bluuebunny/crossref_metadata_2025 huggingface dataset:
Some new van der Waerden numbers and some van der Waerden-type numbers
Authors: Ahmed Tanbir
Published: May 2009

The van der Waerden number
How do infants build a semantic system?
Authors: Styles Suzy J. , Plunkett Kim
Published: May 2009

Do infants learn their early words in semantic isolation? Or do they integrate new words into an inter-connected semantic system? In an infant-friendly adaptation of the adult lexical priming paradigm, infants at 18 and 24 months-of-age heard two words in quick succession. The noun-pairs were either related or unrelated. Following the onset of the target word, two pictures were presented, one of which depicted the target. Eye movements revealed that both age groups comprehended the target word. In addition, 24-month-olds demonstrated primed picture looking in two measures of comprehension: Named target pictures preceded by a related word pair took longer to disengage from and attracted more looking overall. The finding of enhanced target recognition demonstrates the emergence of semantic organisation by the end of the second year.
The cognitive poetics of literary resonance
Authors: Stockwell Peter
Published: May 2009

The application of cognitive science to literary scholarship in the form of a cognitive poetics offers the opportunity for accounting for many features of literary reading that have been rendered only in vague or impressionistic terms in the past. In this paper, an argument for cognitive poetics is made, with a focus on the affective and experiential phenomenon of resonance. This is modelled through cognitivist work on the field of attention and perception, to give a particularly literary-angled approach. The argument is exemplified with reference to a Shakespeare sonnet and then further demonstrated in a poem by Dylan Thomas, where the notion of a lacuna is developed to account for the phenomenon of “felt absence”. The paper concludes with observations on the role of cognitive poetics in relation to cognitive science, literary criticism, and in its own right.
Prototype constructions in early language acquisition
Authors: Ibbotson Paul , Tomasello Michael
Published: May 2009

In this paper we bring together several lines of cross-linguistic research to demonstrate the role of prototypicality in young children's acquisition of the transitive construction. Much research has shown that young children are slow to form abstract constructions because they fail to see the more general applicability of syntactic markers such as word order and case marking. Here we attempt to explain this fact by investigating the nature of the language children do and do not hear, specifically, the reliability and availability of the linguistic cues they are exposed to. We suggest that constructions redundantly marked with multiple cues could have a special status as a nucleus around which the prototype forms—which makes it difficult for them to isolate the functional significance of each cue. The implications of this view for language acquisition are discussed within a usage-based framework.
The enactment of language: Decades of interactions between linguistic and motor processes
Authors: Anderson Sarah E. , Spivey Michael J.
Published: May 2009

Many long-standing predominant theories of cognition have viewed higher levels of processing, such as language and cognition, as free from the influence of lower levels of processing, such as action and perception. However, many recent experiments have found evidence that the delineation between traditional modules is not so clean or precise, with motor output and language comprehension interacting much more fluidly than traditional theories predict. Evidence for this account includes findings of systematic activation of motor cortex while processing action words, as well as functional consequences of language on action and of action on language. It is worth noting that this recent spate of interest in the embodiment of cognition is not without historical precedence. Here, we will review such evidence coming from previous decades of research on the interaction between language and action, in addition to exploring the empirical results of these more recent experiments and methodologies. It seems to be the case, as evidenced from research in cognitive neuroscience and modeling, that motor representations and actions can influence language processing in predictable ways. Not only is there continuous competition between simultaneously active representations in language processing, with multiple sources of information interacting immediately, this competition is apparent in the motor output produced as a response to language.
A Note on the Determination of Plastic Limit of Fine-Grained Soils
Authors: Prakash K. , Sridharan A. , Prasanna H. S.
Published: May 2009

Plastic limit of fine-grained soils is conventionally determined in the laboratory by the soil thread rolling method. Many adverse comments have been recorded in the geotechnical engineering literature on the method about its reproducibility and operator dependency. The present experimental study, which is based on a well-planned and meticulously executed experimental program, critically evaluates the effect of size of the rolled soil thread on the plastic limit of fine-grained soils and the operator dependency of the results. The results have shown that if the plastic limit tests are performed by a trained operator, then consistent results can be obtained and that the effect of size of the rolled soil thread on plastic limit is negligibly small.
Estimated Blood Alcohol Concentrations for Child and Adolescent Drinking and Their Implications for Screening Instruments
Authors: Donovan John E.
Published: May 2009

OBJECTIVE. Blood alcohol concentrations (BACs) in children after consumption of different numbers of standard drinks of alcohol have not been estimated previously. The goal was to determine the number of drinks at each age that led to a BAC of ≥80 mg/dL, the National Institute on Alcohol Abuse and Alcoholism criterion for binge drinking.

METHODS. The updated Widmark equation to estimate BAC was modified to take account of the differing body composition (total body water) and accelerated rates of ethanol elimination of children. The modified formula was used with 1999–2002 National Health and Nutrition Examination Survey data to estimate BACs for >4700 children and adolescents from 9 through 17 years of age, for intake levels of 1 to 5 standard drinks.

