bluuebunny/crossref_metadata_2025 huggingface dataset:
IT capability in primary schools — a case of something lost in the translation?
Authors: Murray D.
Published: April 2008

Abstract  This paper examines the National Curriculum guidelines for Information Technology in Key Stages 1 & 2. Problems of interpretation are identified. The results of a survey indicate that primary school teachers lack sufficient understanding, of the concepts involved, to translate guidelines into practice. In‐service training is recommended. The likely outcomes of National Curriculum guidelines for information technology are also considered.
The impact of portable computers on pupils' attitudes to study
Authors: Morrison H. , Gardner J. , Reilly C. , McNally H.
Published: April 2008

Abstract Over two hundred pupils in nine schools were provided with a personal portable computer for a whole school year. One aspect of the research was to assess the impact which high access to information technology (IT) had on the pupils' attitudes to their schools and to the core disciplines: mathematics, English and science. The attitudes of the experimental and control groups (those with and those without portables) to the disciplines and to their schools were measured using 25‐item semantic differential and 28‐item Likert instruments respectively. Factor analysis revealed that positive impacts of high access to IT upon the attitudes of pupils was relatively marginal and confined to instances where the pupils' process‐based IT work transferred to the content domains in their disciplines. An interpretation of these affective findings, informed by recent National Curriculum research, is offered.
R&D on learning felematics in the European Community
Authors: Van den Brande L.
Published: April 2008

Abstract: This paper will develop the topic of learning through technologies from the viewpoint of research and development actions undertaken by the European Community in particular, R&D on flexible and distance education which is the focus of one of the programmes on telematic systems for general interest. The objectives of this programme, DELTA, are to exploit the benefits of IT&T tools and systems to improve efficiency of education and training, by means of more flexibility, interactivity and access to learning resources. The long term goal is the implementation of telematics‐based learning infrastructures Europe‐wide which will enable learners to access learning whenever and wherever required.
European Community policy and the market
Authors: Lloyd C.
Published: April 2008

Abstract This paper starts with some reflections on the policy considerations and priorities which are shaping European Commission (EC) research programmes. Then it attempts to position the current projects which seek to capitalise on information and communications technologies for learning in relation to these priorities and the apparent realities of the marketplace. It concludes that while there are grounds to be optimistic about the contribution EC programmes can make to the efficiency and standard of education and training, they are still too technology driven.
The strategies and interactions of young children in LOGO tasks
Authors: Yelland N.J.
Published: April 2008

Abstract  The present study analysed the strategies and interactions of 60 7‐year‐old children working on LOGO tasks in gender pairs (girls, boys and boy/ girls). The results revealed that initially there were significant differences on some performance variables, based on gender, in one of the tasks. However, these disappeared when the task was changed to one with a focus on accuracy. By the end of the study differences in performance were found to be associated with the application of higher order strategies for problem‐solving. The research investigated the nature of the early differences between the groups by examining the strategies and interactions of the pairs of children. The study highlights the importance of considering both the type of task and performance over a reasonable period of time when describing the nature and extent of young children's learning when problem solving in a novel environment.
Prototyping a collaborative learning tool for nurses
Authors: Baker B. , Acquah S. , Rada R.
Published: April 2008

Abstract  A Nurse Collaborative Learning (Nurse Co‐Learn) tool was designed and developed to help the Department of Nursing to introduce Information Technology to undergraduate nursing students. The MUCH (Many Using and Creating Hypermedia) system was used as the basis for this tool. The Nurse Co‐Learn tool supported coordination between clinic personnel. Students were required to take on a role in the clinic, and to perform the relevant tasks for that role. Through participating in this role‐playing game students learned word processing, database and spreadsheet skills, whilst performing authentic tasks. Three prototypes were developed and trialled; this paper highlights the features of the prototypes and the responses of the users.
Evaluating the impact of IT on pupils' achievements
Authors: Johnson D.C. , Cox M.J. , Watson D.M.
Published: April 2008

Abstract  It is proposed than any large scale investigation of this multi‐faceted phenomena requires a range of methodologies and data types. The ImpacT study, an evaluation of pupils' achievements, teachers' practices, and schools' policies and resources, was conducted with 2300 pupils from 87 classrooms in primary and secondary schools in England and Wales. The work focussed on the school subjects of mathematics, science, geography, and English, and extends the research base to include longitudinal effects within subjects, cross‐subject considerations of classroom use of IT, and the provision and use of hardware and software resources. Results from the component parts of the work were integrated to address the main theme(s). Overall indications were that in particular circumstances the use of IT had a highly positive impact on children's achievement, but this was not without substantial demands on teachers and schools.
IT in education and teacher education in Australia
Authors: Downes T. , Perry B. , Sherwood C.
Published: April 2008

