bluuebunny/crossref_metadata_2025 huggingface dataset:
Transportation Technologies for Community Policing: A Comparison
Authors: Petty Ross D.
Published: September 2006

Community policing not only deters crime and reassures residents, but also allows police to become aware of community concerns, observe possible criminal activities, and respond quickly to them. Foot patrols have the advantage of being the least costly, the most interactive with community members, and the most manoeuvrable through the urban environment. However, the range and speed is limited. Bicycles are second lowest in cost, still highly manoeuvrable and extend both the speed and range of the patrol officer. Automobiles are the most expensive patrol technology in both acquisition and maintenance. They have the greatest speed and range and allow apprehended suspects to be transported directly to headquarters. The new electric, self-balancing Segway Human Transporter is priced at $5,000–$8,000 with a top speed of 12 mph and a range of 14–15 miles per charge. Intended for sidewalk use, the Segway is fairly manoeuvrable, but at more than 80 pounds it is less transportable than a bicycle.
Profiling, Cajun Style: Racial and Demographic Profiling in Louisiana's War on Drugs
Authors: Ruiz Jim , Woessner Matthew
Published: September 2006

Few topics are more sensitive to police and minority ethnic groups than racial profiling. Because this is a relatively new area of inquiry, researchers lack a comprehensive methodology for conducting inquiries into allegations of racial profiling. To date, most studies of profiling focus on alleged disparities between policing activities and aggregate population statistics. However, as a vast majority of this research cannot account for possible differences in group behaviour, it is impossible to conclude definitively that officers actually target minorities. By contrast, this study examines accusations of racial and demographic profiling by comparing arrest statistics between two overlapping police forces patrolling the same stretch of highway, during the same period of time. We theorise that the Louisiana State Police Criminal Patrol Unit (LSP-CPU) and certain deputies of the St Martin Parish Sheriff's Office (SMSO) conducted focused traffic stops on suspect populations in an effort to interdict drug trafficking along Interstate 10. Indeed, an examination of the arrest statistics between the CPU/SMSO and our baseline (Louisiana State Police Traffic Patrol) reveals dramatic discrepancies which are logically consistent with racial and demographic profiling on the part of the CPU/SMSO. Beyond its specific findings, the study provides a more reliable method by which researchers can assess accusations of profiling by other law enforcement agencies.
Addressing Organisationally Induced Stress in a Police Jurisdiction: An Australian Case Study
Authors: Stevens Stella , Muller Juanita , Kendall Elizabeth
Published: September 2006

Over 3,500 employees in a police jurisdiction have participated in a health promotion initiative designed to encourage staff to take responsibility for their health. This project was part of a range of initiatives to address workplace stress and involved physical and medical testing and advice. This paper presents the results of interviews with 83 participants about the impact of the programme on their health behaviours and the extent to which they feel it has helped them manage workplace stress better. Although health promotion in the workplace is often criticised as a common response by organisations seeking to reduce stress for their workforce by placing the responsibility for that back on to the individual, this study demonstrates that there can be several positive outcomes. Not least of these is a reported increase in morale due to the perception that the organisation acknowledged that stress was generated by the workplace and was acting to provide support. The vast majority of those interviewed also reported changed health behaviours. The factor which reduced the participation rate (38 per cent) in the opinion of those interviewed was, however, a lack of trust on the part of workers about the objectives of the programme. The study reported here contains information useful to those both planning workplace health promotion initiatives and those organisations seeking to reduce workplace stress.
Management Influences on Officer Traffic Enforcement Productivity
Authors: Johnson Richard R.
Published: September 2006

There is significant evidence that aggressive traffic enforcement strategies can have an impact on traffic safety, public disorder and street crime. However, individual patrol officers often devote different levels of effort to traffic patrol with some producing very high levels of citations and arrests, while others produce few or none at all. Therefore, it would be useful for police executives to know how they can effectively motivate officers to engage in high levels of traffic enforcement. This study evaluates a theoretical approach to motivating patrol officer productivity in the areas of traffic citations and drunk driver arrests, and applies this approach across a number of police agencies in one metropolitan area. The findings support this approach and suggest that patrol officer productivity in these two performance tasks is significantly predicted by management expectations, officer capability, officer opportunity, the perception of rewards, and the modelling of the behaviour by the officer's shift supervisor.
The New York City Police Department's Compstat: Dream or Nightmare?
Authors: Eterno John A. , Silverman Eli B.
Published: September 2006

The Compstat paradigm has revolutionised the way policing is accomplished in democratic countries. Many agencies throughout the world have emulated the Compstat programme which originated in New York City in 1994. The strengths of Compstat have been widely publicised: dramatic reductions in crime, accountability of key staff members, and coordination of various units within an agency.

The weaknesses of Compstat are less recognised: due process considerations, community relations, leadership issues, inadequate problemsolving. Weaknesses pose challenges and the authors present an alternative model to address these weaknesses. This model focuses on integrating community policing's essential components within the context of the Compstat paradigm. This provides a more powerful mechanism to combat crime and terrorism.
Automotive Mechatronic Systems – General Developments and Examples (Mechatronische Systeme in Kraftfahrzeugen – Allgemeine Entwicklungen und Beispiele)
Authors: Isermann Rolf
Published: September 2006

Automobiles are showing an increasing integration of mechanics with digital electronics and information processing. This integration is between the components (hardware) and by the information-driven functions (software), resulting in integrated systems called mechatronic systems. Their development involves finding an optimal balance between the basic mechanical structure, sensor and actuator implementation, communication, automatic information processing and overall control.