RESULTS. The estimated BACs for children after consumption of just 3 standard drinks within a 2-hour period were between 80 and 139 mg/dL for boys 9 to 13 years of age and for girls 9 to 17 years of age, indicating substantial potential alcohol impairment. With 5 drinks within 2 hours (the level used to define binge drinking among college students), children 9 to 13 years of age were estimated to have BACs 2 to 3 times the adult legal limit for intoxication of 80 mg/dL.

CONCLUSION. Binge drinking should be defined as ≥3 drinks for 9- to 13-year-old children, as ≥4 drinks for boys and ≥3 drinks for girls 14 or 15 years of age, and as ≥5 drinks for boys and ≥3 drinks for girls 16 or 17 years of age.
Adequacy of a Single Unstimulated Luteinizing Hormone Level to Diagnose Central Precocious Puberty in Girls
Authors: Houk Christopher P. , Kunselman Allen R. , Lee Peter A.
Published: May 2009

OBJECTIVE. Using basal specimens from original gonadotropin radioimmunoassays, it was not possible to differentiate prepuberty from puberty hence gonadotropin-releasing hormone or gonadotropin-releasing hormone analog (GnRHa) testing was required to make this distinction. Third-generation gonadotropin assays have far greater specificity and sensitivity. Using a group of patients who had the diagnosis of central precocious puberty (CPP) verified or excluded by using GnRHa and traditional diagnostic criteria, the objective of this study was to determine if a single basal gonadotropin measurement was adequate to verify the diagnosis of CPP by using 2 third-generation gonadotropin assays.

METHODS. Girls referred for assessment of early puberty had previously been evaluated for central precocious puberty including gonadotropin-releasing hormone analog stimulation testing with gonadotropin measurements by 2 different chemiluminescent third-generation immunoassays. Diagnosis of central precocious puberty was made on the basis of the response to the gonadotropin-releasing hormone analog, and clinical criteria. Girls with central precocious puberty had luteinizing hormone responses ranging from 9.1 to 67.6 U/L, the prepubertal luteinizing hormone response range was 0.2 to 5.0 U/L. Basal serum luteinizing hormone and follicle-stimulating hormone concentrations from these girls have been assessed to determine the utility of using such a single sample to diagnose central precocious puberty.

RESULTS. Basal luteinizing hormone levels using the 2 third-generation gonadotropin assays were sufficient to diagnose central precocious puberty in >90% of the girls. Luteinizing hormone values were undetectable in both assays with different lower limits of detection (<0.15 and <0.20 U/L) in 29 of 34 prepubertal girls; the detectible values in 5 girls ranged from 0.20 to 0.66 U/L. All girls with central precocious puberty had values of >0.83 U/L, except a single value of 0.46 U/L. The basal follicle-stimulating hormone failed to differentiate prepubertal girls from those with central precocious puberty, whereas luteinizing hormone/follicle-stimulating hormone ratios would seem to have limited discernment.

CONCLUSION. A single basal luteinizing hormone measurement is adequate to document a pubertal hypothalamic-pituitary-ovarian axis in most but not all girls with central precocious puberty.
Behavioral Problems and Cognitive Performance at 5 Years of Age After Very Preterm Birth: The EPIPAGE Study
Authors: Delobel-Ayoub Malika , Arnaud Catherine , White-Koning Mélanie , Casper Charlotte , Pierrat Véronique , Garel Micheline , Burguet Antoine , Roze Jean-Christophe , Matis Jacqueline , Picaud Jean-Charles , Kaminski Monique , Larroque Béatrice ,   for the EPIPAGE Study Group
Published: May 2009

OBJECTIVES. We compared the frequency of behavioral problems in very preterm and term children at 5 years of age. We hypothesized that behavioral problems would be associated with cognitive impairment and environmental factors and that differences between the 2 groups would be reduced but persist after adjusting for cognitive performance and environmental factors.

PATIENTS AND METHODS. The Etude Epidémiologique sur les Petits Ages Gestationnels (EPIPAGE) study was a prospective population-based cohort study that included all births occurring between 22 and 32 weeks' gestation and a control group of infants born at 39 to 40 weeks' gestation in 1997 in 9 French regions. Neonatal and obstetrics data were collected at birth. At 5 years of age, sociodemographic status and neurodevelopmental and cognitive development of the children, as well as maternal mental well-being, were assessed. The behavioral problems of 1102 very preterm and 375 term singletons without major impairments were studied by using the parent-completed Strengths and Difficulties Questionnaire.

RESULTS. Parents of very preterm children reported significantly more behavioral problems, with a twofold higher prevalence compared with term children for hyperactivity/inattention, emotional symptoms, and peer problems. Behavioral problems were associated with low cognitive performance, developmental delay, hospitalizations of the child, young maternal age, and poor maternal mental well-being. Very preterm children were still at higher risk of behavioral problems compared with term children after adjustment for cognitive performance and all others factors.

CONCLUSIONS. Behavioral problems were strongly related to cognitive impairment, but very preterm children were still at higher risk even after adjusting for cognitive performance. Early screening for behavioral problems should be encouraged for all very preterm children, and maternal well-being should also be the focus of special attention.
Bubble Continuous Positive Airway Pressure, A Potentially Better Practice, Reduces the Use of Mechanical Ventilation Among Very Low Birth Weight Infants With Respiratory Distress Syndrome
Authors: Nowadzky Teresa , Pantoja Alfonso , Britton John R.
Published: May 2009

OBJECTIVE. The purpose of this work was to assess a quality improvement initiative to implement a potentially better practice, bubble continuous positive airway pressure, to reduce bronchopulmonary dysplasia and improve other pulmonary outcomes among very low birth weight infants with respiratory distress syndrome.