Abstract Responsibility for education at all school levels in Australia is the constitutional prerogative of the states and territories while almost all the funds are produced via Commonwealth taxation. On the other hand, university education, including those faculties responsible for teacher education, come directly under Commonwealth control. These arrangements have been questioned often, particularly in terms of assuring the Commonwealth that ‘they are getting value for their money’. In recent years, there has been a number of moves towards a more national approach to education and many of these have incorporated statements concerning the role of technology in education. This paper sets the context of these developments as they have impinged on teacher education and provides specific examples from two institutions.
Informatics in teacher education in Japan
Authors: Sakamoto T. , Gardner J.
Published: April 2008

Abstract This paper charts the developments in information technology (IT) policies in education in Japan over the past decade with particular emphasis on the impacts on teacher education. Beginning with the work of the National Council on Educational Reform in 1985, the Japanese education system initiated a thorough analysis of the role of information technology in all aspects of education from kindergarten through to high school, vocational education and pre‐ and in‐service teacher education. The various approaches culminated in guidelines and statutory requirements relating to both schools' curricula and teacher training, published in the period 1990–1992. More recently other ministries have contributed to developments including the Ministry for International Trade and Industry which has categorized the different types of information engineers and among these is the new Educational Engineer. The paper reports the processes leading to these developments.
Teachers perceptions of the availability of computer hardware
Authors: Andrews P.
Published: April 2008

Abstract Mathematics teachers in 40 secondary schools in the Greater Manchester region were sent questionnaires asking them, amongst other things, to comment on the availability of various forms of computer hardware for use in their teaching of mathematics. Seventy‐five replies were received and analysed. In respect of a single computer in a classroom –a provision which teachers seem to see as being of little benefit–most believe they can achieve bookable access although spontaneous availability is unlikely for all but a minority. For computer suites–the more favoured provision–even booking in advance guarantees access for less than half of all teachers with spontaneous access granted to less than one teacher in ten. Some implications of these findings and possible ways forward are discussed.
What goes on in school‐based ITT?
Authors: Collison J. , Murray D.
Published: April 2008

Abstract Initial Teacher Training (ITT) is destined to become more, perhaps entirely, school‐based. Teacher competence with IT is still being developed. How might this lack in competence impact on trainee teachers learning to use IT in school? This paper considers the classroom experiences of trainee teachers following an early years, school‐based BA (QTS) degree. Working in pairs the trainees undertook a range of IT work that was planned to exploit cross‐curricular links. Observations of their work in school and recordings of class teacher/trainee conversations are used to describe the reality of school‐based ITT. The data suggest that the value of the school‐based work is largely restricted to that of planning for, and doing, in a specific context. There is little evidence that the class teachers are able to act as mentors for the trainee's IT work. This could have serious consequences for the IT competence of the future teaching profession.
The Norwegian JITOL experience and NITOL as a national extension
Authors: Ask B. , Haugen H.
Published: April 2008

Abstract JITOL (Just In Time Open Learning) as a project under the DELTA programme was particularly aiming at professional training and upgrading in specified fields. Participation in the project gave valuable experiences with electronic networks and distribution of learning material. A growing interest in flexible learning led to the establishment of a new, national project, NITOL (Norwaynet with IT for Open Learning, 1994‐95) that applies the Jitol concept within higher education. Four Norwegian universities and colleges have joined forces in offering courses for credits, online on the academic network, Norwaynet. The combination of electronic conferences and mail systems with attachment/appendix facilities, gives a synergy effect for academic staff and students at the four institutions involved, as well as for groups or individuals that join the electronic learning environment through INTERNET or by private modems. This may be regarded as a continuance of the JITOL activities.
Collaborative learning and directive software
Authors: Wegerif R.
Published: April 2008

Abstract

In this paper interactions of groups of school students working with a variety of educational software are analysed to develop an account of the structure of collaborative educational activities supported by directive software. First the application of a quantitative method is described and its results used to question the hypothesis that directive software limits the quality of discussion between groups of users. The nature of the talk occurring around directive software is then explored in more detail. It is argued that the structure of educational activities around directive software can allow for the possibility of embedding exploratory symmetrical pupil discussion within a directed teaching programme: an educationally desirable combination otherwise difficult to achieve.
Data‐logging: effects on practical science
Authors: Rogers L. , Wild P.
Published: April 2008

Abstract This paper describes an investigation into the processes and effects of using electronic data‐logging in practical science. A pilot study of classical laboratory work in schools was compared with similar tasks performed with data‐logging systems. A more detailed exploration of pupils' performance was then conducted through an extensive series of observations in a range of secondary schools. The results reinforce previous indications of the potential benefits of data‐logging, but such benefits must be viewed in the curriculum context of the type of measurement activity and the pedagogical context of teaching and learning objectives. The paper concludes with a discussion of the latter issues.
Courseware validation: a case study
Authors: Persico D.
Published: April 2008

