bluuebunny/crossref_metadata_2025 huggingface dataset:
Causes of homing behaviour in a group living reef fish
Authors: Kolm N.
Published: December 2003

Homing is a common feature in fish, where for instance many freshwater species return to their place of birth to reproduce. Homing in marine species is, however, less understood. Such homing behaviour may be explained by fitness advantages from staying in a known physical environment as well as a known social environment. Cardinalfish of the family of Apogonidae are small, schooling fish, common in shallow waters in temperate and tropical seas. They form apparently stable group structures both in space and time and it has been shown that they may return to their home site after being experimentally removed up to several kilometres. In order to disentangle whether this homing behaviour in one such cardinalfish species, the Banggai cardinalfish, is driven by preference for the home locality or their original social group, I performed a two part field experiment. Firstly, individuals were allowed to choose between known individuals from their original group and unknown individuals from another group. Secondly, individuals were allowed to choose between their original location inhabited by unknown individuals from another group, and a new location inhabited by individuals from their original group. I discuss the evolution of homing behaviours in fish in light of these experiments.
Social networks in fish
Authors: Krause J. , Croft D. , James R.
Published: December 2003

Social network theory underwent rapid development in the 1970s by sociologists and was recently further refined by physicists. Network theory has been applied to systems consisting of interconnected components as different as that of actors in Hollywood, the neural network of the nematode worm Caenorhabditis elegans, and the US national power grid. Network theory has great potential as a conceptual tool, for example, it can be used to provide quantitative predictions regarding information transmission, spreading of diseases, and the potential for establishing reciprocal altruistic relationships. Conventionally behavioural studies have been restricted to the analysis of social interactions between isolated pairs or small groups of individuals. Here we built up, however, from pair‐wise interactions, the social network of an entire population of guppies (Poecilia reticulata) in Trinidad. We show that guppies have highly structured social networks with significant repeated interactions between male–male, female–female and male–female pairs. Furthermore, sexual segregation within the network is positively correlated with the strength of the social interactions. Finally, individuals were observed to be more variable in their inter‐sexual interactions than their intra‐sexual ones.
Fish don’t read textbooks: juvenile salmon prove ignorant of foraging theory
Authors: MacLean A. , Huntingford F. A. , Armstrong J. D. , Ruxton G. D.
Published: December 2003

The rules governing the selection of feeding patches by foraging animals is an area of intense interest. Much work has focussed on the development of theoretical models that predict when individuals should switch patches. Tests of these models have often been conducted in laboratory environments, but it is not clear how much influence patch‐switching decisions have on population‐level parameters such as growth and distribution in more complex natural environments. We used juvenile Atlantic salmon as a model species to investigate the effects of randomly fluctuating food levels on growth and site selection. We used PIT technology to monitor in detail individuals’ patterns of patch use and activity in an artificial stream, at natural densities. This allowed us experimental control of food supplies and sufficient replication, while retaining many features of a natural system. Only a few individuals of high social rank switched patches as predicted by an appropriate foraging model; otherwise, although frequent, patch‐switching was not related to food availability. Thus, while laboratory experiments indicate that this species has the potential to choose foraging sites on the basis of food availability, it is unlikely that this behavioural mechanism is of great importance in natural systems; further tests of foraging models under natural conditions are essential if we are to understand their effects at the level of populations.
Territorial and foraging behaviour of two corallivorous butterflyfishes
Authors: Righton D.
Published: December 2003

The territorial and foraging behaviour of two Red Sea butterflyfish species was studied at three sites in the Gulf of Aqaba. Chaetodon austricaus, a generalist corallivore that exploited evenly distributed food resources, maintained exclusive pair territories. Individuals fed by grazing for brief periods on a coral colony before moving to the next. In contrast, C. trifascialis, a specialist corallivore that exploited patchily distributed food resources, demonstrated considerable variation in territorial behaviour that ranged from the defence of exclusive solitary territories, to the shared use of a large home range. Individuals showed highly variable feeding behaviour, from grazing analogous to C. austriacus, to continual use of a single large coral colony. The results of this study demonstrate how the use of space by individuals depends critically upon the distribution of key food resources. In addition, the results demonstrate that foraging behaviour of territorial butterflyfish can be quite plastic, and adapt to local conditions.
The European bitterling: a model for oviposition decision
Authors: Smith C.
Published: December 2003