METHODS. An initiative to implement the use of bubble continuous positive airway pressure is described that was based on the adoption of habits for change, collaborative learning, evidence-based practice, and process development. To assess the efficacy of this intervention, very low birth weight infants with respiratory distress syndrome born after implementation of bubble continuous positive airway pressure use (period 2: March 1, 2005, to October 4, 2007; N = 126) were compared with historical controls born during a previous period of ventilator use (period 1: January 1, 2003, to February 28, 2005; N = 88). Infants at both time periods were similar with respect to characteristics and aspects of perinatal care. Pulmonary outcomes compared for the 2 time periods included receipt of mechanical ventilation, duration of mechanical ventilation, pneumothoraces, and incidence of bronchopulmonary dysplasia. Nonpulmonary outcomes were also compared.

RESULTS. The use of mechanical ventilation declined during period 2. The mean duration (+ SD) of conventional ventilation during period 2 was shorter than during period 1 (3.08 + 6.17 vs 5.25 + 8.16 days), and fewer infants during period 2 required conventional ventilation for >6 days compared with those in period 1 (13.6% vs 26.3%). In regression models, the effect of period 2 persisted after controlling for other predictors of duration of conventional ventilation. There were no significant differences in other pulmonary or nonpulmonary outcomes, with the exception of mild retinopathy of prematurity (stage I or II), which was more common during period 2. The enhanced odds of retinopathy of prematurity persisted after controlling for other known predictors of this condition.

CONCLUSION. Among very low birth weight infants with respiratory distress syndrome, the use of bubble continuous positive airway pressure is a potentially better practice that may reduce the use of mechanical ventilation. Although an increase in retinopathy of prematurity was observed in our population, carefully designed randomized, controlled trials will be required to more accurately address the potential risks and benefits of this therapy.
The Impact of Early Behavior Disturbances on Academic Achievement in High School
Authors: Breslau Joshua , Miller Elizabeth , Breslau Naomi , Bohnert Kipling , Lucia Victoria , Schweitzer Julie
Published: May 2009

BACKGROUND. Previous research has indicated that childhood behavioral disturbances predict lower scores on academic tests and curtail educational attainment. It is unknown which types of childhood behavioral problems are most likely to predict these outcomes.

METHODS. An ethnically diverse cohort was assessed at 6 years of age for behavioral problems and IQ and at 17 years of age for academic achievement in math and reading. Of the original cohort of 823 children, 693 (84%) had complete data. Multiple regressions were used to estimate associations of attention and internalizing and externalizing problems at age 6 and with math and reading achievement at age 17, adjusting for IQ and indicators of family socioeconomic status.

RESULTS. Adjusting for IQ, inner-city community, and maternal education and marital status, teacher ratings of attention, internalizing behavior, and externalizing problems at age 6 significantly predict math and reading achievement at age 17. When types of problems are examined simultaneously, attention problems predict math and reading achievement with little attenuation, whereas the influence of externalizing and internalizing problems is materially reduced and not significant.

CONCLUSIONS. Interventions that target attention problems at school entry should be tested as a potential avenue for improving educational achievement.
New Vaccines Against Otitis Media: Projected Benefits and Cost-effectiveness
Authors: O'Brien Megan A. , Prosser Lisa A. , Paradise Jack L. , Ray G. Thomas , Kulldorff Martin , Kurs-Lasky Marcia , Hinrichsen Virginia L. , Mehta Jyotsna , Colborn D. Kathleen , Lieu Tracy A.
Published: May 2009

OBJECTIVE. New vaccines that offer protection against otitis media caused by nontypeable Haemophilus influenzae and by Moraxella catarrhalis are under development. However, the potential health benefits and economic effects of such candidate vaccines have not been systematically assessed.

METHODS. We created a computerized model to compare the projected benefits and costs of (1) the currently available 7-valent pneumococcal conjugate vaccine, (2) a candidate pneumococcal–nontypeable H influenzae vaccine that has been tested in Europe, (3) a hypothetical pneumococcal-nontypeable H influenzae–Moraxella vaccine, and (4) no vaccination. The clinical probabilities of acute otitis media and of otitis media with effusion were generated from multivariate analyses of data from 2 large health maintenance organizations and from the Pittsburgh Child Development/Otitis Media Study cohort. Other probabilities, costs, and quality-of-life values were derived from published and unpublished sources. The base-case analysis assumed vaccine dose costs of $65 for the 7-valent pneumococcal conjugate vaccine, $100 for the pneumococcal-nontypeable H influenzae vaccine, and $125 for the pneumococcal-nontypeable H influenzae–Moraxella vaccine.