This contribution summarizes some ongoing developments for mechatronic systems in automobiles, shows design approaches and examples and considers the various embedded control functions and systems integrity. Some examples of automotive mechatronic systems are shown in more detail. Great progress can be observed in braking systems (ABS, ESP), the first brake-by-wire electro-hydraulic brake system (EHB), steering systems (electrical power steering, active front steering) and active suspension systems.
Feedback Control via AmI-Networks – Managing the Limited Resource Problem by QoS-Adaptive Control (Regelungen über ressourcenbeschränkte AmI-Netzwerke durch Adaption an die Quality of Service)
Authors: Litz Lothar , Gabel Oliver
Published: September 2006

Ambient Intelligence (AmI) systems are typically based on low-energy and low-performance nodes which are connected by wireless ad-hoc networks. Due to these constraints communication is restricted as well, as can be seen from the quality of service (QoS) parameters. If feedback control is used in AmI systems, two main effects are limiting the control performance and threatening the control stability: the variable network delays and the stochastic packet losses. The paper describes an approach taking into account these crucial parameters at the same time. This problem is solved by adapting the control law to the measured QoS parameters of the ad-hoc network. An example is discussed to show the advantages of the proposed QoS-adaptive control.
From H∞ Control to Multiobjective Control: An Overview (Von der H∞-Regelung zur Mehrziel-Regelung: ein Überblick)
Authors: Rieber Jochen M. , Allgöwer Frank
Published: September 2006

The well-known H∞ control paradigm is suited to handle quantitative control performance requirements and robustness considerations. This has led to a widespread use of this method for practical applications in academia and industry. In this paper, an overview on multiobjective control for linear systems is presented, including performance and robustness criteria based on H∞-, H2-, and l1-norms as well as direct time-domain constraints on the system responses. Different qualitative and quantitative control objectives treatable within this context are discussed with respect to their practical relevance. Two application examples exemplify the realization of control system requirements in such a multiobjective framework and the properties of computational relaxations.
Examination of the Validity of the Ionic Additivity Principle in the Determination of Single Ion Thermodynamic Properties
Authors: Bhattacharyya Ranjana , Lahiri Sujit Chandra
Published: September 2006

Single ion thermodynamic values of hydration or solvation (or solution) cannot be experimentally determined. The values are determinable from the thermodynamics of solvation ΔX0solv or soln(MX) [X=H,GorS] based on ionic additivity and using extrathermodynamic assumptions.

However, the principle of ionic additivity is not valid in the determination of single ion thermodynamic values [i.e.ΔG0solv(M+or X−) or ΔG0soln(M+or X−), ΔH0solv(M+or X−) or ΔH0soln(M+or X−)] but additivity principle appears to be valid for the determination of ΔS0solv or soln(M+or X−).

Moreover, appropriation of ΔG0solvor ΔH0solv(MX) equally on the basis of equality of radii of cations and anions is also not tenable due to differences in the effective charges of the cations and anions of equal radii.
Contribution to the Thermodynamics of Complexes of Alkali Metal Cations with Benzo-18-Crown-6 in the Water–Nitrobenzene Extraction System
Authors: Makrlík E. , Vaňura P.
Published: September 2006

From extraction experiments and γ-activity measurements, the exchange extraction constants corresponding to the general equilibrium M+(aq) + NaL+(nb) ⇔ ML+(nb) + Na+(aq) taking place in the two–phase water–nitrobenzene system (M+ = Li+, K+, Rb+, Cs+; L = benzo-18-crown-6; aq = aqueous phase, nb = nitrobenzene phase) were evaluated. Further, the stability constants of the ML+ complexes in water saturated nitrobenzene were calculated; they were found to increase in the cation order Cs+ < Rb+ < Li+ < Na+ < K+.
Quantum Thermodynamics of Entropy Production and Time – An Approach to Irreversibility
Authors: Zimmermann Herbert W.
Published: September 2006