Abstract This paper discusses methods used and problems faced in the validation study of LOGICLANDIA, a courseware package for the learning and teaching of predicate logic in Italian upper secondary schools. The courseware underwent a medium scale evaluation process that involved about three hundred students. LOGICLANDIA's validation consisted of three main phases: subjective evaluation, in‐house evaluation and field test. The study produced a number of indications of revision of the courseware material, as well as information about effectiveness of the educational approach and satisfaction of students. But rather than going into the details of the results of LOGICLANDIA's evaluation, the paper focuses on problems encountered and adopted solutions that can be generalised to similar cases.
Message design guidelines for screen‐based programs
Authors: Rimar G. I.
Published: April 2008

Abstract This paper discusses message design for screen‐based (computer and video) instructional programs. Message design is defined as the art and science of planning for the manipulation of the physical form of the message. Including a comprehensive literature review, this paper supplies information based on personal experience. There are three main purposes for this work. The first purpose is to present a compilation of present conventions. The second purpose is evaluating these conventions in terms of their current relevance. The third purpose is to suggest a new set of guidelines for the instructional designer or message designer creating screen‐based instructional programs.
A new hepatitis C virus‐like flavivirus in patients with cryptogenic liver disease associated with elevated GGT and alkaline phosphatase serum levels
Authors: Colombatto P. , Randone A. , Civitico G. , Gorin G. Monti , Dolci L. , Medaina N. , Calleri G. , Oliveri F. , Baldi M. , Tappero G. , Volpes R. , David E. , Verme G. , Smedile A. , Bonino F. , Brunetto M. R.
Published: April 2008

Summary. The intriguing co‐infection of two flaviviruses (GBV‐A and GBV‐B) in tamarins and the recent discovery of another flavivirus (GBV‐C/HGV) in humans raises the question of the relations between hepatitis C virus (HCV) and GBV‐C/HGV. To address this issue the sera of 285 patients with liver disease (102 patients with cryptogenic and 183 with known forms of chronic liver disease) and 19 patients without liver disease were tested for HGV‐RNA. GBV‐C/HGV‐RNA was detected by RT‐PCR using primers encompassing 5'NC and NS5 regions and hybridization with specific biotinilated and radiolabelled probes. GBV‐C/HGV RNA was found in 11 of 20 (55%) acute hepatitis C patients, in 13 of 117 (11.1%) patients with chronic hepatitis C, in 11 of 27 patients with a liver transplant (40.7%), one of 19 (5.3%) patients with chronic HBV infection, 15 out of 102 (14.7%) patients with cryptogenic liver disease and two out of 19 patients with inflammatory bowel disease. In cryptogenic patients, elevated serum gammaglutamyl transpeptidase (GGT, higher than twice the normal values) and alkaline phosphatase (ALP, above normal values) levels were significantly associated with GBV‐C/HGV‐RNA infection (P<0.001). In conclusion GBV‐C/HGV appears to be transmitted in humans by blood exposure and to be associated with liver disease in HCV co‐infected patients and in a minority of patients with cryptogenic disease. The virus is only occasionally pathogenic for the liver and when liver damage is present; the association with the combined elevation of GGT and APH serum levels might represent a specific feature of the liver tropism of the agent.
Morbidity and mortality of recurrent hepatitis C infection after orthotopic liver transplantation
Authors: Vierling J. M. , Villamil F. G. , Rojter S. E. , Camacho K. B. , Goldman D. E.
Published: April 2008

Summary. Through molecular virological testing it is now clear that HCV reinfection of the allograft is virtually universal in liver transplant recipients. Although histopathological recurrence of hepatitis C occurs in the majority of patients, it is absent in a substantial minority. To date, no prognostic factors, other than genotype lb, have been identified that accurately predict these dissimilar outcomes. The natural history of recurrent hepatitis C varies. Historically, it has been regarded as generally benign. However, with increasing numbers of patients transplanted for hepatitis C it is now clear that a subgroup of patients develops severe progressive cholestatic hepatitis associated with allograft failure and death without retransplantation. Within 5 years following OLT, approximately 15–20% of patients progress to chronic active hepatitis and another 15–20% become cirrhotic. A minority of patients develop glomerulopathy or vasculitis, which are often associated with cryoglobulinaemia. The impact of immunosuppressive medications and rejection episodes on histopathological recurrence of progressive hepatitis C remains controversial and requires further studies. Although actuarial survival rates of patients transplanted for hepatitis C differ among transplantation centres, it appears that histopathological recurrence of hepatitis C does have an adverse impact on actuarial survival compared to the survival of patients transplanted for autoimmune hepatitis, primary biliary cirrhosis, primary sclerosing cholangitis and metabolic liver diseases. When allograft failure develops in patients with recurrent hepatitis C, retransplantation is indicated, even though recent reports indicate that mortality may be increased, especially with concurrent renal insufficiency.
Cytokine amplification and inhibition of immune and inflammatory responses
Authors: Balkwill F.
Published: April 2008