For oviparous species, oviposition decisions can have significant fitness consequences. The European bitterling (Rhodeus sericeus) is a cyprinid fish that lays its eggs on the gills of freshwater mussels. Because bitterling use a discrete spawning site that can be readily manipulated, they are unusually amenable to field and laboratory studies aimed at understanding the adaptiveness and consequences of oviposition decisions. Here I present data demonstrating the adaptiveness of oviposition decisions by female bitterling, and link these decisions, using game‐theory models, with bitterling population dynamics. I explain the proximate cues used by females in making oviposition choices, and how these respond to environmental variables. I also show how the oviposition decisions of males relate to the risk of sperm competition in mussels, and propose that oviposition choices may represent an inter‐sexual conflict in bitterling. Finally, I present behavioural and genetic data from mesocosm experiments to show the implications of global and local male densities for female oviposition opportunities, and consider the consequences for bitterling population dynamics.
Behavioural strategies for species co‐existence during environmental extremes: competition between trout and salmon parr during dewatering
Authors: Stradmeyer L. , Höjesjö J. , Armstrong J. , Griffiths S.
Published: December 2003

Competition between species of animals can be predicted to be intense under extreme environmental conditions during which niche overlap increases. Fluvial aquatic systems fluctuate naturally across a broad range of time‐scales. Land management activities impose further extreme fluctuations, particularly when water is abstracted for irrigation during summer. This study focused on the interaction between Atlantic salmon and brown trout parr during acute dewatering events. Brown trout are known to compete strongly for pool habitat whereas salmon can coexist by using riffle areas during normal flows. It is not known, however, how competition between the species affects their behavioural responses to extreme low flows when riffle areas decrease. Replicated groups of salmon were held in allopatry and sympatry with trout in sections of a large indoor stream, each of which was landscaped into riffles and pools. Space use and behaviours of the fish were recorded by direct visual observations and a network of Passive Integrated Transponder detectors. Here we report the response of the fish to dewatering and consider the system as a model for natural and forced responses of communities to environmental extremes.
Individual differences in microhabitat use in a caribbean cleaning goby: a buffer effect in a marine species?
Authors: Whiteman E. A. , Côté I. M.
Published: December 2003

Buffer effects occur when changes in population size result in the disproportionate use of poor‐quality sites or habitats. For species for which direct measurements of fitness differences between individuals are not possible, assessment of the temporal and spatial variations in patterns of habitat occupancy can therefore, shed light on the differences in quality between habitats and the individual fitness consequences of habitat choice. We provide the first evidence of the potential operation of a buffer effect for a site‐attached marine species. Caribbean cleaning gobies Elacatinus prochilos occupy coral and sponge substrata on fringing reefs in Barbados. Cleaning gobies at coral cleaning stations are frequently solitary or found in small groups, and spend 25 times longer cleaning than those on sponge. In contrast, sponge‐dwelling gobies exhibit highly stable, size‐structured dominance hierarchies in which, larger individuals are able to monopolize areas inside the sponge lumen with the highest abundance of the polychaete Haplosyllis spp, a favoured prey item. For adults, resource selection indices suggested a preference for sponge occupancy. As cleaning goby population size increased, however, the number of adult cleaning gobies occupying sponge substrata increased more rapidly than the number occupying coral habitat. Our results suggest that coral may be the preferred habitat, but in Barbados this habitat becomes saturated at very low population densities as a consequence of low client densities and ectoparasite loads. A larger proportion of the population, therefore, occupies sponge at most observed population densities. A population shift towards sponge rather than coral occupancy occurs between recruitment and maturity and may arise as a combination of differing survival of recruits and juveniles on coral and sponge and active movement of individuals towards sponge. Our results demonstrate that behavioural interactions are an integral part of population distribution and dynamics and are therefore, important in future studies of habitat choice and its associated fitness consequences.
Parasites as indicator of fish behaviour
Authors: Malek M.
Published: December 2003

In the present study two species of gobies, Pomatoschistus microps and P. minutus from southwest Wales were studied and appearance of some unusual parasite of gobies, were used as an indicator for fish behaviour. The occurrence of pleurocercoids of Ligula intestinalis in the body cavity of these fish and Proteocephalus sp., excysted metacercariae and adult of Timoniella spp., excysted metacercariae of Bucephalusbaeri, the excysted metacercariae of Podocotyle atomon and progenetic adult of Bucephaloides gracilescens in their gut indicate host anadromous, cannibalistic and scavenging behaviour.
The bitterling–mussel symbiosis: a model for host‐parasite adaptation
Authors: Reichard M.
Published: December 2003

Bitterlings (Acheilognatinae) are a monophyletic group of cyprinid fishes that lay their eggs in the gill chamber of freshwater mussels. They have evolved many behavioural, morphological and physiological adaptations to the symbiosis. Female bitterling develop a long ovipositor that insert into the exhalant siphon of a mussel and males fertilize the eggs by releasing sperm over the inhalant siphon of the mussel. Embryos hatch within 2 days but develop inside the mussel for further 3 to 6 weeks. Embryos are adapted to the low oxygen environment in the mussel's gill chamber. Both males and females discriminate among mussels in relation to their quality as host for developing embryos. On the other hand, mussels used for oviposition have larvae that obligate ectoparasites on fish. Here I review current knowledge on the status of the symbiosis, developmental and behavioural adaptations by bitterling and mussel and summarize costs and benefits to both symbionts. Further, I use a recent well‐resolved bitterling phylogeny to emphasize the potential of this model system to study the evolution of this symbiosis, which is a part of the ongoing study.
Sex differences in dogfish behaviour: alternative activity patterns and habitat choice
Authors: Wearmouth V. J. , Sims D. W. , Partridge J. C. , Cuthill I. C.
Published: December 2003