RESULTS. With no vaccination, we projected that 13.7 million episodes of acute otitis media would occur annually in US children aged 0 to 4 years, at an annual cost of $3.8 billion. The 7-valent pneumococcal conjugate vaccine was projected to prevent 878000 acute otitis media episodes, or 6.4% of those that would occur with no vaccination; the corresponding value for the pneumococcal–nontypeable H influenzae vaccine was 3.7 million (27%) and for the pneumococcal–nontypeable H influenzae–Moraxella vaccine was 4.2 million (31%).

Using the base-case vaccine costs, pneumococcal–nontypeable H influenzae vaccine use would result in net savings compared with nontypeable 7-valent pneumococcal conjugate use. Conversely, pneumococcal–nontypeable H influenzae–Moraxella vaccine use would not result in savings compared with pneumococcal–nontypeable H influenzae vaccine use, but would cost $48 000 more per quality-adjusted life-year saved. The results were sensitive to variations in assumptions on vaccine effectiveness and vaccine dose costs but not to variations in other assumptions.

CONCLUSIONS. New candidate vaccines against otitis media have the potential to prevent millions of disease episodes in the United States annually. If priced comparably with other recently introduced vaccines, these new otitis vaccines could achieve cost-effectiveness comparable with or more favorable than that of the 7-valent pneumococcal conjugate vaccine.
Pitfalls, Problems, and Progress in Bronchopulmonary Dysplasia
Authors: Bhandari Anita , Bhandari Vineet
Published: May 2009

Bronchopulmonary dysplasia is a chronic lung disease associated with premature birth and characterized by early lung injury. In this review we discuss some pitfalls, problems, and progress in this condition over the last decade, focusing mainly on the last 5 years, limited to studies in human neonates. Changes in the definition, pathogenesis, genetic susceptibility, and recent biomarkers associated with bronchopulmonary dysplasia will be discussed. Progress in current management strategies, along with novel approaches/therapies, will be critically appraised. Finally, recent data on long-term pulmonary and neurodevelopmental outcomes of infants with bronchopulmonary dysplasia will be summarized.
Attitudes Toward Neonatal Intensive Care Treatment of Preterm Infants With a High Risk of Developing Long-term Disabilities
Authors: Lam Hugh Simon , Wong Samuel Po Shing , Liu Flora Yuen Big , Wong Hiu Lei , Fok Tai Fai , Ng Pak Cheung
Published: May 2009

OBJECTIVES. To assess (1) the differences in attitudes toward disabilities of 3 groups of subjects involved in neonatal care decision-making: health care workers, mothers of term infants, and parents of preterm infants, and (2) the impact of subject characteristics on these attitudes including parental education level, religion, and severity of disability.

METHODS. Five hundred seventy-eight subjects were interviewed, of whom 135 were health care workers, 155 were mothers of term infants, and 288 were parents of preterm infants. We assessed between-group differences of the (1) health state ranking permutations, (2) proportion of subjects willing to save the infant at all costs, (3) pivotal risks of each group to the 5 health states comprising varying combinations of mental, physical, and social disabilities, and (4) impact of personal characteristics on decision-making.

RESULTS. Most health care workers ranked the most severe disability health state as worse than death, whereas most parents of preterm infants ranked death as the worst outcome. Significantly more parents of preterm infants chose to save the infant at all costs, compared with mothers of term infants and health care workers, and the pivotal risks of the parents of preterm infants group were highest for all health states. Religious worship was associated with increased probability of saving at all costs and pivotal risks. Increased severity of neonatal complications was associated with decreased probability of saving at all costs and pivotal risks in parents of preterm infants.

CONCLUSIONS. Our findings suggest that parents of preterm infants as a group were most likely to save the infant at all costs and prepared to tolerate more severe disability health states. However, personal characteristics, in particular religious belief and severity of neonatal complications, have overriding influence on these attitudes. We suggest inclusion of experienced parents of preterm infants for more effective counseling of parents in making life-and-death decisions.
Access to the Medical Home: New Findings From the 2005-2006 National Survey of Children With Special Health Care Needs
Authors: Strickland Bonnie B. , Singh Gopal K. , Kogan Michael D. , Mann Marie Y. , van Dyck Peter C. , Newacheck Paul W.
Published: May 2009

OBJECTIVE. This article reports new findings from the 2005–2006 National Survey of Children with Special Health Care Needs (NS-CSHCN) regarding parental perceptions of the extent to which children with special health care needs (CSHCN) have access to a medical home.

METHODS. Five criteria were analyzed to describe the extent to which CSHCN receive care characteristic of the medical home concept. Data on 40840 children included in the NS-CSHCN were used to assess the presence of a medical home, as indicated by achieving each of the 5 criteria.

RESULTS. Results of the survey indicate that (1) approximately one half of CSHCN receive care that meets all 5 criteria established for a medical home; (2) access to a medical home is affected significantly by race/ethnicity, income, health insurance status, and severity of the child's condition; (3) parents of children who do have a medical home report significantly less delayed or forgone care and significantly fewer unmet needs for health care and family support services; and (4) limited improvements have occurred since success rates were first measured by using the 2001 NS-CSHCN.

