
Authors: Harvey Ian M. , Nowlan W. Anthony
Published: April 2008

The recent controversy surrounding the use of the reflex anal dilatation (RAD) sign in cases of suspected sexual abuse is a general illustration of the difficulties clinicians face in determining which symptoms, signs or laboratory tests to use in their daily practice. The evidence required fully to evaluate RAD is incomplete. The specificity in particular is uncertain. Sufficient evidence is, however, available to permit a quantitative examination of the test's performance under various circumstances. Our analysis suggests that, at the prevalence of anal abuse reported in one large series of children referred to paediatricians with suspected sexual abuse (13%), only if the specificity of the test is 99% or greater, may the positive predictive value of RAD be as high as 90%. At the likely prevalence of anal abuse in the general child population (less than 0.5%), however, an even higher specificity of 99.99% would be necessary to achieve a similar positive predictive value.
Using logistic regression in perinatal epidemiology: an introduction for clinical researchers. Part 1: basic concepts
Authors: Brand R. , Keirse M.J.N.C.
Published: April 2008

Summary. Logistic regression is a statistical modelling technique which may be applied to estimate the simultaneous effect of a set of predictors (e.g. gestational age, birthweight) on the risk of a certain outcome variable (e.g. neonatal death) which can take either one of two possible values (yes/no, alive/dead) or in the situation where one wants to estimate the effect of a particular risk factor (e.g. sex) while adjusting (correcting) for the effect of other risk factors (eg. gestational age). Since this situation often occurs both in medical or epidemiological research and in daily practice it is important to have a flexible and readily interpretable technique to predict risk of mortality and morbidity. Since the logistic regression technique is a powerful and widely applicable tool which is appearing more and more often in the epidemiological literature, a basic understanding of this technique becomes necessary for the clinical researcher. In this paper we explain logistic regression to medical researchers who do not have any particular statistical background. Part 1 covers the basic concepts. Part 2 will describe the actual representation of the basic concepts in a logistic framework.
The roll over test is not of value in predicting pregnancy induced hypertension
Authors: Mahomed K. , Lasiende O.O.
Published: April 2008

Summary. As a predictor of pregnancy induced hypertension (PIH) the roll over test (ROT) has conflicting predictive values in the literature, possibly as a result of sample size, composition or methodology. In this study the roll over test was performed on 600 African women in their first pregnancy and at 26–32 weeks. The test was positive in 15% of women and had a positive predictive value of only 20%. It is concluded that the roll over test is of no value in the prediction of PIH.
Changing incidence of anencephaly in the eastern Black Sea region of Turkey and Chernobyl
Authors: Mocan Hilal , Bozkaya Hasan , Mocan Mehmet Ziya , Furtun Engin Mazlum
Published: April 2008

Summary. The incidence of neural tube defects (NTD) was 2.12 per 1000 births and that of anencephaly was 1.29 per 1000 births when we reviewed the 40 997 consecutive births between 1981 and 1986 in the major maternity hospital in the eastern Black Sea region of Turkey. There was a significant increase in the incidences of NTD and anencephaly after 1986 to 4.39 and 2.46 per 1000 births respectively (P<0.000l; P<0.005). Although this might be a coincidence, it may be due to the nuclear contamination of the region following the Chernobyl accident.
Are race and length of gestation related to age at death in the sudden infant death syndrome?
Authors: Adams Melissa M. , Rhodes Philip H. , McCarthy Brian J.
Published: April 2008