Summary. Cytokines are soluble mediators of intercellular communication. They contribute to a chemical signalling language that regulates development, tissue repair, haematopoiesis, inflammation and the immune response. Potent cytokine polypeptides have pleiotropic activities and functional redundancy. They act in a complex network where one cytokine can influence the production of, and response to, many other cytokines. In the past 5 years this bewildering array of 100+ effector molecules and associated cell surface receptors has been simplified by study of three‐dimensional cytokine and cytokine receptor structure; elucidation of convergent intracellular signalling pathways; and molecular genetics, especially targeted gene disruption to ‘knockout’ production of individual cytokines in mice. It is also now clear that much of the pathophysiology of infectious disease can be explained by the induction of cytokines and the subsequent cellular response. Cytokine and cytokine antagonists have also shown therapeutic potential in a number of chronic and acute diseases.
Immunological approach to hepatocellular carcinoma
Authors: Wands J. R. , Lavaissiere L. , Moradpour D. , de la Monte S. , Mohr L. , Nicolau C. , Tanaka S.
Published: April 2008

Summary. A library of monoclonal antibodies (MoAbs) has been produced against a human hepatocellular carcinoma (HCC) cell line designated FOCUS in order to study the antigenic properties of transformed hepatocytes. Several monoclonal antibodies (MoAbs) were initially selected for study since they bound to antigens which were overexpressed in HCC tissues compared with the adjacent uninvolved normal liver counterpart; in addition, these MoAbs revealed low level antigen expression on other normal human tissues. Subsequently, HCC cell lines were metabolically labelled and the antigens further characterized by immunoprecipitation and Western blot analysis. If the MoAb recognized a primary linear epitope on a protein, cloning was performed using a ΛGT11 cDNA expression library prepared from the FOCUS HCC cell line. These studies characterized the HCC associated antigen(s) at the molecular level. This review illustrates the value of such an experimental approach to search for and identify HCC associated antigens and emphasizes the biological properties of novel proteins may be defined and characterized by these techniques. More important, our investigations have described unique proteins that may not only be important in the pathogenesis of HCC but also demonstrates how such antigen‐antibody systems may be used to develop strategies for immuno‐targetting and gene therapy of HCC.
Marital status and cohabitation during pregnancy: relationship with social conditions, antenatal care and pregnancy outcome in France
Authors: Blondel Beatrice , Zuber MARIE‐CHRISTINE
Published: April 2008

Summary. A survey of a representative sample of 5508 births in France in 1981 permitted the study of social characteristics of pregnant women, the medical care they received during their pregnancy and their pregnancy outcome, as a function of their marital status and whether or not they lived with the father of the child. Unmarried women living with the father (n = 412) like unmarried women living alone (n = 171), were more often younger, having their first baby and had a lower educational level than did married women living with the father (n = 4590). However, among the unmarried women, those living alone were in a more unfavourable position than those living with the father; in particular, they were more often less than 20 years old, had the minimum educational level required and were unemployed. Both groups of unmarried women had a higher preterm delivery rate than did married women, even after taking other risk factors into account in a logistic regression. The odds ratios (95% confidence interval) for pre‐term delivery among unmarried mothers living without the father was 1.9 (1.0–3.4) and that for the unmarried cohabiting with the father was 1.6 (1.0–2.4). Thus, to fully appreciate the perinatal risks and medical needs during pregnancy, both the marital and cohabitational status of the women should be considered.
Trends in infantile hypertrophic pyloric stenosis in Olmsted County, Minnesota, 1950–1984
Authors: Jedd MARY B. , Melton L. JOSEPH , Griffin MARIE R. , Kaufman BRUCE H. , Hoffman ALAN D. , Broughton DANIEL D. , O'Brien PETER C.
Published: April 2008

Summary. In the 35‐year period, 1950–1984, 154 Olmsted County, Minnesota, infants were diagnosed with definite infantile hypertrophic pyloric stenosis (IHPS). Patients were identified using outpatient and inpatient records of all providers of care to the circumscribed population, and ascertainment was complete insofar as diagnosed cases are con cerned. The overall incidence of IHPS was 2.6 per 1000 person‐years (95% confidence interval: 2.2–3.0), with a male‐female ratio of 4.1:l. A dramatic rise in incidence was seen among male infants over the study period, but not for females, so that by 1980–1984 the rates for the two sexes were 6.2 and 0.9 per 1000 person‐years, respectively. Improvements in diagnostic capabilities and case identification may have occurred but seem unlikely to entirely account for these changes. Aetiologic hypotheses should reflect the different trends for male and female infants.
The Liverpool Congenital Malformations Registry
Authors: Owens J.R. , Simpkin J.M. , McGuinness L. , Harris F.
Published: April 2008