CONCLUSIONS. The findings suggest that, although some components of the medical home concept have been achieved for most CSHCN, care synonymous with the principles underlying the medical home is not yet in place for a significant number of CSHCN and their families.
Acute Illness Care Patterns Change With Use of Telemedicine
Authors: McConnochie Kenneth M. , Wood Nancy E. , Herendeen Neil E. , Ng Phillip K. , Noyes Katia , Wang Hongyue , Roghmann Klaus J.
Published: May 2009

OBJECTIVE. Health-e-Access, a telemedicine service providing care for acute illnesses in children, has delivered >6500 telemedicine visits from 10 primary care practices in Rochester, New York, by using telemedicine access at 22 child care and school sites. The goal was to assess the hypotheses that children served by Health-e-Access received health care more often for acute illnesses but had fewer emergency department (ED) visits and lower health care expenditures than did children without access through this service.

METHODS. By using insurance claims, this case study compared utilization (starting in May 2001) of telemedicine, office, or ED care for children with versus without telemedicine access. Children included in analyses had ≥6 consecutive insurance-covered months through July 2007. Claims data captured all utilization. A total of 19 652 child-months from 1216 children with telemedicine access were matched with respect to age, gender, socioeconomic status, and season with child-months for children without telemedicine availability.

RESULTS. The mean age at utilization was 6.71 years, with 79% of all child-months being covered by Medicaid managed care. The overall utilization rate was 305.1 visits per 100 child-years. In multivariate analyses with adjustment for potential confounders, overall illness-related utilization rates (in-person or telemedicine visits per 100 child-years) for all sites were 23.5% greater for children with telemedicine access than for control children, but ED utilization was 22.2% less.

CONCLUSION. The Health-e-Access telemedicine model holds potential to reduce health care costs, mostly through replacement of ED visits for nonemergency problems.
Impact of a Primary Care Intervention on Physician Practice and Patient and Family Behavior: Keep ME Healthy—The Maine Youth Overweight Collaborative
Authors: Polacsek Michele , Orr Joan , Letourneau Lisa , Rogers Victoria , Holmberg Robert , O'Rourke Karen , Hannon Cindy , Lombard Kenneth A. , Gortmaker Steven L.
Published: May 2009

OBJECTIVE. To evaluate the effect of a pediatric primary care–based intervention, on improved clinical decision support and family management of risk behaviors for childhood overweight.

METHODS. An experimental field trial was conducted with 12 intervention sites in urban and rural areas of Maine and nonrandomized control sites. Change was assessed by using clinical and parent measures from 9 intervention and 10 control sites before and during the Maine Youth Overweight Collaborative intervention. Longitudinal information was collected from chart audits of patients aged 5–18 years (n = 600), systematic samples of parents collected before (n = 346) and during (n = 386) the intervention in 12 sites, and systematic samples of parents in 9 intervention (n = 235) and 10 control (n = 304) sites collected during the intervention. Surveys of health care providers (n = 14 and 17) before and during the intervention were also collected. Teams worked over 18 months to implement improvements in clinical decision support, including tracking BMI percentiles, identification of overweight patients, appropriate laboratory tests, counseling of families and patients use of a behavioral screening tool, and other improvements following the chronic-care model targeting patients aged 5 to 18 and their families.

RESULTS. Large changes occurred in clinical practice from before to during the Maine Youth Overweight Collaborative: increases in assessment of BMI (38%–94%), BMI percentile for age and gender (25%–89%), use of the 5-2-1-0 behavioral screening tool (0%–82%), and weight classification (19%–75%). Parent surveys indicated improvements in providers’ behavior and rates of counseling. Intervention providers reported improvements in knowledge, attitudes, self-efficacy, and practice.

CONCLUSIONS. The Maine Youth Overweight Collaborative intervention improved clinical decision support and family management of risk behaviors, indicating a promising primary care–based approach to address overweight risk among children and youth.
5-2-1-0 Goes to School: A Pilot Project Testing the Feasibility of Schools Adopting and Delivering Healthy Messages During the School Day
Authors: Rogers Victoria W. , Motyka Elizabeth
Published: May 2009

OBJECTIVE. Our goal was to determine the feasibility of school staff voluntarily adopting strategies to deliver health-promotion messages to primary and middle school students during the school day.

METHODS. During the 2006–2007 school year, we provided a resource kit with strategies for promoting physical activity and healthy eating through use of the 5-2-1-0 message (encouraging ≥5 servings of fruits and vegetables daily, limiting screen time to ≤2 hours per day, promoting ≥1 hour of physical activity daily, and avoiding sugar-sweetened beverages) to 7 primary schools and 2 middle schools in southern Maine. Teachers and administrators voluntarily implemented resource-kit strategies in classrooms and schools. The resource kit included educational handouts that could be sent home to parents. Administrators, teachers, and parents were surveyed at the end of the school year to ascertain their level of awareness of the project, ease of implementation, and perceived usefulness of the resource kit. In small discussion groups with students, we assessed their level of awareness of and attitude toward the 5-2-1-0 message.

RESULTS. Most administrators and teachers and half of the parents reported being more aware of the 5-2-1-0 message as a result of the project. Eighty percent of the teachers who reported using the resource kit found it easy or extremely easy to use. Ninety percent of the teachers reported that they would be willing to continue implementing strategies in the future; of those who would not, a lack of time was cited as the reason. All administrators reported that the project had been worthwhile for their district. Parents were less aware of the message than teachers and administrators; 2 in 5 parents reported receiving educational handouts. Most students responded positively to the messages.