Acoustic tracking of wild lesser spotted dogfish, Scyliorhinus canicula, in Lough Hyne, a tidal sea‐water lough in southwest Ireland, has demonstrated that the sexes exhibit alternative behaviours. Male dogfish remain active throughout the day and night in deep water (12–24 m), and forage in shallow or deep water by night. Female dogfish, on the other hand, refuge in shallow water caves by day (<3 m), but undertake nocturnal foraging excursions into deep or very shallow water every two or three nights. These nocturnal foraging excursions are comparatively more extensive than those undertaken by the males. Here I report on recent laboratory experiments which have been conducted in an attempt to determine whether the baseline activity patterns of the sexes differ, and therefore, underlie these sex‐based alternative strategies.
Neonatal Group B streptococcal infection at the Mount Hope Women's Hospital, Trinidad
Authors: Ali Z.
Published: December 2003

Objective  To determine the incidence of early onset Group B streptococcal (GBS) infection in neonates at the Mount Hope Women's Hospital, Trinidad over the period 1996–97.

Design and methods  This retrospective study included all babies with a positive blood culture for GBS during the study period.

Results  There were 9866 live births (LB) of whom 29 were diagnosed as early onset GBS disease. The incidence was 2.9/1000 LB. 37.9% of babies were preterm and 65.5% were delivered to primiparous women. Rupture of amniotic membranes occurred within 12 h of delivery in 55% of infected babies. Four of the 29 infected babies died and all were preterm.

Conclusion  The incidence of early onset neonatal GBS sepsis was five to six times higher in this series than that reported in the USA and UK. An intervention policy to control this preventable disease is urgently needed.
Developmental, behavioural and somatic factors in pervasive developmental disorders: preliminary analysis
Authors: Whiteley P.
Published: December 2003

Objectives  To ascertain the frequency of parental reporting of selected variables related to development, behaviour and physiology in subgroups diagnosed with pervasive developmental disorders (PDDs) and identify any significant intragroup differences.

Design  Retrospective cross‐sectional analysis of records of patients (n = 512) held on a computerized database with a chronological age between 3 and 11 years resident in the UK/Republic of Ireland and with a formal diagnosis of autism, Asperger syndrome (AS) or autism spectrum disorder (ASD).

Methods  Non‐parametric analysis (P > 0.01) of the frequency of specific variables for PDD subgroups reported by parents/primary caregiver.

Variables included  timing of symptom onset, presence of skills acquired prior to symptom onset, indications of regression and regression events, current language, history of viral infections, history of ear problems, achievement of continence, current skin complaints, current bowel habits and adverse events at parturition.

Results  Preliminary results showed general agreement with the principle diagnostic differences between the PDD subgroups with patients diagnosed with AS showing an increased frequency of skills acquired before symptom onset (two‐ to three‐word phrase speech, toileting skills) and a decreased frequency of regression in acquired skills when compared with other PDD subgroups. Developmental milestones such as the achievement of bowel and bladder continence were also more frequently reported for the AS group. Infantile feeding problems defined as vomiting, reflux, colic and failure to feed were more frequently reported for the AS group as was a reported history of the bacterial skin infection impetigo. Results are discussed with reference to relationships between behavioural and somatic factors in PDD.
Care co‐ordination and key worker schemes for disabled children: results of a UK‐wide survey
Authors: Greco V. , Sloper P.
Published: December 2003

Aim  To investigate the prevalence and nature of care co‐ordination and key worker services for disabled children and their families.

Methods  Postal survey of 225 Children with Disabilities Teams across the UK.

Results  Out of 159 questionnaires returned (70%), 35 (22%) reported having a care co‐ordination scheme, with 30 (19%) of these providing key workers for families. The majority had multiagency and parent involvement in setting up and overseeing the schemes. However, multiagency funding was less common and funding for many schemes was short term. Different models of key working were apparent. Five schemes employed full‐time key workers. In 21 schemes, professionals key worked with a few families as part of a larger case load, and in three schemes, both types of key workers were employed. Most schemes provided initial or ongoing training for key workers, but a few provided neither of these.