Summary

Data collection and validation for the Liverpool Congenital Malformations Registry (LCMR) are described. Founded in 1960, the LCMR increased its area of surveillance in 1979 to include five health districts in Liverpool and its environs with approximately 20 000 births per annum. The LCMR is now one of the members of the European Congenital Anomalies Register (EUROCAT). Multiple sources of ascertainment are employed, the most useful of these being OPCS notifications, hospital discharge letters and data from specialised paediatric units. In spite of several difficulties encountered in data collection the data base is an invaluable tool both for routine monitoring of prevalence rates and as a starting point for epidemiological research.
Birthweight of single livebirths and weight specific early neonatal mortality in Hungary and Norway
Authors: Bjerkedal Tor , Czeizel Andrew , Hosmer David W.
Published: April 2008

Summary. Comparisons of birthweights of single livebirths in Hungary and Norway reveal distributions to have similar shapes; however, in the case of Hungary the distribution is shifted to the left, i.e. towards lower weights. In the registration of pregnancy outcomes, almost identical definitions are applied in the two countries, and the observed difference in distributions of birthweights is taken to reflect that Norwegian livebirths, are on average about 300 g heavier than Hungarian livebirths. Employing the method of analysis of birthweight and perinatal mortality suggested by Wilcox & Russell, it can be demonstrated that the proportions of births in the residual distributions of birthweights in the two countries are of the same magnitude and that the relative differences in first week mortality risks are similar for all birthweights. These results are taken to support the conclusion that to use a cut‐off point of 2500 g in defining low birthweight, which will result in a two fold higher proportion of such infants in Hungary compared to Norway, is unwarranted, as it will falsely convey the impression of relatively more obstetric and paediatric problems in Hungary.
Perinatal mortality audit in a Zimbabwean district
Authors: Muylder X. De
Published: April 2008

Perinatal deaths were systematically investigated over a 25‐month period in a Zimbabwean district and were classified into pathological subgroups according to Wigglesworth. There were 319 perinatal deaths (a rate of 30.6 per 1000) including 83 normally formed macerated stillbirths, 28 cases of congenital malformation, 79 deaths associated with immaturity, 111 due to asphyxial conditions developing in labour and 18 specific problems. Syphilis infection was a contributory factor among 27 cases, hypertension in 39 cases, amniotic fluid infection in 31 cases and diabetes in 11 cases. An avoidable factor was detected among 242 cases (75.6%) involving the mother in 120 cases, the maternity centres in 28 and the hospital in 94. These data suggest that educational programmes should try to convince all the pregnant women to attend an antenatal clinic at least once. A further perinatal mortality reduction might be obtained through treatment for syphilis, hypertension, diabetes and amniotic fluid infection, closer monitoring of the fetal condition during labour and skillful management of dystocia.
Association between low gynaecological age and preterm birth
Authors: Scholl Theresa O. , Hediger Mary L. , Salmon Ruth W. , Belsky Daniel H. , Ances Isadore G.
Published: April 2008

Summary. Low gynaecological age, defined as conception within 2 completed years of menarche, was examined for its association with preterm birth, using data from a geographically based cohort of over 1700 young primigravidae aged 18 or younger at start of prenatal care. After stratifying by chronological age and controlling for confounding variables, low gynaecological age was associated with almost double the risk of preterm delivery whether estimated from the mother's last menstrual period (adjusted odds ratio (AOR) = 1.77, 95% CI 1.19–2.64) or using the obstetric estimate of gestation (AOR = 2.10, 95% CI 1.36–3.25). Low gynaecological age was also associated with an increase in risk of low birthweight (LBW) (AOR=1.70, 95% CI 1.01–2.88), but not of small‐for‐gestational‐age babies (AOR = 0.94, 95% CI 0.49–1.81). Thus low gynaecological age may be an important addition to assessment systems to detect women at risk of preterm labour and delivery.
Subclinical amnionitis in patients with intact membranes in preterm labour
Authors: Guvenc Muzehher , Guvenc Huseyin , Cengiz Lugen , Cengiz Tevfik , Uslu Turhan
Published: April 2008

Summary. Preterm delivery is the major obstetric and paediatric problem, being responsible for much perinatal morbidity and mortality. Subclinical amnionitis may cause preterm labour and delivery. The rate of subclinical bacterial infection of amniotic fluid was studied in 25 afebrile pregnant women with intact membranes in preterm labour. Specimens of amniotic fluid were collected by transabdominal amniocentesis. Serum and amniotic fluid lactic dehydrogenase (LDH) levels were assessed to determine their usefulness in making the diagnosis of subclinical amnionitis. Aerobic bacteria were isolated from 48% (12/25) of the specimens. Thus, subclinical amnionitis may play a substantial role in patients with intact membranes in preterm labour. However, transabdominal amniocentesis is not routinely indicated in similar asymptomatic patients because microbiological and especially LDH studies require further evaluation.
Prediction of possibly preventable death: a case‐control study of postneonatal mortality in southern New Zealand
Authors: Nelson E.A.S. , Williams S.M. , Taylor B.J. , Morris B. , Ford R.P.K. , Binney V.M. , Wilsod C.
Published: April 2008