CONCLUSIONS. It is feasible for primary and middle schools to voluntarily deliver health-promotion messages during the school day through implementing strategies from the 5-2-1-0 resource kit. For school staff to fully implement the strategies, time constraints, both real and perceived, need to be addressed.
The Food and Beverage Vending Environment in Health Care Facilities Participating in the Healthy Eating, Active Communities Program
Authors: Lawrence Sally , Boyle Maria , Craypo Lisa , Samuels Sarah
Published: May 2009

BACKGROUND. Little has been done to ensure that the foods sold within health care facilities promote healthy lifestyles. Policies to improve school nutrition environments can serve as models for health care organizations.

OBJECTIVE. This study was designed to assess the healthfulness of foods sold in health care facility vending machines as well as how health care organizations are using policies to create healthy food environments.

METHODS. Food and beverage assessments were conducted in 19 California health care facilities that serve children in the Healthy Eating, Active Communities sites. Items sold in vending machines were inventoried at each facility and interviews conducted for information on vending policies. Analyses examined the types of products sold and the healthfulness of these products.

RESULTS. Ninety-six vending machines were observed in 15 (79%) of the facilities. Hospitals averaged 9.3 vending machines per facility compared with 3 vending machines per health department and 1.4 per clinic. Sodas comprised the greatest percentage of all beverages offered for sale: 30% in hospital vending machines and 38% in clinic vending machines. Water (20%) was the most prevalent in health departments. Candy comprised the greatest percentage of all foods offered in vending machines: 31% in clinics, 24% in hospitals, and 20% in health department facilities. Across all facilities, 75% of beverages and 81% of foods sold in vending machines did not adhere to the California school nutrition standards (Senate Bill 12). Nine (47%) of the health care facilities had adopted, or were in the process of adopting, policies that set nutrition standards for vending machines.

CONCLUSIONS. According to the California school nutrition standards, the majority of items found in the vending machines in participating health care facilities were unhealthy. Consumption of sweetened beverages and high-energy-density foods has been linked to increased prevalence of obesity. Some health care facilities are developing policies that set nutrition standards for vending machines. These policies could be effective in increasing access to healthy foods and beverages in institutional settings.
Small Steps to Health: Building Sustainable Partnerships in Pediatric Obesity Care
Authors: Pomietto Mo , Docter Alicia Dixon , Van Borkulo Nicole , Alfonsi Lorrie , Krieger James , Liu Lenna L.
Published: May 2009

BACKGROUND. Given the prevalence of childhood obesity and the limited support for preventing and managing obesity in primary care settings, the Seattle Children's Hospital's Children's Obesity Action Team has partnered with Steps to Health King County to develop a pediatric obesity quality-improvement project.

METHODS. Primary care clinics joined year-long quality-improvement collaboratives to integrate obesity prevention and management into the clinic setting by using the chronic-disease model. Sustainability was enhanced through integration at multiple levels by emphasizing small, consistent behavior changes and self-regulation of eating/feeding practices with children, teenagers, and families; building local community partnerships; and encouraging broader advocacy and policy change. Cultural competency and attention to disparities were integrated into quality-improvement efforts.

RESULTS. Participating clinics were able to increase BMI measurement and weight classification; integrate management of overweight/obese children and family and self-management support; and grow community collaborations. Over the course of 4 years, this project grew from a local effort involving 3 clinics to a statewide program recently adopted by the Washington State Department of Health.

CONCLUSIONS. This model can be used by other states/regions to develop pediatric obesity quality-improvement programs to support the assessment, prevention, and management of childhood obesity. Furthermore, these health care efforts can be integrated into broader community-wide childhood-obesity action plans.
Childhood Abuse, Avatar Choices, and Other Risk Factors Associated With Internet-Initiated Victimization of Adolescent Girls
Authors: Noll Jennie G. , Shenk Chad E. , Barnes Jaclyn E. , Putnam Frank W.
Published: May 2009

OBJECTIVE. The objective of the study was to determine the risk factors for Internet-initiated victimization of female adolescents. In particular, it was expected that girls who experienced childhood abuse would show higher vulnerability than their nonabused peers. In addition, the study examined how provocative self-presentations might be related to online sexual advances and offline encounters.

PATIENTS AND METHODS. Adolescent girls aged 14 to 17 years who had experienced substantiated childhood abuse (N = 104) were demographically matched with nonabused girls (N = 69) and surveyed regarding Internet usage, maternal and paternal caregiver presence, substance use, high-risk sexual attitudes, and involvement with high-risk peers. To measure online self-presentation, participants each created avatars, which were quantified according to the degree of provocative physical features.

RESULTS. Forty percent of the sample reported experiencing online sexual advances, and 26% reported meeting someone offline who they first met online. Abused girls were significantly more likely to have experienced online sexual advances and to have met someone offline. Having been abused and choosing a provocative avatar were significantly and independently associated with online sexual advances, which were, in turn, associated with offline encounters.