We consider the temporal evolution of an isolated system of particles from a non-equilibrium state of entropy S = S′ to the equilibrium state of maximum entropy S = S
max, S′ ≤ S
max. The application of usual density matrix theory to the temporal development of S leads us to the unexpected result P = dS/dt = 0. The entropy does not change in time. This result is valid in case of the equilibrium state. However it is wrong for a non-equilibrium state, which could not irreversibly change from S′ to S
max by entropy production P > 0. This contradicts the second law of thermodynamics. The paradoxial result can be traced back to the Liouville theorem. To overcome this difficulty, we introduce the t–P space. The time t and the entropy production P are observables in quantum thermodynamics. They are defined by the eigenvalue equations t|t〉 = t|t〉 and P|P〉 = P|P〉. The operators t and P do not commute. We have a non-vanishing commutator, [t,P] = ik, and consequently a t–P uncertainty relation, ΔtΔP ≥ k/2. The Boltzmann constant k is characteristic of quantum thermodynamics and represents the atomic entropy unit. — The time evolution operator U(τ) = exp[−(i/k)τP] shifts the time t by τ, U(τ)|t〉 = |t + τ〉. The generator of τ is the operator P of entropy production. Then the eigenvector |P〉 is also an eigenket of U(t), and it follows with progressing time τ ≥ 0 that τP ≥ 0 and hence P = dS/dt ≥ 0. This is the second law of thermodynamics, which is correctly reproduced in quantum thermodynamics. — Exchanging −τ for +τ replaces the equations of forward time +τ by the equations of backward time −τ. Independent of the direction of the arrow of time, the entropy of the system always increases or remains constant in the limit of the equilibrium state, dS ≥ 0. This is characteristic of irreversibility, for the system does not return to its initial state on time reversal. — The t–P uncertainty relation allows to discuss the temporal evolution of the expectation value 〈P〉 of entropy production and the lifetime Δt of the transient states, the system passes through on approaching the equilibrium state. In case of a non-equilibrium state 〈P〉, ΔP, and Δt are finite. On approaching the equilibrium state, 〈P〉 and ΔP decrease, consequently Δt increases. Finally, in the case of equilibrium (eq), we have 〈P〉eq = 0, ΔP
eq = 0, and Δt
eq → ∞. The lifetime of the equilibrium state is unlimited, because the entropy production 〈P〉 and the uncertainty of entropy production ΔP exactly vanish. The temporal evolution of the system can be described by means of a phenomenological equation.
Density and Surface Tension of the System KF–K2TaF7–Ta2O5
Authors: Boča Miroslav , Ivanová Zuzana , Kucharík Marián , Cibulková Jarmila , Vasiljev Roman , Chrenková Marta
Published: September 2006

The density of the system KF–K2TaF7–Ta2O5 was measured by the Archimedean method and the surface tension by the maximum bubble pressure method in the composition range up to 20 mol% Ta2O5.

The density in the system KF–K2TaF7–Ta2O5 increases from KF through K2TaF7 to Ta2O5 and the surface tension increases from K2TaF7 through KF to Ta2O5. Based on the measured density values, the molar volumes of the binary and ternary melts at 860 °C, 900 °C and 950 °C were calculated as well as the partial molar volumes of particular components in different binaries. The small negative deviation from ideal behaviour in the binary system KF–K2TaF7 was identified by the calculation of the molar excess volume. The formation of complex anions [TaF8]3− is expected in this binary system.

The surface tension decreases monotonically from KF to K2TaF7 in the binary system KF–K2TaF7. In the next two binaries KF–Ta2O5 and K2TaF7–Ta2O5 decrease of the surface tension was observed with the initial addition of Ta2O5 followed by the increase of the surface tension by further addition of Ta2O5. Based on measured data it was concluded that in binaries KF–Ta2O5 and K2TaF7–Ta2O5 the surface active component is Ta2O5 and in the binary KF–K2TaF7 the surface active component is K2TaF7.

Mathematical description of the concentration dependence of the molar volume and surface tension of the measured ternary system was done by the polynomial function at 860°C, 900°C, and at 950°C.
Medium Effects on Dissociation Constants of Maleic and Malonic Acids in Acetone–Water Binary Mixtures. A Thermodynamic Study
Authors: Al-Juhaiman L. A. , Al-Alwan L. A. , Zaghloul A. A.
Published: September 2006

The pK
1 and pK
2 values of maleic and malonic acids were determined by using a precise EMF method in acetone–water media of varying solvent compositions at different temperatures. The thermodynamic functions of dissociation (ΔH°, ΔG°, and ΔS°) have been computed, discussed and analyzed in terms of solute–solvent interactions. The pK values have been correlated with both the mole fraction of the organic solvent and the distance between the dicarboxyl groups in each acid.
Neonatal Screening for Cystic Fibrosis Does Not Affect Time to First Infection WithPseudomonas aeruginosa
Authors: Baussano Iacopo , Tardivo Irene , Bellezza-Fontana Rossana , Forneris Maria Pia , Lezo Antonella , Anfossi Luciano , Castello Mario , Aleksandar Veljkovic , Bignamini Elisabetta
Published: September 2006

OBJECTIVE. Newborn screening for cystic fibrosis was introduced in the Piedmont region of Italy in the year 2000. Our aim with this study was to estimate the effect of newborn screening on the risk of Pseudomonas aeruginosa infection at the regional cystic fibrosis pediatric reference center.

METHODS. The time to first infection with P aeruginosa within the historical cohort of cystic fibrosis children diagnosed between January 1, 1997, and June 30, 2004, was investigated, comparing survival functions and the adjusted hazard ratio of children diagnosed before and after newborn screening introduction. The role of pancreatic insufficiency was also concurrently investigated.

RESULTS. Overall, 71 children diagnosed with cystic fibrosis were identified, 27 cases were clinically diagnosed before newborn screening introduction, and 5 of them presented with meconium ileus, whereas 44 were identified by newborn screening. Among them 35 needed pancreatic enzyme supplementation, whereas 34 children were infected with P aeruginosa. Both the nonparametric and semiparametric survival estimates failed to show any significant increase in the risk of P aeruginosa infection among screened children compared with historical controls. However, the median time from cystic fibrosis diagnosis to P aeruginosa infection among screened children was significantly shorter (183 vs 448 days). Children with impaired pancreatic function were at high risk of P aeruginosa infection.