Summary. The postneonatal mortality rate in three southern regions of New Zealand was 8.1 per 1000 live births for 1979–1984. The possibly preventable postneonatal mortality rate was 7.1 per 1000 live births and data on 377 possibly preventable deaths and 936 randomly selected controls were used to develop a two‐stage risk‐scoring system. Logistic regression analysis was undertaken separately on two sub‐samples of the total sample. The data were used to evaluate three other previously published scoring systems. The four variables used in our birth score (mother's age, parity, marital status, and birth weight) have all appeared in other scoring systems, and this score could identify a group of infants in southern New Zealand with an estimated 1.7% mortality rate in the first year of life. It is suggested that currently the only valid use of risk‐scoring in this region is for the definition of a high‐risk population for the purpose of evaluating potential intervention strategies.
Secondary enuresis in a birth cohort of New Zealand children
Authors: Fergusson D.M. , Horwood L.J. , Shannon F.T.
Published: April 2008

Summary. The development of secondary enuresis was examined in a birth cohort of New Zealand children studied to the age of 10 years. By this age, 7.9% of children had developed secondary enuresis. Analysis suggested two risk factors were involved in secondary enuresis. First, children who were late to attain nocturnal bladder control had significantly higher risks of secondary enuresis than children who attained early nocturnal bladder control. Secondly, the child's level of exposure to adverse life events was associated with the onset of secondary enuresis. Children who attained bladder control after 5 years were 3.39 (1.76–6.56) times more likely to develop secondary enuresis than those who attained bladder control before the age of 3 years (P<0.001); children who were exposed to four or more life events in a given year were 2.56 (1.18–5.50) times more likely to develop secondary enuresis in that year (P<0.05). These results suggest that the rate at which the child acquires primary bladder control acts as a vulnerability factor which determines the child's susceptibility to developing secondary enuresis when exposed to stress.
Health, growth and sexual development of teenagers exposed in utero to medroxyprogesterone acetate
Authors: Jaffe B. , Shye D. , Harlap S. , Baras M. , Belmaker E. , Gordon L. , Magidor S. , Fortneys J.
Published: April 2008

Summary. General health, growth and sexual development were evaluated in 74 teenage boys and 98 girls who had been exposed to medroxyprogesterone acetate (MPA) in utero, and 385 boys and 448 girls not exposed. In this 17‐year prospective study, the ascertainment of the end points was ‘double blind’ in that neither the interviewer nor the subject was aware of our interest in MPA. On average, girls exposed to MPA reported reaching the menarche 4 months earlier than the comparison group. This difference disappeared, however, in a multiple regression analysis taking into account social class, the mother's age at menarche and height of the girl's mother and father. Boys exposed to MPA reported their growth spurt to have occurred an average of 6 months earlier and voices to have broken 5 months earlier than unexposed boys. Again, the differences between them and the comparison group disappeared after controlling for confounding variables. There were no significant differences between the MPA‐exposed and comparison groups in a wide variety of indices of health reported by the teenagers' mothers. These findings are consistent with the hypothesis that intrauterine exposure to MPA, in the doses used for pregnancy maintenance or for contraception, poses no threat to the long‐term health and development of the progeny.
International variations in the incidence of childhood lymphomas
Authors: Stiller C.A. , Parkin D.M.
Published: April 2008

Summary. The International Agency for Research on Cancer has coordinated a worldwide study of childhood cancer incidence, with data provided by contributors from over 50 countries. We present here the results on lymphomas from this study and other sources. Hodgkin's disease had a relatively high incidence in North Africa and West Asia and a low incidence throughout East Asia. In populations of predominantly European origin, the highest rates tended to be in warmer countries of lower latitude. In industrialised Western countries, the incidence increased steeply with age and was low in childhood compared with that in young adults whereas elsewhere the increase in incidence between childhood and adults aged 20–34 was much less marked. The age‐distribution of Hodgkin's disease in childhood appears to be related to levels of socio‐economic development but the total incidence seems to be determined more by ethnic and environmental factors. The highest incidence of Burkitt's lymphoma occurred in tropical Africa and Papua New Guinea. Elsewhere, Burkitt's lymphoma was rare, though the incidence was higher in Spain, North Africa and the Middle East than in other areas. In most Western countries, a third of all non‐Hodgkin lymphomas may be Burkitt's. There was no consistent pattern in the incidence of other non‐Hodgkin lymphomas except for a tendency towards higher rates around the Mediterranean and in some Latin American registries.
Proportionality of small for gestational age babies as a predictor of neonatal mortality and morbidity
Authors: Cuttini M. , Cortinovis I. , Bossi A. , de Vonderweid U.
Published: April 2008