CONCLUSIONS.A history of childhood abuse may increase Internet-initiated victimization vulnerability. Parents should be aware of the ways in which their adolescents are presenting themselves online. Making adolescent girls and their parents aware that provocative online self-presentations may have implications for sexual solicitation might help to ward off sexual advances and might help prevent Internet-initiated victimizations. Practitioners should consider standard inquiry into Internet and media usage an aspect of comprehensive care.
Adolescents and MP3 Players: Too Many Risks, Too Few Precautions
Authors: Vogel Ineke , Verschuure Hans , van der Ploeg Catharina P. B. , Brug Johannes , Raat Hein
Published: May 2009

OBJECTIVE. The goal was to assess risky and protective listening behaviors of adolescent users of MP3 players and the association of these behaviors with demographic characteristics and frequency of use.

METHODS. In 2007, 1687 adolescents (12–19 years of age) in 68 classes in 15 Dutch secondary schools were invited to complete questionnaires about their music-listening behaviors.

RESULTS. Ninety percent of participants reported listening to music through earphones on MP3 players; 32.8% were frequent users, 48.0% used high volume settings, and only 6.8% always or nearly always used a noise-limiter. Frequent users were >4 times more likely to listen to high-volume music than were infrequent users, and adolescents in practical prevocational schools were more than twice as likely to listen to high-volume music as were those attending preuniversity education.

CONCLUSIONS. When using MP3 players, adolescents are very likely to engage in risky listening behaviors and are unlikely to seek protection. Frequent MP3 player use is an indicator of other risky listening behaviors, such as listening at high volumes and failing to use noise-limiters.
Adolescents Living the 24/7 Lifestyle: Effects of Caffeine and Technology on Sleep Duration and Daytime Functioning
Authors: Calamaro Christina J. , Mason Thornton B. A. , Ratcliffe Sarah J.
Published: May 2009

OBJECTIVE. Adolescents may not receive the sleep they need. New media technology and new, popular energy drinks may be implicated in sleep deficits. In this pilot study we quantified nighttime technology use and caffeine consumption to determine effects on sleep duration and daytime behaviors in adolescents. We hypothesized that with increased technology use, adolescents increase caffeine consumption, resulting in insufficient sleep duration.

PATIENTS AND METHODS. Subjects were recruited from a pediatric office in a proximal suburb of Philadelphia, Pennsylvania. Inclusion criteria for this study were middle and high school subjects aged 12 to 18 years old. The questionnaire, Adolescent Sleep, Caffeine Intake, and Technology Use, was developed by the investigators to measure adolescents' intake of caffeinated drinks, use of nighttime media-related technology, and sleep behaviors. Descriptive statistics characterized the subjects, their caffeine and technology use, and sleep variables. Regression models assessed the relationships between caffeine, technology use, and sleep variables, having adjusted for age, race, gender, and BMI.

RESULTS. Sleep was significantly related to the multitasking index. Teenagers getting 8 to 10 hours of sleep on school nights tended to have 1.5- to 2-fold lower multitasking indices compared with those getting less sleep. Thirty-three percent of the teenagers reported falling asleep during school. Caffeine consumption tended to be 76% higher by those who fell asleep. The log-transformed multitasking index was significantly related to falling asleep during school and with difficulties falling asleep on weeknights.

CONCLUSIONS. Many adolescents used multiple forms of technology late into the night and concurrently consumed caffeinated beverages. Subsequently, their ability to stay alert and fully functional throughout the day was impaired by excessive daytime sleepiness. Future studies should measure more than television hours when evaluating the impact of nighttime activities on sleep patterns in adolescents.
Conservative Management of Pediatric Nephrolithiasis Caused by Melamine-Contaminated Milk Powder
Authors: Zhu Sheng-lang , Li Jiu-hong , Chen Lu , Bao Zhong-xian , Zhang Long-jiang , Li Jia-ping , Chen Jie-hui , Ji Kun-mei
Published: May 2009

OBJECTIVE. In this article we report our experience with the diagnostic screening and management of children with melamine-induced nephrolithiasis.

METHODS. A total of 1091 children younger than 4 years who had been exposed to melamine-contaminated formula from September 17 to October 12, 2008, were screened for nephrolithiasis at the department of pediatrics at Shenzhen Nanshan Hospital in China. During the clinical examination, each patient's demographic characteristics were recorded together with the details of his or her milk-consumption profile during the contamination scare and any clinical signs of poisoning. Urinary stones were detected by B-ultrasonography, and renal status was examined by a routine urine test panel and a renal function test. When urinary stones were detected, patients were ordered to cease consumption of the suspected formula, and a conservative treatment course was adopted, including infusion of fluids, urinary alkalinization, increased water consumption, and diuresis.

RESULTS. Of the 1091 children screened, 12 (1.1%) were diagnosed with kidney stones. They had been exposed to the contaminated milk from 1 to 24 months. Eleven (91.7%) of these 12 patients had consumed milk with a high level of melamine content (955–2563 ppm); 1 patient (8.3%) had consumed milk with a low-level melamine content (6.2–17.0 ppm). Six patients exhibited dysuria; the remaining 6 patients were asymptomatic. All 12 patients had normal renal function, although 4 had proteinuria, and 1 had hematuria. The kidney stones were resolved within 3 to 5 days of commencing treatment in all 12 cases.