Summary. Although race and preterm delivery are known to be associated with sudden infant death syndrome (SIDS), the relationships between age at death from SIDS and these factors have not been well described. To examine these relationships, we used linked infant birth and death records for the cohort of 1 204 375 White and 283 776 Black postneonates who were born from 1979 to 1981 in five states: California, Georgia, Missouri, South Carolina and Tennessee. Deaths attributable to SIDS occurred to 1404 White postneonates and to 696 Black postneonates. Although postneonatal SIDS rate among Black infants was twice that of White infants, the relative risk was smaller among infants with gestations of <35 weeks. For White postneonates, the median postneonatal age at death sharply declined for gestations from 28–29 weeks to 36–37 weeks and levelled off for longer gestations. For Black postneonates, the results do not support an association between length of gestation and age at death. The findings suggest that practitioners investigating approaches to avert SIDS need to maintain their interventions to an older age among White preterm infants. Researchers investigating the causes of SIDS need to consider the relationship between length of gestation and age at death from SIDS as well as possible developmental differences between White and Black preterm infants.
Home accidents to children under 2 years of age
Authors: Tursz A. , Lelong N. , Crost M.
Published: April 2008

Summary. Within a population‐based register of childhood injuries, 641 home accidents to children aged under 2 years were recorded in six hospitals. The annual rate was higher in children over 1 year (6.6 per 100) than in infants (2.7 per 100). A male predominance was observed only after the first birthday. Most injuries were related to physical trauma (mainly falls), but burns and poisonings were frequent in the second year. Most lesions were benign, except in the case of falls from a height (from a window or baby furniture). Nineteen per cent of the children were admitted to hospital. There were 15 skull fractures, two fatal cases and two severe sequelae. Child abuse was seldom suspected and the reasons for this are discussed. The study of the circumstances in which accidents occur leads to the conclusion that the main aspect of prevention should be passive protection ensured by the creation of a safe environment (compulsory safety standards for baby furniture, child resistant packaging), but that parents' information and education should also be developed, with emphasis on knowledge of children's normal psychological and motor development and abilities.
The effects of smoking and drinking on the anthropometric measurements of neonates
Authors: Haste F.M. , Anderson H.R. , Brooke O.G. , Bland J.M. , Peacock J.L.
Published: April 2008

Summary. This study investigated the effects of smoking and alcohol consumption in pregnancy on length, head circumference, upper arm circumference and ponderal index, of neonates born to 1513 Caucasian women who delivered at St George's Hospital, south London. All measurements were adjusted for gestational age, maternal height, parity and sex of infant. Babies of smokers were shorter, had lower ponderal index and smaller upper arm circumference than those of non‐smokers. After controlling for alcohol consumption, these differences remained (but with reduced statistical significance). There was no statistically significant difference in head circumference between smokers and non‐smokers. Alcohol consumption at booking had no effect on growth measurements in non‐smokers but had a significant, negative effect on all measurements in smokers. Drinking later in pregnancy had less effect. Alcohol appears to enhance the growth‐retarding effect of smoking. It is suggested that both smoking and alcohol also have an inhibitory effect on fat deposition in babies, which contributes to the reduction in birthweight associated with smoking and drinking.
Sudden infant deaths and cold weather: was the rise in infant mortality in 1986 in England and Wales due to the weather?
Authors: Campbell M.J. , Rodrigues Laura , Macfarlane Alison J. , Murphy M.F.G.
Published: April 2008

Summary. Using the daily number of deaths due to sudden infant death syndrome in England and Wales from 1979 to 1985, and the daily temperature recorded at the London Weather Centre, two models were constructed, one including a temperature term and one without it, and the models used to predict the mortality in 1986. It was found that the model using temperature had a slightly better predictive power and successfully accounted for the increased mortality in February 1986. Thus, we conclude that the excess mortality of February 1986 was associated with the unusually cold weather during that month.
Why do UK‐born Pakistani babies have high perinatal and neonatal mortality rates?
Authors: Bundey Sarah , Alam Hasina , Kaur Amritpal , Mir Samina , Lancashire Robert
Published: April 2008