Summary. Neonatal mortality and morbidity of 2609 babies who weighed less than the fifth centile for gestational age were studied in order to evaluate the relationship between the type of intrauterine growth retardation and the short‐term prognosis after birth. Of these babies, 1175 had both a birth weight and head circumference below the fifth centile (‘proportionately small’); the others, whose body weight was below but head circumference above the fifth centile, were defined as ‘disproportionately small’. The former group showed a consistently higher risk of death during the neonatal period. Morbidity defined by birth asphyxia, respiratory distress and neonatal infections was higher in those proportionately small babies who were delivered at term. The picture reversed for hyperbilirubinaemia, which was more frequent among disproportionately small babies. Proportionality, defined on the basis of the correspondence between birthweight and head circumference centiles, appears to be a simple and non‐invasive clinical method to identify babies who are at higher risk of adverse outcome.
Perinatal mortality in southern Italy
Authors: Pisacane Alfredo , Quagliata Luigi , Scarpellino Benedetto , Mendes Claudia , Latino Anna , Volpicelli Giuseppina , Coppola Angelo , Mazzarella Gianfranco
Published: April 2008

Summary. Perinatal deaths occurring in the Campania region of southern Italy in 1982 were analysed. The perinatal mortality rate was 17.6 per thousand (stillbirth rate 8.3, early neonatal mortality rate 9.3). Compared with Swedish data, our deaths excess does not seem attributable to an unfavourable birthweight distribution, but to high birthweight mortality rates in every birthweight category and particularly in the normal birthweight group (>2500 g). This group of newborns, representing about 94% of the births, contributes 45.4% of perinatal deaths; this situation is not common in developed countries, where the normal birthweight newborns form a much smaller proportion of perinatal deaths. The analysis of the causes of perinatal mortality, even though autopsies are rarely executed in Campania, shows a high prevalence of events which should be prevented by good antenatal and perinatal care.
Smoking during pregnancy and its effects on child cognitive ability from the ages of 8 to 12 years
Authors: Fergusson D.M. , Lloyd M.
Published: April 2008

Summary. Maternal smoking during pregnancy and subsequent child cognitive development and ability were examined in a birth cohort of New Zealand children studied to the age of 12 years. Analysis at a bivariate level showed that children whose mothers smoked during pregnancy scored significantly lower on standardised tests of intelligence, reading and mathematical ability than children whose mothers did not smoke. However, after adjustment for confounding covariates, the results showed no detectable relationship between smoking during pregnancy and child cognitive ability. These results suggest that children whose mothers smoked during pregnancy fared worse on tests of cognitive ability not because of possible causal effects of smoking, but rather because these children tended to come from families which provided a relatively disadvantaged home environment.
The conference scene
Authors: PANETH NIGEL
Published: April 2008

The Society for Pediatric Epidemiologic Research: Third Annual Meeting, Snowbird, Utah, 12 Tune 1990
Is preterm delivery genetically determined?
Authors: Wildschut Hajo I.J. , Lumey L.H. , Lunt Peter W.
Published: April 2008

Summary. Surprisingly, the genetics of preterm delivery have received very little attention in the literature. Possible explanations are the inability to obtain accurate information on the length of gestation in family studies and the heterogeneous nature of this disorder. In contrast to the many studies which consider the relative contribution of both genetic and environmental variance to the total variance of birthweight, few studies have examined the genetic basis of the duration of gestation in man. It is argued that both genetic and epidemiological approaches are needed to separate the effects of heredity and the environment on the duration of gestation.
Marijuana and spontaneous abortion of known karyotype
Authors: Kline Jennie , Hutzler Michelle , Levin Bruce , Stein Zena , Susser Mervyn , Warburton Dorothy
Published: April 2008

Summary We tested whether marijuana use in the 2 months before the last menstrual period and during pregnancy affects the risk of spontaneous abortions of known karyotype. Spontaneous abortions (cases) were defined as chromosomally normal (n= 567) or chromosomally aberrant (n= 393) and, within the latter, by type of aberration (212 trisomies, 71 monosomies X, 49 triploidies, 61 others). Controls were women with prenatal care before 22 weeks gestation and delivering at 28 weeks or later (n= 2042). In comparison with controls, adjusted odds (OR) of reported marijuana use in chromosomally normal cases were 1.1 (95% confidence interval (CI) 0.7, 1.5) and in chromosomally aberrant cases combined 1.2(95% CI 0.7,1.9). With respect to specific aberrations, use in the perifertilisation period did not differ significantly from that in controls for trisomies (adjusted OR = 0.8, 95% CI 0.4, 1.8), monosomies X (adjusted OR = 1.8, 95% CI0.7, 4.3), and triploidies (adjusted OR = 1.3, 95%) CI 0.4, 4.5). Comparisons of karyotype groups with each other yielded similar results. Our data do not support causal associations of marijuana use, at the levels represented in our sample, with either chromosomally normal or trisomic spontaneous abortion. With monosomy X and triploidy, no statistically significant associations were detected although numbers were insufficient to rule out moderate effects.
The Chernobyl accident, congenital anomalies and other reproductive outcomes
Authors: Little J.
Published: April 2008

