bluuebunny/crossref_metadata_2025 huggingface dataset:
School children's attitudes towards computers as a function of gender, course subjects and availability of home computers
Authors: Martin R.
Published: April 2008

Abstract The attitudes of 328 British Secondary School children towards computers were examined in a cross‐sectional survey. Measures of both general attitudes towards computers and affective reactions towards working with computers were examined in relation to the sex of the subject, courses studied (computer related/noncomputer related) and availability of a home computer. A differential pattern of results was observed. With respect to general attitudes towards computers, main effects were found for all three independent variables indicating that more favourable attitudes increased as a function of being male, doing computer courses and having a home computer. In contrast to this, affective reactions to working with computers was primarily related to doing computer courses, such that those doing computer courses reported more positive and less negative reactions. The practical and theoretical implications of these results are discussed.
Knowledge as an asset ‐ a view from industry
Authors: Thomas Grant
Published: April 2008

Abstract  Corporations around the world are re‐thinking their learning and training approaches in response to the enormous pressures they face because of rapid technological change, increased competition and global complexity. They are coming to understand that the knowledge held within the organization, individually and collectively, is perhaps their most important competitive asset. They are seeking new ways of formalizing and transacting knowledge — becoming learning organizations. New forms of user‐centred, open learning environments are being tried, and new relationships with the learning industry are being sought. This paper attempts to present a view from industry and suggests a framework to guide corporate knowledge planning.
The Multimedia Teleschool – linking European initiatives
Authors: Davies D. , Pritchard A.
Published: April 2008

Abstract In the context of current European programmes it is in vogue to point to complementarity between projects in different programmes. This complementarity is often seen as a self‐evident good. Whilst agreeing with the sentiment this paper will stress that ‘self‐evidence’ is not sufficient. Complementarity must be demonstrated both in terms of a rationale and in practice. This paper details how, in the context of two of the current European Commission education programme initiatives, a complementarity has been achieved in practice that can be argued for at two levels: firstly, at the level of cross‐programme linkage within a particular domain and secondly, at the level of the merging of educational technologies within the programmes.
Towards a consolidated model for a collaborative courseware authoring system
Authors: Dobson M. , Rada R. , Chen C. , Michailidis A. , Ulloa A.
Published: April 2008

Abstract In an effort to reduce the expensive resource requirements in courseware production and to allow effective management of, and communication and collaboration between authors, a model is needed to harmonize the diverse theoretical backgrounds such a process requires. To this end we look at five abstract models which where chosen for their apparent appropriateness within the general area of collaborative authoring and reuse of multimedia courseware. These models consist of a functional model of hypertext, an infrastructure model for an open collaborative authoring system, two object‐oriented communication models, and a courseware production model. We attempt a consolidation of these models and ultimately make several conclusions, which are exposed during a conceptual harmonisation. The principal conclusion is that a hypermedia logical model is not by itself adequate to support collaboration and reuse. Our modeling conclusions have driven the design of a system which will be implemented and tested.
Equality and CAL in Higher Education
Authors: Henry M. S. , Rafferty J.
Published: April 2008

Abstract Information technology is being heralded both as a liberating force and as the answer to the increasing demands of higher education. To date, however, there has not been an analysis of the equitable implications for higher education. Indeed, many institutions are unaware of the direct application of their own equal opportunity policies to the expanding role of IT in higher education. The authors suggest that by linking equal opportunity policies to the implementation of computer‐assisted learning, higher education will be better placed to provide a higher quality of learning to a more diverse range of students.
A 3‐D motion tracing system in High School Physics teaching
Authors: Ronen M.
Published: April 2008

Abstract This article presents a study of a large scale incorporation of one data acquisitionsystem into physics teaching in Israel. By 1994 about 30% of the schools throughout the country used the V‐scope, a 3‐D multibody motion tracing system, in their lab programme. The views and reactions of post‐training teachers, experienced teachers and students on various aspects of using the system are described, analysed and compared.
Measuring users' performance with interactive information systems
Authors: Oliver R.
Published: April 2008