CONCLUSIONS. Nephrolithiasis was associated with high melamine-exposure levels. A combination of B-ultrasonography and urinalysis is suitable for screening for pediatric nephrolithiasis caused by melamine poisoning. The condition can be resolved with a conservative treatment approach in patients without serious clinical symptoms who have normal kidney function.
Drinking Water From Private Wells and Risks to Children
Authors: Rogan Walter J. , Brady Michael T. ,   the Committee on Environmental Health, and the Committee on Infectious Diseases
Published: May 2009

This Technical Report was reaffirmed January 2013 and September 2019.

Drinking water for approximately one sixth of US households is obtained from private wells. These wells can become contaminated by pollutant chemicals or pathogenic organisms, leading to significant illness. Although the US Environmental Protection Agency and all states offer guidance for construction, maintenance, and testing of private wells, there is little regulation, and with few exceptions, well owners are responsible for their own wells. Children may also drink well water at child care or when traveling. Illness resulting from children's ingestion of contaminated water can be severe. This report reviews relevant aspects of groundwater and wells; describes the common chemical and microbiologic contaminants; gives an algorithm with recommendations for inspection, testing, and remediation for wells providing drinking water for children; reviews the definitions and uses of various bottled waters; provides current estimates of costs for well testing; and provides federal, national, state, and, where appropriate, tribal contacts for more information.
High-pressure and high-temperature sintering of nanostructured bulk NiAl materials
Authors: Wang Shanmin , He Duanwei , Zou Yongtao , Wei Jianjun , Lei Li , Li Yongjun , Wang Jianghua , Wang Wendan , Kou Zili
Published: May 2009

Nanostructured bulk NiAl materials were prepared at high pressure and temperature (0–5.0 GPa and 600–1500 °C, respectively). The sintered samples were characterized by x-ray diffraction, scanning electron microscope, density, and indentation hardness measurements. The results show that NiAl nanoparticles may have a compressed surface shell, which may be the reason why NiAl nanomaterials were difficult to densify sintering using conventional methods and why high-pressure sintering was an effective approach. We also observed that B2-structured NiAl could undergo a temperature-dependent phase transition and could be transformed into Al0.9Ni4.22 below 1000 °C for the first time. It is interesting to note that Vickers hardness decreased as grain size decreased below ∼30 nm, indicating that the inverse Hall-Petch effect may be observed in nano-polycrystalline NiAl (n-NiAl) samples. Moreover, a tentative interpretation was developed for high-pressure nanosintering, based on the shell-core model of nanoparticles.
Texture characteristics controlled by single slip plane slipping in the warm-rolled Fe-14Mn-5Si-9Cr-5Ni shape memory alloy
Authors: Li H. , Yin F. , Sawaguchi T. , Zhao X. , Tsuzaki K.
Published: May 2009

To clarify the texture evolution mechanism of Fe-Mn-Si-based shape memory alloys, the rolling texture of an Fe-14Mn-5Si-9Cr-5Ni shape memory alloy is investigated during rolling to a final reduction of 82% at 873 K. A new rolling texture caused by single slip plane slipping is observed from such alloy, which is different from the conventional copper-type and brass-type textures. By means of the {111} pole figure scattering analysis of the local deformation structure, we conclude that such single slip plane slipping results in the weakness of brass orientation in the α fiber and the great enhancement of β fiber connecting S′ {331}<213> and B′ orientations {110}<114>.
Vanadium (IV) benzenedicarboxylate: A novel adsorbent for selective separations
Authors: Liu Lumei , Wang Xiqu , Jacobson A.J.
Published: May 2009

The crystal structure of VOBDC (BDC = 1,4-benzenedicarboxylate) has a 1-dimensional channel system with apertures of ∼8 Å, and shows remarkable flexibility upon adsorption/desorption of various guest molecules in the channels. VOBDC can selectively and rapidly adsorb organic molecules containing sulfur on exposure to a 5% CH4/He stream with different contents of thiophene or dimethyl sulfide at ambient temperature. Selective uptake of thiophene from liquid octane with thiophene concentrations from 2000 ppmw down to 100 ppmw is also observed. X-ray crystallographic data show that the adsorbed thiophene molecules adopt a herringbone packing arrangement within the channels of VOBDC while adsorbed dimethyl sulfide molecules are disordered among several positions in the channels with the sulfur atoms pointing toward the channel walls. The observed adsorptive capacities for thiophene and dimethyl sulfide are 155 mg and 208 mg sulfur per gram of VOBDC, respectively, consistent with the crystal structure data.
Atomic arrangement variations of 30° in-plane rotation domain boundaries in ZnO thin films grown on Si substrates due to thermal annealing
Authors: Shin J.W. , Lee J.Y. , No Y.S. , Kim T.W. , Choi W.K.
Published: May 2009

High-resolution transmission electron microscopy (HRTEM) images of annealed ZnO thin films showed the domain boundaries of a (0) plane with a transition zone and a (1) plane without a transition zone. The 30° in-plane rotation domain boundaries were formed in the ZnO thin films because the angle of the c-axis was tilted 3.5° in comparison with that of neighboring 30° in-plane rotation domains to reduce the misfit strain energy. The atomic arrangement variations of 30° in-plane rotation domain boundaries in ZnO thin films grown on Si substrates due to thermal annealing are described.