Summary.Studies of the association between the Chernobyl accident in April 1986 and reproductive outcome, with particular reference to congenital anomalies, are reviewed. All of the studies so far have been based on the detection of a change in frequency over time. An increased frequency of trisomy 21 in the former West Berlin in January 1987, and increases in the frequency of neural tube defects in several small hospital‐based series in Turkey, are not confirmed in larger and more representative series in Europe. No clear changes in the prevalence at birth of anomalies which might be associated with the accident are apparent in Byelorussia or the Ukraine, the republics with the highest exposure to fallout. However, these data are difficult to interpret as the methods of acquisition have not been described and they have not yet been reported in full. Thus, there is no consistent evidence of a detrimental physical effect of the Chernobyl accident on congenital anomalies. This is also the case for other measured outcomes of pregnancy. There is evidence of indirect effects ‐ an increase in induced abortions substantial enough to show as a reduction in total births, due to anxieties created.

Data are not available on the reproductive outcomes of women pregnant at the time of the accident who were evacuated from the 30 km zone of immediate contamination, of workers in the plant at the time of the accident or of decontamination workers. Moreover, no data are available from several of the other countries closest to the Chernobyl area.
Aetiological pathways to spastic cerebral palsy
Authors: Blair Eve , Stanley Fiona
Published: April 2008

Summary. An aetiological pathway is a sequence of interdependent events culminating in disease. Recognition of such pathways can be clinically useful if it suggests more effective methods of disease prevention. Kernicterus arising from feto‐maternal Rhesus incompatibility and resulting in choreoathetosis comprises an aetological pathway to cerebral palsy. The failure to recognise sufficient causes or to intervene effectively when a sufficient cause is suspected in the majority of cerebral palsy cases suggests that there may be other aetiological pathways. Evidence for other pathways was sought in the data from the Western Australian case‐control study of 183 children with spastic cerebral palsy. Two or more factors likely to be of aetiological significance were recognised for nearly one‐third of cases. As anticipated, the numbers with any specific combination of factors were small, pointing to the need for collaborative studies to obtain larger numbers to confirm their aetiological significance. The implications for the true proportion of cases with multifactorial aetiology and the problems inherent in such an investigation are discussed.
Factors limiting the effectiveness of prenatal screening for anencephaly and spina bifida in a high‐risk area
Authors: Omran Maeda , McLoone Philip , Stone David , Aitken David , Crossley Jennifer
Published: April 2008

Summary. The effectiveness of a prenatal screening programme in reducing the birth prevalence of anencephaly and spina bifida (ASB) is influenced by three principal factors: the proportion of affected pregnancies screened (uptake), the proportion of affected pregnancies detected on screening (sensitivity) and the proportion of affected pregnancies terminated when detected (compliance). The purpose of the study was twofold: to develop an epidemiologically‐based method for the retrospective monitoring of these three factors and to attempt to quantify their relative importance in relation to the outcome of screening. Data on births and terminations associated with ASB for the period 1976–1986 were obtained from the Glasgow Register of Congenital Anomalies and from the Department of Medical Genetics, Yorkhill Hospitals. Increasing proportions of affected pregnancies screened, detected and terminated were observed, to a greater degree for anencephaly than for spina bifida. The relationships between uptake, sensitivity, compliance and terminations are described in the form of a simple arithmetic expression. In policy terms, further efforts are required to increase all three in order to improve the effectiveness of screening for spina bifida.
Patterns of use of obstetrical interventions in 12 countries
Authors: Stephenson P.A. , Bakoula C. , Hemminki E. , Knudsen L. , Levasseur M. , Schenker J. , Stembera Z. , Tiba J. , Verbrugge H.P. , Zupan J. , Wagner M.G. , Karagas M. , Pizacani B. , Pineault R. , Tuimala R. , Houd S. , Lomas J.
Published: April 2008

Summary. Recent obstetrical practice trends in 12 countries were surveyed. There was a 3‐fold difference in caesarean section rates and a 10‐fold difference in instrumental vaginal delivery rates among countries. There was a net increase in the caesarean section rate of all countries over the study period and a net decrease in the instrumental vaginal delivery rate of some countries. There was a decrease in the caesarean section rate during the last year of observation in Australia, Denmark and Finland. In general, countries with high caesarean rates also had high instrumental vaginal delivery rates. There was no consistent relationship between use of caesarean section and use of instrumental vaginal delivery, although in several countries increasing use of caesarean section was accompanied by decreasing use of instrumental vaginal delivery. Oxytocin use rates were associated positively with instrumental delivery but not with caesarean section rates. While it was not possible to determine the proportions of women who received appropriate obstetrical care, we can infer that a significant proportion of interventions were unnecessary or only marginally beneficial. Continued increases in rates of obstetrical intervention are unlikely to result in improvements in birth outcome overall and may pose a risk to mothers and their newborns.