Abstract The purpose of this study was to investigate the discrete forms of knowledge required for successful use of interactive information systems (IIS). Using an existing framework, an instrument was created to measure the achievement of three discrete forms of knowledge among novice users of an CD‐ROM encyclopedia. The instrument included tasks designed to measure users' knowledge and skills in managing and controlling the system, navigating between information nodes and selecting appropriate search strategies given information related problems. The study examined hierarchical knowledge and compared the development of these forms of knowledge and skills among novices using two different IIS. The results found significant differences in the user performances between two systems in tasks that measured navigation skills and an understanding of the information organisation. It is suggested that these differences were due to differences in the interface design of the two systems and suggestions are made for selecting and implementing IIS systems in school and educational settings.
Software standards in undergraduate computing courses
Authors: Joy M. , Luck M.
Published: April 2008

Abstract High‐quality software must be robust, reliable and maintainable. The design and coding of such software is no longer a craft; it is an engineering discipline, and the teaching of computer programming must reflect this. Consequently, students need to be aware of the importance of formulating accurate specifications for programming tasks, and of coding programs which correctly implement such specifications. However, the increase in student numbers experienced in recent years has caused manual methods of assessing students' programming assignments to become inefficient, and consistency more difficult to enforce. In order to support and motivate a rigorous approach in the context of these difficulties, an innovative on‐line assessment system for programming language modules has been developed which addresses both concerns. This paper describes the package and discusses its importance in the delivery and assessment of undergraduate programming modules.
Interleukin‐12: potential clinical applications in the treatment of chronic viral hepatitis
Authors: Gately M. K.
Published: April 2008

Summary. Interleukin‐12 (IL‐12) is a heterodimeric cytokine that promotes cell‐mediated immunity by facilitating type 1 helper T‐lymphocyte responses, inducing the secretion of interferon‐γ from both T and natural killer cells, enhancing the lytic activity of natural killer cells, and augmenting specific cytolytic T‐lymphocyte responses. In addition, IL‐12 can increase the production of some subclasses of IgG antibodies. IL‐12 has been shown to have potent therapeutic effects in a number of animal models of tumours and infectious diseases, including several viral infections. These results have led to the initiation of clinical trials to evaluate the therapeutic potential of IL‐12 in human cancer patients and in patients infected with the human immunodeficiency virus. The biological activities of IL‐12 suggest that it may also have clinical utility in the treatment of patients suffering from chronic hepatitis B or Cvirus infections. Because of the lack of suitable animal models for evaluating the efficacy of IL‐12 in the treatment of infections with these viruses, only a clinical trial in patients with chronic viral hepatitis can address the potential role of IL‐12 as an effective treatment for these disorders.
A preliminary experience with GM‐CSF plus interferon in patients with HBV and HCV resistant to interferon therapy
Authors: van Thiel D. H. , Friedlander L. , Kania R. J. , Molloy P. J. , Hassanein T. , Faruki H.
Published: April 2008

Summary. An open label trial of GM‐CSF plus high‐dose interferon (IFN) α 2b was performed in eight patients with chronic hepatitis B infection and 16 patients with chronic hepatitis C, who either failed to clear virus with 6 months of daily high‐dose IFN (5 MU daily) therapy (n= 22) or were considered untreatable because of advanced disease and leukopenia (n= 2). The dose of GM‐CSF used was 500 μg subcutaneously twice weekly. The dose of IFN used was 5 MU daily. Both agents were administered for 4 months. Five of the eight hepatitis B patients and five of the 16 hepatitis C virus patients responded to combined therapy having previously failed IFN therapy alone. The hepatitis B virus responders had low entry ALT, AST, and gamma GPT levels as compared to the non‐responders. No such differences for responders and non‐responders were seen with the hepatitis C virus patients. These data suggest that the combination of GM‐CSF and IFN may be more effective at achieving viral clearance than IFN alone.
Treatment of hepatocellular carcinoma
Authors: Colombo M.
Published: April 2008