Discussion  The proportion of areas having care co‐ordination or key worker services is consistent with findings on research with parents of disabled children, which reports that less than one‐third of families have a key worker. The extent of multiagency involvement in planning and overseeing the operation of the service was positive but joint funding was more problematic. There was considerable variation in service models and as yet, little is known about whether or how such variations relate to outcomes for children and families. Further research will investigate these issues.
Mothers’ mental health and infant growth: a case–control study from Rawalpindi, Pakistan
Authors: Rahman A. , Lovel H. , Bunn J. , Iqbal Z. , Harrington R.
Published: December 2003

Background  Epidemiological studies in Pakistan show high rates of depression in women, while rates of malnutrition in children are also high. This study aimed to determine whether poor maternal mental health is associated with an increased risk of infant undernutrition.

Methods  Clinic‐based case–control study. A total of 172 consecutive infants and their mothers attending for 9‐month measles immunization were recruited over a 3‐month period. Eighty‐two undernourished infants [weight for age below the National Centre for Health Statistics (NCHS)/World Health Organization (WHO) third centile] were matched to 90 controls (weight for age above 10th centile), and their mothers interviewed for mental distress using the Self‐Reporting Questionnaire (WHO SRQ‐20, a psychiatric screening instrument). Infants’ exposure to maternal distress (score ≥ 10 on SRQ‐20) and other potential risk or protective biological, social, socio‐economic and family factors were measured.

Results  Mental distress determined by WHO SRQ‐20 was associated with increased risk of undernutrition in infants (odds ratio 3.91, 95% confidence interval 1.95–7.86). This association remained significant after controlling for birthweight and social factors.

Conclusion  Exposure to maternal mental distress is associated with undernutrition in 9‐month infants in urban Pakistan. These mothers may represent a group whose children are at higher risk of ill health, and potentially be a specific target for advice on infant care. Early recognition and treatment of mental health problems in mothers may help reduce morbidity and mortality rates in children.
Absence from childcare for respiratory illness
Authors: Slack‐Smith L. M. , Read A. W. , Stanley F. J.
Published: December 2003

Background  This population‐based study investigated prospectively collected absence for respiratory illness data in two types of formal childcare (centre day care and family day care) in Perth, Western Australia, and factors associated with such absence.

Methods  All centres (n = 11) and 95% of family day care caregivers (n = 130) selected at random from licensing lists agreed to participate. Demographic details were obtained from a parental questionnaire and absences were recorded prospectively. Characteristics of the child and family were described using univariate odds ratios (OR) with 95% confidence intervals (CI). Multivariable analysis including generalized estimating equations was used to investigate having at least one absence for respiratory illness, having two or more absences, and having six or more absences.

Results  No statistically significant difference between care types for having had at least one absence episode for respiratory illness (OR 1.37, 95% CI 0.92–2.04) was found. Children who attended care for more days per week (OR 1.40, 95% CI 1.26–1.56) and those in the study for more weeks (OR 1.03, 95% CI 1.01–1.05) were more likely to be absent for respiratory illness. Those children in care for a greater number of hours per day were less likely to be absent (OR 0.88, 95% CI 0.80–0.97). Family history of bronchitis was also associated with absence for respiratory illness (OR 1.86, 95% CI 1.32–2.63).

Conclusions  Statistically significant factors which had an impact on absence for respiratory illness were primarily those relating to the time spent in childcare and to family history of bronchitis.
Children's beliefs about the importance of gender in transgression situations
Authors: Sorbring E. , Palmérus K.
Published: December 2003

Objective  In previous research, several variables are shown to have an impact on children's perception of gender. The aim of this study was to examine the relation between discipline methods and the child's beliefs about the importance of gender in transgression situations.

Methods  In this study, variables such as type of siblings, socioeconomic status, child's sex, parental values and shared responsibility are controlled for. Two hundred and five 8‐year‐old children in Sweden were interviewed about discipline methods in five transgression situations and their parents were asked to fill in a battery of questions.

Results  The results show that harsher discipline methods, such as behaviour modification, physical restraint and physical punishment, relate to stronger beliefs about the importance of gender in transgression situations.
The health of Swedish‐speaking and Finnish‐speaking schoolchildren in Finland
Authors: Saarela J. M. , Finnäs F. S. A.
Published: December 2003

Background  It is well known that Swedish‐speaking adults in Finland have higher life expectancy and better health than their Finnish‐speaking counterparts. Among young people, similar comparisons have been scarce. The present paper aims to compare the health of Swedish‐speaking and Finnish‐speaking schoolchildren.

Methods  Survey data from 1997, representing children at grades 8 and 9 of compulsory school in a bilingual region, are analysed with the help of logistic regression models. Self‐rated health as well as objective measures of health are explored.

Results  We find that Swedish‐speaking schoolchildren are healthier than Finnish‐speaking ones in terms of objective measures of health, whereas there is no difference between language groups in terms of self‐assessed health. Self‐rated health seems to reflect well‐being in a very broad context rather than objective health from a medical perspective. Risk factors and health behaviours being equal, both language groups consequently assess their health in a similar manner.