Summary. A prospective study of 4934 babies of different ethnic groups has confirmed the high perinatal mortality rate for Pakistanis and has shown that this was not due to a reluctance to terminate a fetus who is known to be seriously malformed. The major cause of early mortality was a high rate of lethal malformations, which occurred in about 1 in 100 Pakistani babies and which accounted for about half of their perinatal mortality. Many of these were autosomal recessive and occurred only in the offspring of consanguineous parents. However, there was also an excess of lethal cardiac malformations which were not associated with parental consanguinity. The remainder of the excess perinatal mortality was probably due to socio‐economic factors. These causes are partly amenable to preventive measures, such as the referral of Pakistani women for expert ultrasonography at 18 to 20 weeks of pregnancy.
A comparison of recurrent and isolated small‐for‐gestational‐age term births
Authors: Read Anne W. , Stanley Fiona J.
Published: April 2008

Summary. In this study, based on total Western Australian singleton Caucasian births, women who had repeatedly given birth to small‐for‐gestational‐age (SGA) term infants (‘repeater’ mothers) were compared with multiparous women who had had only one such infant (‘non‐repeater’ mothers). Women with any preterm births were excluded. The study population comprised 678 repeater and 986 non‐repeater mothers. Multiple logistic regression analysis indicated that weight loss or static weight in the third trimester of pregnancy, paternal smoking, low maternal birthweight, short maternal height and unknown family disease history were independent risk factors for repeater status compared with non‐repeaters. The risk associated with paternal smoking was confined to mothers who were non‐smokers themselves. There may have been a direct association between paternal smoking and recurrent fetal growth retardation or paternal smoking may have acted as a ‘marker’ for certain behavioural, environmental, social and economic factors which were not measured. Neonatal outcome was worse for the SGA infants of non‐repeater mothers than for those of repeater mothers, although the latter were significantly more likely to weigh less than 2500 grams.
An educational intervention on promotion of breast feeding complemented by continuing support
Authors: Neyzi Okay , Güleçyüz Mehmet , Dinçer Zekâi , Olgun Pervin , Kutluay Türkân , Uzel Nedret , Saner Günay
Published: April 2008

Summary The study, aiming to document the effect of continued support for mothers on frequency of exclusive breast feeding, was carried out by inclusion of breast feeding counselling in the context of well‐baby care. One hundred and forty‐six mothers who had been exposed to two educational sessions on breast feeding after delivery were given appointments to bring their baby to the paediatric hospital for well‐baby care. The mother‐infant pairs were followed by the same two residents for 4 months. Mean number of visits was six. A conscious effort was made during all visits to influence the mothers and their close relatives towards exclusive breast feeding. It was observed that in a large proportion of the infants, breast milk was being supplemented with water at the time of the first visit and no further effort was made to change this traditional behaviour. Comparison of the results with a group of mothers who had been exposed to similar educational sessions after delivery but without further support showed a striking increase in frequency of exclusive breast feeding (breast milk and water) in the supported group.
The Chiang Mai lactation project: study design and implementation
Authors: Drewett Robert , Amatayakul Kosin , Chiowanich Pien , Tansuhaj Antika , Ruckphaopunt Somsri , Wongsawasdii Lumduan , Baum David , Imong Stella , Jackson Dorothy , Woolridge Michael
Published: April 2008

Summary The Chiang Mai lactation project is a longitudinal field study of human lactation carried out among northern Thai women living in the Sanpatong area of Chiang Mai Province. Its aim was to measure the volume and composition of breast milk transferred from mothers to their infants in the first year postpartum, and to relate it to predictors of milk production, and to the growth of the child. Breast milk and supplementary food intake, and nursing patterns, were recorded over two consecutive 24‐hour periods six times during the first year. Samples of breast milk and of supplementary foods were analysed for energy and protein. Supplementary foods were also analysed for bacterial contamination. The growth of the child was measured, and health assessed using a combination of health diaries and examination by a physician. Recruitment to the study was excellent. After recruitment, two subjects left the study area, but otherwise only two dropped out, so complete sets of data covering these variables are available for 58 of the 62 recruited subjects.
Perinatal care in the Soviet Union: a time of transition
Authors: Stephenson Patricia A. , Bakoula Chryssa , Houd Susanne , Enkin Murray , Wagner Marsden G.
Published: April 2008