Summary. Treatment of patients with hepatocellular carcinoma (HCC) is largely influenced by local resources and the clinical stage of the disease. Hepatic resection is the treatment of choice for patients with HCC and normal liver. Tumour size and number, and liver status are common guidelines for choosing treatment in patients with cirrhosis. Hepatic resection and liver transplantation offered the best chances of cure in patients with a single small tumour. The 3‐year survival of these patients was definitively better than that of historical controls. In the setting of patients with well‐preserved liver function, a controlled study comparing the cost‐efficacy of resection and transplantation is deemed necessary by many, but it is hardly feasible for both ethical and practical considerations. One major drawback of surgery in patients with a small tumour is early tumour spread to regional lymph‐nodes, which favours early tumour recurrence after operation. Patients with more advanced tumour disease were rarely eligible for surgery and had dismal prognoses. For those with small tumours who were not eligible for surgery, percutaneous ethanol injection appeared to be a cost‐saving and effective treatment modality. Arterial embolization is the only recom‐mendable palliative treatment of patients with large tumours and poor hepatic function.
Treatment of cirrhotic hepatitis C virus patients with daily doses of interferon‐α2a
Authors: Cooksley W. G. E. , Dudley F. J. , Watson K.
Published: April 2008

Summary. In patients with hepatitis C who have cirrhosis the rate of sustained response following interferon therapy is less than half that of patients without cirrhosis. It has been suggested, however, that a higher dose regime in patients with cirrhosis may improve response. The results of a recent Australian study of cirrhotic patients who were given an intense interferon programme of 4.5 MIU daily for 24 weeks were compared with previous studies of patients with hepatitis C. In the Australian study, 14% of patients had a sustained response at 6 months after end of therapy. Of 11 studies of interferon response in chronic hepatitis C comparison of pretreatment variables showed considerable differences. Identification of predictors of response by univariate and multivariate analysis regularly indicated the importance of age and fibrosis. Analysis of six studies with either a poor (5% or less) or a reasonable (14–19%) sustained response rate to interferon in patients with cirrhosis suggested that a higher dose or longer duration of therapy was associated with better results. The experience of the Australian study, where 14% of patients had a sustained biochemical response to interferon and side‐effects were reasonably tolerated with careful monitoring, suggests that future studies in cirrhosis should be carried out exploring higher doses and longer durations of therapy.
Biological properties of interleukin‐12 and its therapeutic use in persistent hepatitis B virus and hepatitis C virus infection
Authors: Carreño V. , Quiroga J. A.
Published: April 2008

Summary. Interleukin (IL)‐12 is a pleiotropic cytokine produced by antigen‐presenting cells in response to diverse stimuli. IL‐12 is a key molecule in the regulation of host's immune responses. In particular, IL‐12 influences the balance between the T‐helper cells type 1 (TH1) and type 2 (TH2); it modulates macrophage responses through the control of interferon‐gamma synthesis by TH1 cells; and, suppresses IgE class antibody production (has a suppressive effect on allergic reactions) and promotes a shift in the IgG subclasses. IL‐12 enhances resistance to several infectious diseases, is a powerful antitumor agent in vivo, and acts as a vaccine adjuvant. The biological properties of IL‐12 point to the potential therapeutic use in persistent hepatitis B virus and hepatitis C virus infection.
Interobserver variability in neonatal cranial ultrasonography
Authors: Pinto Jennifer , Paneth Nigel , Kazam Elias , Kairam Ram , Wallenstein Sylvan , Rose Walter , Rosenfeld David , Schonfeld Steven , Stein Irving , Witomski Thomas
Published: April 2008