Conclusions  Policy makers should be careful when advocating the health needs of schoolchildren based on survey results concerned with self‐assessed health measures, particularly when they are concerned with targeting measures towards specific subgroups of the population. Self‐rated health is obviously not well suited for reflecting overall and specific needs of medical assistance and expertise for schoolchildren.
Child health on a dollar a day: some tentative cross‐country comparisons
Authors: Reading Richard
Published: December 2003

Children living on a dollar a day – the international extreme poverty line – appear to have radically different chances of dying in childhood and being malnourished, depending on the country in which they live. In Kazakhstan, a child living on a dollar a day has only a 10% risk of being underweight, while the risk facing a child living on a dollar a day in India is nearly 60%. The Kazakh child has a risk of less than 40 per 1000 of dying before his first birthday, while a child living on a dollar a day in Niger faces a risk of nearly 160 per 1000. Countries where mortality and malnutrition risks at a dollar a day are high are not typically those where there are large gaps in child survival and in malnutrition between the poor and better‐off. The two concepts of inequality and health risks at the poverty line are not only conceptually distinct – they are empirically distinct too. The large differences between countries in the risks of mortality and malnutrition in childhood beg the obvious question – what accounts for these differences? Some regression results presented in the paper suggest that these differences may be due to differences across countries in levels of per capita expenditure on the health sector. Regressions find that higher levels of per capita public spending on the health sector are associated with significantly lower levels of mortality and malnutrition among children living on a dollar a day.
Parental review of service uptake during the pre‐school period
Authors: Wiseman P. T. , Wakeman A.
Published: December 2003

This article outlines the development and analysis of the results of a community‐led survey undertaken in year 1 of a 3‐year period of evaluation for a first wave Sure Start programme. The survey had initially been suggested as a means of collecting data that was required, at the time, by the central Sure Start unit, however, its potential outside of this specific evaluative purpose was also recognized. In addition to providing important pointers for the future development of the programme, the findings give insight into a community within the west midland conurbation, and reviews the support that carers have accessed during the first 4 years of their youngest child's life. Their feelings and opinions are presented and demonstrate factors that influence the involvement of carers in this and other related programmes.
Infant hospitalization and maternal depression, poverty and single parenthood – a population‐based study
Authors: Guttmann A. , Dick P. , To T.
Published: December 2003

Objectives  There is variation in rates of hospitalization for young children which is unexplained by differences in health. We used population‐based survey data to examine the contribution of family sociodemographic and psychodynamic factors to the risk of hospitalization in children under the age of 2 years in Canada.

Methods  Baseline data from the National Longitudinal Survey of Children and Youth (a population‐based study of child health and well‐being) were used. A weighted sample of 332 697 (unweighted n = 2184) children between the age of 12 and 24 months, whose biological mother reported data on hospitalization over the past year, were included. Logistic regression analyses were conducted to estimate the risk of hospitalization by sociodemographic and psychodynamic factors controlling for important biological covariates.

Results  The overall proportion of children who were hospitalized was 11.2%. After adjusting for prematurity, the only statistically significant biological factor associated with the risk of hospitalization was reported present health [odds ratio (OR) 4.04, 95% confidence intervals (CI): 2.93, 5.58]. However, three family variables were significantly associated with hospitalization: low income adequacy (OR 1.66, 95% CI: 1.15, 2.40), single parenthood (OR 1.55, 95% CI: 1.03, 2.34) and maternal depression (OR 1.81, 95% CI: 1.22, 2.69). Having a parent who is a recent immigrant to Canada is associated with a reduced risk of hospitalization (OR 0.53, 95% CI: 0.35, 0.78).

Conclusions  Most of the significant associations with hospitalization in the first 2 years of life in the Canadian population relate to the overall family's social and mental health. Maternal depression is a treatable disorder which if recognized might prevent some infant morbidity.
Frequency and determinants of formal respite service use among caregivers of children with cerebral palsy in Ontario
Authors: Damiani G. , Rosenbaum P. , Swinton M. , Russell D.
Published: December 2003

Objective  To describe the use of formal respite services among caregivers of children with cerebral palsy in Ontario and discuss the factors that may contribute to respite use and non‐use.

Methods  A total of 468 caregivers were interviewed about their experience with formal respite services. Interviews were part of a larger cross‐sectional study on caregiver health. Caregivers were asked about their knowledge of formal respite services; their use of formal respite services in the past year; financial implications relating to formal respite use; perceived barriers to formal respite service use; and reasons for not using formal respite services (if applicable).