Summary. Recent Soviet reforms in health care policy and financing are expected to have a significant impact on perinatal services. Efforts are under way to upgrade the care of pregnant and birthing women. This paper describes some aspects of the current system of perinatal care and prospects for future change.
The contrasting effects of parental birthweight and gestational age on the birthweight of offspring
Authors: Alberman Eva , Emanuel Irvin , Filakti Haroulla , Evans Stephen J. W.
Published: April 2008

Summary. Investigations on intergenerational effects on birthweight have been carried out using the data of the 1958 British National Birthday Trust Fund cohort and its follow‐up to 23 years, the National Child Development Study (NCDS‐4), which included information on all births to cohort members by that age. This report is directed particularly at ascertaining the independent effect of parental gestational age on babies' birthweight. The two main findings are a direct association between parental and offspring birthweight (significant for both mothers and fathers after allowing for confounding factors), but an inverse association with parental gestational age (significant only for the mothers). It is postulated that at least part of this effect is mediated through the association between maternal fetal growth rate and their babies' birthweight; the faster the rate the shorter the gestational age for a given birthweight. It was not possible to ascertain what part genetic factors played in this relationship. Larger and more informative intergenerational studies are needed to further knowledge on this question.
Decreased birthweights in infants after maternal in utero exposure to the Dutch famine of 1944–1945
Authors: Lumey L.H.
Published: April 2008

Summary. Using maternity records of the University of Amsterdam teaching hospital for births 1960–1984, obstetric outcomes in 1808 firstborn singleton offspring of mothers born between 1 January 1944 and 30 June 1946 in The Netherlands were analysed. Most of these mothers had experienced, during intra‐uterine life, a war‐induced famine that lasted from November 1944 to May 1945. The study was prompted by a report on increased perinatal mortality in offspring of such mothers and it aimed at describing late effects, if any, of such an exposure. Mothers exposed to famine during their first and second trimester in utero had offspring with birthweights lower than mothers not exposed to famine. The decrease in birthweight was in part due to slower fetal growth rate, in part to shorter gestation. Birthweights in the offspring of mothers exposed in their third trimester in utero were, however, not reduced. These findings in mothers exposed to famine in utero are in contrast to the effects of the famine on their mothers during their pregnancies, where third trimester exposure was associated with a reduction in birthweight. The effect of in utero exposure on birthweight persisted after control for potential confounding and intervening variables. Paradoxically, similar effects were seen in offspring of some mothers presumably not exposed to malnutrition. In this study, clear effects on reproductive outcomes are seen in the generation following an environmental exposure in utero.
Prenatal events and the risk of subependymal/intraventricular haemorrhage in very low birthweight neonates
Authors: O'Shea Michael , Savitz David A. , Hage Marvin L. , Feinstein K.A.
Published: April 2008

Summary. The effects of prenatal factors on the risk of subependymal and/or intraventricular brain haemorrhage in very low birthweight (VLBW) neonates were studied. Data were collected on 201 consecutively born VLBW neonates without major congenital anomalies, who were born at a regional obstetric referral centre. Brain haemorrhage was identified by cranial ultrasound examinations. The reliability of these examinations (concordance among readers' interpretations) was assessed and found to be moderate (kappa = 0.47 for the finding of subependymal haemorrhage (SEH); kappa = 0.50 for the finding of intraventricular haemorrhage (IVH)). Prenatal factors were more strongly associated with IVH than with SEH. In univariable analyses, maternal pre‐eclampsia, multiple gestation and maternal treatment with betamethasone were associated most strongly with a decreased risk of haemorrhage whereas labour and vaginal delivery were associated most strongly with an increased risk. These associations remained in a multi‐variable analysis which included prenatal events (maternal illnesses, fetal presentation and obstetrical interventions), as well as gestational age, birthweight, gender, treatment with assisted ventilation, and the occurrence of pneumothorax. Further aetiological study of the effects of prenatal factors could provide information useful in preventing SEH/IVH.