Summary. The reliability of cranial ultrasound diagnosis in the premature neonate was examined using data from an ongoing multi‐ centre study of the epidemiology and long‐term consequences of neonatal brain haemorrhage. First week ultrasound films (obtained at 4 hours,24 hours and 7 days) from 60 study subjects were randomly selected for independent review by two groups of experienced interpreters, and results were recorded separately for observations (i.e. presence or absence of an abnormal echodense area on a film) and interpretations(i.e. presence or absence of haemorrhage or ventricular dilatation) in each hemisphere. Because of deaths in the first week of life, the total number of films examinedwas 138. Concordance on the presence or absence of an abnormal echodensity was examined for each individual film for three areas of interest: the germinal matrix, the ventricles and the parenchyma. Concordance on the presence or absence of haemorrhage or ventricular dilatation was examined only for the seventh‐day film, or the final film prior to death. Finally, concordance was analysed with the diagnostic interpretations grouped into categories thought to differ prognostically for long‐term outcome. In general, concordance was poorest for germinal matrix lesions and best for parenchymal lesions. Concordance was lower for observations made on each individual film than it was for interpretation of the final film in each case. Fifty‐five of 60 cases (92%) were assigned to the same major prognostic category by both readers. Ultrasound review conferences were held periodically and there was evidence that concordance in ultrasound reading and interpretation improved during the course of the study.
Prediction of outcome shortly after delivery for the very low birth weight (≪1500 g) infant
Authors: Patterson C.C. , Halliday H.L.
Published: April 2008

Summary

Obstetric and perinatal data for 387 very low birthweight infants (≪1500 g) who were admitted to a neonatal intensive care unit were used to derive and test a multivariate statistical model for predicting shortly after birth the risk of death before hospital discharge. Using the gestational age, the Apgar score at 5 minutes and the presence or absence of respiratory distress, the model correctly predicted outcome for 94% of survivors but for only 53% of deaths. The model successfully identified a subgroup with a low (less than 1 in 20) predicted risk of death. This subgroup comprised over one‐third of the infants but included 47% of the survivors and only 5% of the deaths. The probabilities derived from the model are tabulated and may help paediatricians in maternity units without neonatal intensive care facilities to decide which very low birthweight infants to transfer for additional care.
Infant clothing, bedding and room heating in an area of high postneonatal mortality
Authors: Nelson E.A.S. , Taylor B.J.
Published: April 2008

Summary. Documentation of infant care practices (clothing, bedding and room heating) was undertaken in an area where the postneonatal mortality rate is 9.3 per 1000 live births. Three hundred and eleven infants (mean age 5 weeks) were studied in their own home during winter and spring. Low room temperatures were associated with low socioeconomic status, but not consistently with clothing or bedding thicknesses. The estimated thickness of bedding covering infants was less if their mothers were less well educated. Infants at high risk for possibly preventable postneonatal mortality, based on a locally developed scoring system, had less bedding and colder rooms. Ideas of illness management were often inappropriate, in that a large number of mothers would further wrap up their infants if they had a cold (58%), were febrile (8%) or had a convulsion (21%). The clothing and bedding appropriate for different environmental conditions in health and illness needs physiological evaluation. Meanwhile parents should be reminded of the risks of both hypothermia and hyperthermia.
Childhood injuries: a population‐based study of emergency room visits in Jerusalem
Authors: Gofin Rosa , Palti Hava , Adler Bella , Edet Edet
Published: April 2008

Summary. A study of childhood injuries of 0–17‐year‐old Jewish children based on emergency room records of the four major hospitals and the first aid stations was conducted in Jerusalem during 1986. The incidence of visits was 99.7/1000 child‐years with 95% confidence intervals (CI)=98.0–101.5. The rate was 97.2/1000 child‐years (CI=94.4–100.0) among the 0–5‐year‐olds, 114.6/1000 child‐years (CI=111.3–118.0) in the 6–12 age group, and was 93.6/1000 child‐years (CI=90.1–97.1) among 13–17‐year‐olds. The male to female rate ratio was 1.7 for the 0–5‐year‐olds, 2.1 for the 6–12‐year‐olds and 2.3 for the 13–17‐year‐olds. The most frequent causes of injuries were falls, 38.5/1000 child‐years (CI=37.4–39.6), being struck or caught, 21.1/1000 child‐years (CI=20.3–21.9), and road accidents, 5.4/1000 child‐years (CI=5.0–5.8). Only burns among children aged 6 years and over and poisoning among 13–17‐year‐olds showed a higher incidence among females than among males. The head was the most frequently injured part of the body (45.2/1000 child‐years, CI=44.0–46.4). Head injuries decreased as age increased, while injuries to the extremities and trunk increased with increasing age. Two per cent of the injured children were admitted to hospital.
Time‐trends in necropsy prevalence and birth prevalence of lung hypoplasia
Authors: Moessinger Adrien C. , Santiago Angelita , Paneth Nigel S. , Rey Henry R. , Blanc William A. , Jr John M. Driscoll
Published: April 2008