Results  Nearly half (46%) of caregivers in the sample reported using respite services in the past year. Most of the caregivers who used respite services used more than one source of respite, had services provided in their home, often for less than 1 day, and reported using them more than six times. The most commonly cited reason for using formal respite services was for a planned break. Many factors influenced caregivers’ use of formal respite services. Caregivers who had a child with a lower level of function, with multiple additional conditions, or who was male, were more likely to use formal respite services. Although over 90% of caregivers indicated that respite use is beneficial for both their family and child, over 60% reported facing many barriers while attempting to access respite services.

Conclusion  Results from this cross‐sectional study indicate that caregivers who used respite services used them frequently for breaks from caregiving. Caregivers described facing many barriers while attempting to access respite services therefore to improve caregiver's experience with respite services, strategies are suggested.
Health‐related quality of life of severely obese children and adolescents
Authors: Maher Elise
Published: December 2003

Context  One in seven US children and adolescents is obese, yet little is known about their health‐related quality of life (QOL).

Objective  To examine the health‐related QOL of obese children and adolescents compared with children and adolescents who are healthy or those diagnosed as having cancer.

Design, setting and participants  Cross‐sectional study of 106 children and adolescents (57 males) between the ages of 5 and 18 years [mean (SD) 12.1 (3) years], who had been referred to an academic children's hospital for evaluation of obesity between January and June 2002. Children and adolescents had a mean (SD) body mass index (BMI) of 34.7 (9.3) and BMI z‐score of 2.6 (0.5).

Main outcome measures  Child self‐report and parent‐proxy report using a paediatric QOL inventory generic core scale (range 0–100). The inventory was administered by an interviewer for children aged 5 through 7 years. Scores were compared with previously published scores for healthy children and adolescents and children and adolescents diagnosed as having cancer.

Results  Compared with healthy children and adolescents, obese children and adolescents reported significantly (P < 0.001) lower health‐related QOL in all domains [mean (SD) total score, 67 (16.3) for obese children and adolescents; 83 (14.8) for healthy children and adolescents]. Obese children and adolescents were more likely to have impaired health‐related QOL than healthy children and adolescents [odds ratio (OR) 5.5; 95% confidence interval (CI) 3.4–8.7] and were similar to children and adolescents diagnosed as having cancer (OR 1.3; 95% CI 0.8–2.3). Children and adolescents with obstructive sleep apnoea reported a significantly lower health‐related QOL total score [mean (SD), 53.8 (13.3)] than obese children and adolescents without obstructive sleep apnoea [mean (SD), 67.9 (16.2)]. For parent‐proxy report, the child or adolescent's BMI z‐score was significantly inversely correlated with total score (r = −0.246; P = 0.01), physical functioning (r = −0.263; P < 0.01), social functioning (r = −0.347; P < 0.001), and psychosocial functioning (r = −0.209; P = 0.03).

Conclusions  Severely obese children and adolescents have lower health‐related QOL than children and adolescents who are healthy and similar QOL as those diagnosed as having cancer. Physicians, parents and teachers need to be informed of the risk for impaired health‐related QOL among obese children and adolescents to target interventions that could enhance health outcomes.
Bicycle helmet campaigns and head injuries among children. Does poverty matter?
Authors: Reading Richard
Published: December 2003

Objectives  To assess the impact of a community‐based bicycle helmet programme aimed at children aged 5–12 years (about 140 000) from poor and well‐off municipalities.

Methods  A quasi‐experimental design, including a control group, was used. Changes in the risk of bicycle‐related head injuries leading to hospitalization were measured, using rates ratios.

Results  Reductions in bicycle‐related head injuries were registered in both categories of municipalities. Compared with the pre‐programme period, the protective effect of the programme during the post‐programme period was as significant among children from poor municipalities (RR 0.45; 95% CI 0.26–0.78) as among those from richer municipalities (RR 0.55; 95% CI 0.41–0.75).

Conclusion  Population‐based educational programmes may have a favourable impact on injury risks in poor areas despite lower adoption of protective behaviours.
The ‘lids For kids’ Project Team. Inequalities in cycle helmet use: cross sectional survey in schools in deprived areas of Nottingham
Authors: Reading Richard
Published: December 2003

Aims  To describe cycle helmet owning and wearing among children in a deprived area and to investigate the association between helmet ownership and wearing and socioeconomic deprivation.

Methods  Cross‐sectional survey in 28 primary schools in deprived areas of Nottingham; 1061 year 5 schoolchildren were studied.

Results  All year 5 children attending school on the day of the survey completed the questionnaire (87% of children registered at participating schools). Children residing in a deprived area were less likely to own a bike and more likely to ride it 4 days a week or more. Half the children owned a helmet (52%), but only 29% of these always wore their helmet. Children in deprived areas were less likely to own a helmet, but those that owned a helmet were not less likely to always wear one. Family encouragement and parental warning of dangers of not wearing a helmet were associated with increased helmet ownership rates. Family encouragement and best friends wearing a helmet were associated with higher rates of helmet wearing.