CONCLUSIONS. The results of the study suggest that health authorities should regard newborn screening for cystic fibrosis as an opportunity to improve care and outcomes among affected children and shift the focus from whether it is appropriate to screen to how to optimize biomedical and psychosocial outcomes of screening.
Pediatricians' Knowledge, Training, and Experience in the Care of Children With Fetal Alcohol Syndrome
Authors: Gahagan Sheila , Sharpe Tanya Telfair , Brimacombe Michael , Fry-Johnson Yvonne , Levine Robert , Mengel Mark , O'Connor Mary , Paley Blair , Adubato Susan , Brenneman George
Published: September 2006

OBJECTIVES. Prenatal exposure to alcohol interferes with fetal development and is the leading preventable cause of birth defects and developmental disabilities. The purpose of this study was to identify current knowledge, diagnosis, prevention, and intervention practices related to fetal alcohol syndrome and related conditions by members of the American Academy of Pediatrics.

METHODS. This study was developed collaboratively by the American Academy of Pediatrics and the Centers for Disease Control and Prevention. Questionnaires were mailed to a 3% random sample (n = 1600) of American Academy of Pediatrics members in the United States. General pediatricians, pediatric subspecialists, and pediatric residents were included.

RESULTS. Participation rate was 55% (n = 879). Respondents almost universally knew the teratology and clinical presentation of fetal alcohol spectrum disorders. However, they were less likely to report comfort with routine pediatric care of these children. Whereas 62% felt prepared to identify and 50% felt prepared to diagnose, only 34% felt prepared to manage and coordinate the treatment of children with fetal alcohol spectrum disorders. Even fewer (n = 114 [13%]) reported that they routinely counsel adolescent patients about the risks of drinking and pregnancy.

CONCLUSIONS. The survey confirms that pediatricians are knowledgeable about fetal alcohol syndrome but do not feel adequately trained to integrate the management of this diagnosis or prevention efforts into everyday practice. Furthermore, the respondents were not active in routine anticipatory guidance with adolescents for prevention of alcohol-affected pregnancies. The development, dissemination, and implementation of best practice tools for prevention, diagnosis, and referral of fetal alcohol syndrome that are specific for general and subspecialist pediatricians are recommended.
Are Encephaloceles Neural Tube Defects?
Authors: Rowland Courtney A. , Correa Adolfo , Cragan Janet D. , Alverson Clinton J.
Published: September 2006

OBJECTIVE. Encephalocele is classified as a neural tube defect, but questions have been raised regarding whether its epidemiological characteristics are similar to those of other neural tube defects.

DESIGN. We compared characteristics of temporal trends in, and the impact of folic acid grain fortification on, the prevalence of encephalocele, spina bifida, and anencephaly using data from the Metropolitan Atlanta Congenital Defects Program, a population-based birth defects surveillance system. Prevalences of encephalocele, spina bifida, and anencephaly were compared by maternal age, gender, race, birth weight, ascertainment period (1968–1981, 1982–1993, or 1994–2002), and fortification period (1994–1996 [prefortification] and 1998–2002 [postfortification]) using prevalence ratios with 95% confidence intervals. Temporal trends were assessed using Poisson and negative binomial regression models.

RESULTS. Prevalence rates of encephalocele (n = 167), spina bifida (n = 650), and anencephaly (n = 431) were 1.4, 5.5, and 3.7 per 10 000 live births, respectively. Encephalocele was similar to anencephaly in showing an increased prevalence among girls and multiple gestation pregnancies and to spina bifida and anencephaly in an annual prevalence decrease between 1968 and 2002 (−1.2% for encephalocele, −4.2% for spina bifida, and −3.6% for anencephaly). With fortification, prevalence decreased for spina bifida but not significantly for encephalocele or anencephaly.

CONCLUSIONS. Encephalocele shows more similarities to spina bifida or anencephaly than it shows differences with respect to characteristics, temporal trend, and impact of fortification. Additional studies should be done to explore the etiologic heterogeneity of encephalocele using better markers of folate status and a wider range of risk factors.
Maternal Depression and Violence Exposure: Double Jeopardy for Child School Functioning
Authors: Silverstein Michael , Augustyn Marilyn , Cabral Howard , Zuckerman Barry
Published: September 2006

OBJECTIVE. The goal was to determine how violence exposure affects the relationship between maternal depression, cognitive ability, and child behavior.

METHODS. A multivariate regression analysis of data for a nationally representative sample of kindergarten students was performed. Maternal depression and violence exposure were measured with standardized parent interviews. Standardized T scores were derived from direct testing of children in reading, mathematics, and general knowledge; child behavior was reported by teachers.

RESULTS. A total of 9360 children had neither maternal depression nor violence exposure, 779 violence only, 1564 depression only, and 380 both. Maternal depression alone was associated with poorer mean T scores for reading, mathematics, and general knowledge. However, this effect was attenuated by nearly 25% for reading and general knowledge with adjustment for violence. Children with concurrent exposure to depression and violence had lower mean T scores for reading, mathematics, and general knowledge, as well as more-concerning behaviors, than did those exposed to either factor alone. Across all outcome measures, boys seemed more affected than girls.

CONCLUSIONS. Violence compounds the effect of maternal depression on school functioning and behavior. Research and intervention planning for children affected by maternal depression should consider violence exposure.
Rural and Urban Children With Asthma: Are School Health Services Meeting Their Needs?
Authors: Hillemeier Marianne M. , Gusic Maryellen E. , Bai Yu
Published: September 2006

OBJECTIVE. Children with asthma spend a large portion of their day in school, and the extent to which public schools are prepared to meet their health needs is an important issue. The objective of this study was to identify asthma policies and practices in rural and urban school settings and to compare them with current National Heart, Lung, and Blood Institute recommendations.