Conclusions  Programmes aimed at preventing head injury among child cyclists will need to address the inequality in helmet ownership that exists between children residing in deprived and non‐deprived areas. Strategies to increase family encouragement to wear a helmet may be useful, as may those recognizing the importance of the attitudes and behaviours of peers, such as peer education programmes. Further work is required to assess how exposure to risk of cycling injury varies with deprivation.
Thimerosal and the occurrence of autism: negative ecological evidence from Danish population‐based data
Authors: Reading Richard
Published: December 2003

Objective  It has been suggested that thimerosal, a mercury‐containing preservative in vaccines, is a risk factor for the development of autism. We examined whether discontinuing the use of thimerosal‐containing vaccines in Denmark led to a decrease in the incidence of autism.

Design  Analysis of data from the Danish Psychiatric Central Research Register recording all psychiatric admissions since 1971, and all outpatient contacts in psychiatric departments in Denmark since 1995.

Patients  All children between 2 and 10 years old who were diagnosed with autism during the period from 1971 to 2000.

Outcome measures  Annual and age‐specific incidence for first day of first recorded admission with a diagnosis of autism in children between 2 and 10 years old.

Results  A total of 956 children with a male‐to‐female ratio of 3.5 : 1 had been diagnosed with autism during the period from 1971 to 2000. There was no trend towards an increase in the incidence of autism during that period when thimerosal was used in Denmark, up through 1990. From 1991 until 2000, the incidence increased and continued to rise after the removal of thimerosal from vaccines, including increases among children born after the discontinuation of thimerosal.

Conclusions  The discontinuation of thimerosal‐containing vaccines in Denmark in 1992 was followed by an increase in the incidence of autism. Our ecological data do not support a correlation between thimerosal‐containing vaccines and the incidence of autism.
Association of autistic spectrum disorder and the measles, mumps, and rubella vaccine – A systematic review of current epidemiological evidence
Authors: Jacobson Robert M.
Published: December 2003

The authors conducted a systematic review of the evidence for and against the existence of an association between autistic spectrum disorder and the measles, mumps and rubella (MMR) vaccine. Specifically, they tested four hypotheses: (1) that the rates of autistic spectrum disorder is higher in individuals who have received MMR than those who did not, (2) that an increase in autistic spectrum disorder may be occurring as a result of MMR, (3) that the development of autistic spectrum disorder is temporally associated with receiving the MMR, and (4) that a new variant form of autistic spectrum disorder may be associated with the MMR vaccine. The authors sought to identify all controlled epidemiological articles examining for an association between autistic spectrum disorder and the MMR vaccine. They extracted data from the articles on the characteristics and objectives of the study as well as evidence of an association.

Twelve articles met the inclusion criteria. One study found no difference in the rates of autistic spectrum disorder and the MMR vaccine in children who were vaccinated and those who were not. Six studies examined for evidence of an increase in autistic spectrum disorder associated with an increase in the MMR vaccine coverage; none of the six showed evidence of an association. Four studies examined if a variant form of autistic spectrum disorder was associated with the MMR vaccine; none of the four showed evidence of an association. Eight studies attempted to determine if there was a temporal association between developing autistic spectrum disorder and receiving the MMR vaccine. Of these, one study identified an increase in parental concern in the 6‐month period following vaccination with MMR in one of its analyses. The results of all other studies showed no association between autistic spectrum disorder and the MMR vaccine. The authors concluded that the current literature does not suggest an association between autistic spectrum disorder and the MMR vaccine. The authors did note that the studies were not large enough even in aggregate to rule out a link between a rare variant form of autistic spectrum disorder and the MMR vaccine; they held, however, that given the real risks of not vaccinating and that the risks and existence of variant autistic spectrum disorder remain theoretical, current policies should continue to advocate the use of the MMR vaccine.
Parents’ beliefs and expectations when presenting with a febrile child at an out‐of‐hours general practice clinic
Authors: Bhrolchain Cliona Ni
Published: December 2003

Background  A qualitative study in a central out‐of‐hours consultation room in Aarhus, Denmark, a city of about 250 000 people.

Aim  To describe why parents of children with fever and/or respiratory symptoms used the service, what parents did before seeking medical advice and what they expected from their consultation.

Method  All parents with a child under 12 attending the centre on 17 weekdays (except Fridays) in September and October 1998 were invited for a structured interview before seeing the GP.

Results  Of 153 parents, 152 agreed to an interview, but six were later excluded as it became apparent their main reason for consultation was not fever or respiratory symptoms. The only refusal was because a mother did not wish to delay her consultation with the doctor.