METHODS. A stratified random sample of school nurses who represented each of the 500 active Pennsylvania school districts were surveyed in 2004 concerning nurse staffing patterns, availability of asthma monitoring and treatment-related equipment, emergency preparedness, availability of asthma-related support and case management services, school-specific procedures including identification of children with asthma and accessibility of inhaler medication during school hours, presence and content of written asthma management plans, and perceived obstacles to asthma management in the school setting. Sampling weights were incorporated into the analyses to take the survey design into account.

RESULTS. The overall response rate was 76%, with a total of 757 surveys analyzed. In more than half of secondary schools and three quarters of elementary schools, nurses were present <40 hours per week. Nearly 1 in 5 schools reported that staff who know what to do for a severe asthma attack were not always available. In 72% of rural schools, children were allowed to self-carry rescue inhalers, as compared with 47% of urban schools. Asthma management plans were on file for only 1 quarter of children with asthma, and important information often was omitted. Approximately half of the schools were equipped with peak flow meters and nebulizers, and spacers were available in 1 third of schools.

CONCLUSIONS. Improvements are needed to bring schools into compliance with current recommendations, including more consistent availability of knowledgeable staff, improved access to asthma monitoring and treatment-related equipment, more universal use of asthma management plans, and greater access to inhalers while at school, including increasing the proportion of children who are allowed to carry and self-administer inhaler medication.
Matters of Spirituality at the End of Life in the Pediatric Intensive Care Unit
Authors: Robinson Mary R. , Thiel Mary Martha , Backus Meghan M. , Meyer Elaine C.
Published: September 2006

OBJECTIVE. Our objective with this study was to identify the nature and the role of spirituality from the parents' perspective at the end of life in the PICU and to discern clinical implications.

METHODS. A qualitative study based on parental responses to open-ended questions on anonymous, self-administered questionnaires was conducted at 3 PICUs in Boston, Massachusetts. Fifty-six parents whose children had died in PICUs after the withdrawal of life-sustaining therapies participated.

RESULTS. Overall, spiritual/religious themes were included in the responses of 73% (41 of 56) of parents to questions about what had been most helpful to them and what advice they would offer to others at the end of life. Four explicitly spiritual/religious themes emerged: prayer, faith, access to and care from clergy, and belief in the transcendent quality of the parent-child relationship that endures beyond death. Parents also identified several implicitly spiritual/religious themes, including insight and wisdom; reliance on values; and virtues such as hope, trust, and love.

CONCLUSIONS. Many parents drew on and relied on their spirituality to guide them in end-of-life decision-making, to make meaning of the loss, and to sustain them emotionally. Despite the dominance of technology and medical discourse in the ICU, many parents experienced their child's end of life as a spiritual journey. Staff members, hospital chaplains, and community clergy are encouraged to be explicit in their hospitality to parents' spirituality and religious faith, to foster a culture of acceptance and integration of spiritual perspectives, and to work collaboratively to deliver spiritual care.
Pheochromocytoma and Paraganglioma in Children: A Review of Medical and Surgical Management at a Tertiary Care Center
Authors: Pham Tuan H. , Moir Christopher , Thompson Geoffrey B. , Zarroug Abdalla E. , Hamner Chad E. , Farley David , van Heerden Jon , Lteif Aida N. , Young William F.
Published: September 2006

OBJECTIVE. The aim of this study was to review our institutional experience managing pheochromocytomas and paragangliomas in children.

METHODS. A retrospective chart review of the Mayo Clinic database from 1975 to 2005 identified 30 patients <18 years of age with histologically confirmed pheochromocytoma or paraganglioma.

RESULTS. There were 12 patients with pheochromocytomas and 18 with paragangliomas. The most common presenting symptoms were hypertension (64%), palpitation (53%), headache (47%), and mass-related effects (30%). Nine patients (30%) had a genetic mutation or documented family history of pheochromocytoma or paraganglioma. Fourteen patients (47%) had malignant disease, whereas 16 (53%) had benign disease. Logistic analysis showed that statistically significant risk factors for malignancy were (1) paraganglioma, (2) apparently sporadic, as opposed to familial, pheochromocytoma or paraganglioma, and (3) tumor size of >6 cm. Surgical resection was performed for 28 patients (93%), with perioperative mortality and major morbidity rates of 0% and 10%, respectively. Resection achieved symptomatic relief for 25 patients (83%). All patients with benign disease appeared cured after resection. For patients with malignant disease, the 5- and 10-year disease-specific survival rates were 78% and 31%, respectively, and the mean survival time was 157 ± 32 months.

CONCLUSIONS. The incidence of malignant pheochromocytoma/paraganglioma was high in children (47%), particularly those with apparently sporadic disease, paraganglioma, and tumor diameters of >6 cm. Patients with a known genetic mutation or familial pheochromocytoma/paraganglioma were more likely to achieve resection with negative microscopic margins and had improved disease-specific mortality rates. Surgical resection remains the treatment of choice for pheochromocytoma and paraganglioma.
Child Maltreatment in the United States: Prevalence, Risk Factors, and Adolescent Health Consequences
Authors: Hussey Jon M. , Chang Jen Jen , Kotch Jonathan B.
Published: September 2006

OBJECTIVES. The purpose of this study was to estimate the prevalence of child maltreatment in the United States and examine its relationship to sociodemographic factors and major adolescent health risks.