Fifty‐two per cent of parents had sought advice from family, friends, day‐care staff and others before seeking medical help. Twenty‐one per cent had tried over‐the‐counter remedies. Forty‐six per cent did not consider the illness serious, but 1/3 did not know how serious it was and 12% thought their child was very ill.

They were asked an open‐ended question about their expectation of the consultation. Nearly all expected their child to be examined, 79% expected a diagnosis or an explanation but only 13% said they expected a prescription. To the more specific question ‘Do you expect a prescription of an antibiotic?’, 71% said no, 19% said yes and 10% didn’t know.

Conclusions  The study confirms previous findings in relation to parents’ seeking informal advice prior to seeking a medical opinion. However, the study shows different parental expectations in relation to the likelihood of a prescription after the consultation. The authors stress the importance of exploring parents’ expectations during emergency consultations. Concentrating on clinical examination and communicating with parents about the child's condition may be better than a prescription.
The paradox of Prader–Willi syndrome: a genetic model of starvation
Authors: Cundall David
Published: December 2003

People with Prader–Willi syndrome have many other problems in addition to their insatiable appetites, and Tony Holland and his colleagues from Cambridge have done much to advance our understanding of this condition. In this article, which appears under the ‘Hypothesis’ banner in the Lancet, he makes the striking assertion that all of the many problems experienced by people with Prader–Willi syndrome can be explained by considering the syndrome as a syndrome of starvation, which manifests as obesity in a food‐rich environment.

They postulate that, in this syndrome, the body incorrectly interprets the absence of satiation as starvation. It had been assumed that other aspects of the phenotype, like growth hormone deficiency, central hypogonadism, low metabolic rate, lower IQ, ritualistic behaviours were all somehow related to genes on the long arm of chromosome 15. However, the authors assert that all the various aspects of the phenotype can be attributed to their starvation hypothesis and put forward two main supporting arguments. The first is all about energy balance and they present some strong evidence that the low metabolic rate and hypogonadism is centrally mediated and what one might expect with abnormal hypothalamic responsiveness.

The second is about imprinted genes in the placenta. This might explain the neonatal hypotonia, failure to thrive and arrested brain development. There is little experimental evidence to support this part of the argument yet, but like all good hypotheses, it should be a stimulus to more research.
Research on the quality of parent‐provider communication in paediatric care: implications and recommendations
Authors: Glascoe Francis Page
Published: December 2003

This narrative review of the correlates of effective parent‐provider communication and relevant interventions indicates that effective parent‐provider communication is associated with parental satisfaction with care, adherence to treatment recommendations, and enhanced discussion of psychosocial concerns. Moreover, interventions designed to improve parent‐provider communication resulted in more discussion of psychosocial concerns, better recall of information from the visit, and improved parent‐provider communication. Recommendations for the development of more effective studies of parent‐provider communication and relevant interventions in paediatric primary care include the need for theoretical models to help guide research, the development of reliable and valid self‐report measures of communication, the assessment of clinically relevant correlates of parent‐provider communication, and the study of children's roles in communication with their paediatricians.

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Rhesus macaque antibody molecules: sequences and heterogeneity of alpha and gamma constant regions
Authors: Scinicariello Franco , Engleman Carrie N. , Jayashankar Lakshmi , McClure Harold M. , Attanasio Roberta
Published: December 2003

Rhesus macaques (Macaca mulatta) are extensively used in vaccine development. Macaques infected with simian immunodeficiency viruses (SIV) or simian‐human immunodeficiency viruses (SHIV) are the best animal model currently available for acquired‐immune‐deficiency‐syndrome‐related studies. Recent results emphasize the importance of antibody responses in controlling HIV and SIV infection. Despite the increasing attention placed on humoral immunity in these models, very limited information is available on rhesus macaque antibody molecules. Therefore, we sequenced, cloned and characterized immunoglobulin gamma (IGHG) and alpha (IGHA) chain constant region genes from rhesus macaques of Indian and Chinese origin. Although it is currently thought that rhesus macaques express three IgG subclasses, we identified four IGHG genes, which were designated IGHG1, IGHG2, IGHG3 and IGHG4 on the basis of sequence similarities with the four human genes encoding the IgG1, IgG2, IgG3 and IgG4 subclasses. The four genes were expressed at least at the messenger RNA level, as demonstrated by real‐time reverse transcription polymerase chain reaction (RT‐PCR). The level of intraspecies heterogeneity was very high for IGHA genes, whereas IGHG genes were remarkably similar in all animals examined. However, single amino acid substitutions were present in IGHG2 and IGHG4 genes, indicating the presence of IgG polymorphism possibly resulting in the expression of different allotypes. Two IgA alleles were identified in several animals and RT‐PCR showed that both alleles may be expressed. Presence of immunoglobulin gene polymorphism appears to reflect the unusually high levels of intraspecies heterogeneity already demonstrated for major histocompatibility complex genes in this non‐human primate species.