METHODS. The National Longitudinal Study of Adolescent Health is a prospective cohort study following a national sample of adolescents into adulthood. The wave III interview, completed by 15 197 young adults in 2001–2002 (77.4% response rate), included retrospective measures of child maltreatment. We used these measures to estimate the prevalence of self-reported supervision neglect, physical neglect, physical assault, and contact sexual abuse during childhood. Next, we investigated the relationship between sociodemographic characteristics and maltreatment. Finally, we examined the association between child maltreatment and adolescent self-rated health; overweight status; depression; cigarette, alcohol, marijuana, and inhalant use; and violent behavior.

RESULTS. Having been left home alone as a child, indicating possible supervision neglect, was most prevalent (reported by 41.5% of respondents), followed by physical assault (28.4%), physical neglect (11.8%), and contact sexual abuse (4.5%). Each sociodemographic characteristic was associated with ≥1 type of maltreatment, and race/ethnicity was associated with all 4. Each type of maltreatment was associated with no fewer than 8 of the 10 adolescent health risks examined.

CONCLUSIONS. Self-reported childhood maltreatment was common. The likelihood of maltreatment varied across many sociodemographic characteristics. Each type of maltreatment was associated with multiple adolescent health risks.
Simultaneous Multigene Mutation Detection in Patients With Sensorineural Hearing Loss Through a Novel Diagnostic Microarray: A New Approach for Newborn Screening Follow-up
Authors: Gardner Phyllis , Oitmaa Eneli , Messner Anna , Hoefsloot Lies , Metspalu Andres , Schrijver Iris
Published: September 2006

OBJECTIVE. The advent of universal newborn hearing screening in the United States and other countries, together with the identification of genes involved in the process of hearing, have led to an increase in both the need and opportunity for accurate molecular diagnosis of patients with hearing loss. Deafness and hearing impairment have a genetic cause in at least half the cases. The molecular genetic basis for the majority of these patients remains obscure, however, because of the absence of associated clinical features in ∼70% (ie, nonsyndromic hearing loss) of patients, genetic heterogeneity, and the lack of molecular genetic tests that can evaluate a large number of mutations across multiple genes.

DESIGN. We report on the development of a diagnostic panel with 198 mutations underlying sensorineural (mostly nonsyndromic) hearing loss. This panel, developed on a microarray, is capable of simultaneous evaluation of multiple mutations in 8 genes (GJB2, GJB6, GJB3, GJA1, SLC26A4, SLC26A5 and the mitochondrial genes encoding 12S rRNA and tRNA-Ser[UCN]).

RESULTS. The arrayed primer extension array for sensorineural hearing loss is based on a versatile platform technology and is a robust, cost-effective, and easily modifiable assay. Because hearing loss is a major public health concern and common at all ages, this test is suitable for follow-up after newborn hearing screening and for the detection of a genetic etiology in older children and adults.

CONCLUSIONS. Comprehensive and relatively inexpensive genetic testing for sensorineural hearing loss will improve medical management for affected individuals and genetic counseling for their families.
Changing Their Minds With Time: A Comparison of Hypothetical and Actual Reproductive Behaviors in Parents of Children With Cystic Fibrosis
Authors: Sawyer Susan M. , Cerritelli Belinda , Carter Lucy S. , Cooke Mary , Glazner Judith A. , Massie John
Published: September 2006

OBJECTIVE. Newborn screening for cystic fibrosis, with appropriate counseling, enables carrier parents to be informed early about future reproductive choices. Previous studies have assessed attitudes toward reproductive decisions in a hypothetical pregnancy or have measured reproductive behaviors. We aimed to measure parent attitudes to reproductive technologies and to compare prospectively these attitudes with later reproductive behaviors.

METHODS. Parents of children who had cystic fibrosis and were aged 2 to 7 years were surveyed at baseline using a written questionnaire that explored attitudes to prenatal testing and termination of pregnancy in a hypothetical pregnancy. Parent knowledge and access to genetic counseling services also were assessed. Five years later, we compared attitudes with actual reproductive behaviors.

RESULTS. Fifty-six mothers participated at baseline, and 43 were resurveyed 5 years later. Parent knowledge of cystic fibrosis and genetics was very good. A total of 93% had met a genetic counselor at the time of diagnosis, and more than half had on at least 1 subsequent occasion. At baseline, 82% reported that they would be likely to have prenatal diagnosis in a subsequent pregnancy, and 56% reported that they would be likely to terminate an affected pregnancy. Twenty-seven mothers since had been pregnant, with prenatal diagnosis used in 33 of the 55 pregnancies. In 67%, the hypothetically reported behavior regarding use of prenatal testing was the same as their actual behavior. Five of the 33 tested pregnancies were affected; all ended in termination. Reproductive choices in relationship to the number of children wanted, together with attitudes toward prenatal diagnosis and termination of pregnancy, were dynamic over time, with decisions having changed in both directions.

CONCLUSIONS. This cohort of parents has actively used reproductive technologies since the birth of a child who has cystic fibrosis that was diagnosed by newborn screening. The dynamic aspect of reproductive choices highlights the importance of ongoing access to genetic counseling beyond the initial period of diagnosis and education, regardless of whether parents report that they expect to use reproductive technologies.
Role of Pediatric Health Care Professionals in the Provision of Parenting Advice: A Qualitative Study With Mothers From 4 Minority Ethnocultural Groups
Authors: Dumont-Mathieu Thyde M. , Bernstein Bruce A. , Dworkin Paul H. , Pachter Lee M.
Published: September 2006

OBJECTIVE. This study's aim was to elicit the perspectives of minority parents on their expectations of pediatric health care providers as a source of advice on “raising their child” and whether they would seek advice from these providers. A secondary aim was to demonstrate the value of qualitative methods for assessing parental attitudes in pediatric research.

METHODS. Mothers with children between 3 and 12 years of age who identified themselves as African American, Jamaican, Haitian, or Puerto Rican were recruited from community sites. Audiotaped focus groups were conducted by trained moderators using an interview guide, to obtain the perspectives of the participants regarding the role of pediatric providers in the provision of parenting advice.

RESULTS. Ninety-one mothers participated in a total of 20 focus groups, with 4 to 6 discussions per ethnocultural group. The focus groups revealed that, in general, parents do not look to child health care providers for advice on raising their children. The identified themes emphasized the importance of the relationship between providers and families. A few parents had the type of relationship within which the pediatrician already functioned as a provider of parenting advice. Physicians were considered skilled in the maintenance of physical health. The parents expressed a desire to receive more anticipatory guidance on developmental and behavioral stages and milestones. Pediatricians also served specific administrative functions valued by parents.

CONCLUSIONS. Minority parents of preschool-aged and school-aged children do not view the primary care provider's role as including the provision of parenting advice. Expectations must be modified to enable health care professionals to function effectively in the role of advisor regarding parenting issues.
Surveillance for Influenza Admissions Among Children Hospitalized in Canadian Immunization Monitoring Program Active Centers, 2003–2004
Authors: Moore Dorothy L. , Vaudry Wendy , Scheifele David W. , Halperin Scott A. , Déry Pierre , Ford-Jones Elizabeth , Arishi Haider M. , Law Barbara J. , Lebel Marc , Le Saux Nicole , Grimsrud Karen , Tam Theresa
Published: September 2006

OBJECTIVES. Influenza is a common childhood infection that may result in hospitalization. Our objectives were to (1) determine characteristics of children hospitalized for influenza and disease manifestations and (2) obtain baseline data before implementation of new recommendations for routine immunization of young children and their caretakers against influenza.

METHODS. All of the children hospitalized with laboratory-confirmed influenza at 9 Canadian tertiary care hospitals during the 2003–2004 influenza season were identified from virology laboratory reports, and their charts were reviewed.

RESULTS. There were 505 children admitted because of influenza. Fifty-seven percent were <2 years old. Previously healthy children accounted for 58% of all of the cases. Pulmonary and neurologic disorders were the most common underlying chronic conditions. Fever and cough were the most frequent manifestations. Seizures occurred in 9% of cases. Serious complications included myocarditis (2), encephalopathy (6), and meningitis (1). There were 3 influenza-related deaths. Mean duration of hospitalization was 5.3 days. Twelve percent of children required ICU admission, and 6% required mechanical ventilation. Antibiotic therapy was administered in 77% of cases, and 7% received anti-influenza drugs. Information on influenza vaccination was available for 84 of 154 children identified as vaccine candidates. Twenty two had received vaccine, but only 7 children had been fully immunized >14 days before the onset of illness.

CONCLUSIONS. Healthy young children and children with chronic conditions are at risk for serious illness with influenza. Ongoing surveillance is needed to evaluate the impact of changing immunization recommendations on the burden of influenza illness in children.
Immunogenicity and Safety of an Inactivated Hepatitis A Vaccine Administered Concomitantly With Diphtheria-Tetanus-Acellular Pertussis and Haemophilus influenzae Type B Vaccines to Children Less Than 2 Years of Age
Authors: Nolan Terry , Bernstein Henry , Blatter Mark M. , Bromberg Kenneth , Guerra Fernando , Kennedy William , Pichichero Michael , Senders Shelly D. , Trofa Andrew , Collard Alix , Sullivan Diane C. , Descamps Dominique
Published: September 2006

OBJECTIVE. The availability of a hepatitis A virus vaccine for infant and early childhood immunization could reduce the transmission of hepatitis A virus in the United States. This study evaluated the immunogenicity and safety of a hepatitis A virus vaccine (Havrix, GlaxoSmithKline Biologicals, Rixensart, Belgium) administered concomitantly with diphtheria-tetanus-acellular pertussis and Haemophilus influenzae type b vaccines to children <2 years.

METHODS. In this open, comparative, multicenter study, 1084 healthy children aged 11 to 25 months were allocated (4:4:3:3:4 ratio) to 5 treatment groups based on age and previous vaccination history. Subjects 11 to 13 months of age received 2 doses of hepatitis A virus vaccine 6 months apart (N = 243). Subjects aged 15 to 18 months received 2 doses of hepatitis A virus vaccine 6 months apart (N = 241); or hepatitis A virus vaccine, diphtheria-tetanus-acellular pertussis, and H influenzae type b at month 0 and the second dose of hepatitis A virus vaccine 6 months later (N = 183); or diphtheria-tetanus-acellular pertussis and H influenzae type b at month 0 and hepatitis A virus vaccine at months 1 and 7 (N = 175). Subjects 23 to 25 months of age received hepatitis A virus vaccine at months 0 and 6 (N = 242). Immune responses were measured at baseline and 30 days after vaccine doses, and solicited and unsolicited adverse events were collected.

RESULTS. After 2 doses of hepatitis A virus vaccine, all of the subjects in all of the groups were seropositive. Coadministration of hepatitis A virus vaccine with diphtheria-tetanus-acellular pertussis and H influenzae type b vaccines did not impact the immunogenicity of the 3 vaccines, except for the antipertussis toxoid vaccine response, which was slightly decreased. Hepatitis A virus vaccine was well tolerated in children 11 to 25 months of age.

CONCLUSION. The administration of 2 doses of hepatitis A virus vaccine on a 0- and 6-month schedule starting at 11 to 13 months of age or at 15 to 18 months of age was as immunogenic and well tolerated as the administration of 2 doses in children 2 years of age. Immune responses to diphtheria-tetanus-acellular pertussis and H influenzae type b either given alone or coadministered with hepatitis A virus vaccine were similar except for antipertussis toxoid response.
Cost-effectiveness of 4 Neonatal Screening Strategies for Cystic Fibrosis
Authors: van den Akker-van Marle M. Elske , Dankert Hinke M. , Verkerk Paul H. , Dankert-Roelse Jeannette E.
Published: September 2006

OBJECTIVES. The purpose of this work was to assess the costs of 4 neonatal screening strategies for cystic fibrosis in relation to health effects. In each strategy, the first test was the measurement of serum concentration of immunoreactive trypsin. The second step consisted of either a second immunoreactive trypsin test (strategy 1) or a multiple mutation analysis (strategy 2). In strategies 3 and 4, a third step was added to strategy 2: a second immunoreactive trypsin test (strategy 3) or an extended mutation analysis of the cystic fibrosis gene, that is, a denaturing gradient gel electrophoresis analysis (strategy 4).

METHODS. We conducted an economic-modeling exercise in the Netherlands based on published data and expert opinions. Subjects were a hypothetical cohort of 200 000 neonates, the approximate number of children born annually in the Netherlands, and we assessed the costs and number of life-years gained as a result of neonatal screening for cystic fibrosis. The costs and effects of changes in reproductive decisions because of neonatal screening were also assessed.

RESULTS. Immunoreactive trypsin + immunoreactive trypsin had the most favorable cost-effectiveness ratio of €24800 per life-year gained. Immunoreactive trypsin + DNA + denaturing gradient gel electrophoresis achieved more health effects than immunoreactive trypsin + DNA + immunoreactive trypsin at lower cost. The incremental costs per life-year gained of the immunoreactive trypsin + DNA + denaturing gradient gel electrophoresis strategy compared with the immunoreactive trypsin + immunoreactive trypsin strategy were €130700, whereas the incremental costs of the immunoreactive trypsin + DNA strategy compared with the immunoreactive trypsin + DNA + denaturing gradient gel electrophoresis strategy were €2154300. When changes in reproductive decisions as a result of neonatal screening are also taken into account, neonatal screening for cystic fibrosis may lead to financial savings of approximately €1.8 million annually, depending on the screening strategy used.

CONCLUSIONS. Cystic fibrosis screening for neonates is a good economic option, and positive health effects can also be expected. Immunoreactive trypsin + immunoreactive trypsin and immunoreactive trypsin + DNA + denaturing gradient gel electrophoresis are the most cost-effective strategies.
Smoking Prevention and Cessation Intervention Delivery by Pediatric Providers, as Assessed With Patient Exit Interviews
Authors: Pbert Lori , Fletcher Kenneth E. , Flint Alan J. , Young Martin H. , Druker Susan , DiFranza Joseph
Published: September 2006

OBJECTIVE. The goal was to evaluate the degree to which a smoking prevention and cessation intervention was delivered by providers to adolescents in the pediatric office setting.

METHODS. Eight pediatric clinics in central Massachusetts were assigned randomly to either a special intervention (brief pediatric provider-delivered intervention plus peer counseling) or the usual care condition. Subjects (n = 2710) were adolescents 13 to 17 years of age, both smokers (smoked in the past 30 days) and nonsmokers/former smokers. The degree to which smoking prevention and treatment interventions were delivered by providers was assessed through patient exit interviews with adolescents after their clinic visits; interviews assessed the occurrence of 10 possible intervention steps.

RESULTS. The percentage of providers engaging in the smoking interventions differed significantly between the special intervention and usual care conditions, according to adolescent reports in the patient exit interviews. For nonsmokers/former smokers, overall patient exit interview scores were 7.24 for the special intervention condition and 4.95 for the usual care condition. For current smokers, overall patient exit interview scores were 8.40 and 6.24 for the special intervention and usual care conditions, respectively. Intervention fidelity of special intervention providers was 72.2% and 84.0% for nonsmokers/former smokers and current smokers, respectively.

CONCLUSIONS. Pediatric providers who receive training and reminders to deliver a brief smoking prevention and cessation intervention to adolescents in the context of routine pediatric primary care practice can do so feasibly and with a high degree of fidelity to the intervention protocol.