Summary. Congenital lung hypoplasia (LH) has been identified with increasing frequency in perinatal and neonatal necropsy reviews. The available prevalence figures have been derived using various diagnostic criteria in different populations and at various times. We therefore reviewed our experience in 15 years of consecutive early neonatal necropsies using one constant set of diagnostic criteria for LH and looked for a time‐trend. We determined the necropsy prevalence (no. of cases of LH/no. of necropsies) and the birth prevalence (no. of cases of LH documented at necropsy per 1000 livebirths for inborn patients, and per 1000 referrals for outborn patients) between 1971 and 1985. We then divided this 15‐year period into five consecutive 3‐year periods to determine if a time‐trend was discernible.

Whereas early neonatal mortality for neonatal intensive care unit (NICU) admissions progressively decreased from 11.4% to 4.0% between the first and the last 3‐year periods, the number of cases of LH per 3‐year period did not vary appreciably. As a result, the prevalence of LH at necropsy showed a slight upward trend with time. The overall prevalence was 18%; it was 13% during the first and 23% during the last 3‐year period. We found no time‐trend in birth or referral prevalence for this lesion, which averaged 1.1 per 1000 livebirths and 9.8 per 1000 referrals. We conclude that lung hypoplasia appears to be emerging as an increasingly prevalent necropsy finding as a result of a shift in proportionate mortality, with the number of patients dying of other causes (denominator) decreasing, and the number of patients dying with lung hypoplasia remaining constant.
Classification of small‐for‐gestational age births: weight‐by‐gestation standards of second birth conditional on the size of the first
Authors: Skjaerven Rolv , Bakketeig Leiv S.
Published: April 2008

Summary. Percentiles of weight‐by‐gestational age were constructed for first and second births, based on linked sibship‐data from the Medical Birth Registry of Norway. Standards were made for weight‐by‐gestational age of second births conditional on whether the first birth was small‐for‐gestational age (SGA) or large‐for‐gestational age (LGA). These standards were compared with the conventional, cross‐sectional standard of all second births. The relevance of the conditional standards was assessed on the basis of perinatal mortality, using logistic regression analyses. When applying cross‐sectional standards of second births, more than 30% of the births following a SGA first birth were classified as SGA, compared with only 1.7% following an LGA first births. The overall risk for a perinatal loss in second births following a SGA first birth was twice that among second births following a LGA first birth.

When second births were themselves categorised as SGA or non‐SGA using the cross‐sectional standards, the mortality among the SGA second births was such that the risk was 4 to 5 times higher following LGA first births compared with SGA first births. When conditional standards were applied to define SGA among second births, the risk relation between the subgroups (defined by classification of first birth) corresponded to the observed overall risk pattern. An unconditional SGA classification conceals important differences between clinically distinct subgroups.
Factors influencing the relationship between a newborn assessment of gestational maturity and the gestational age interval
Authors: Alexander Greg R. , Hulsey Thomas C. , Smeriglio Vincent L. , Comfort Marilee , Levkoff Abner
Published: April 2008

Summary. This study examines the correlation and agreement between the calculated ‘gestational interval’ from the date of last menstrual period (LMP) and the Ballard newborn assessment of gestational maturity. It then investigates selected maternal socio‐demographic, prenatal, intrapartum and infant factors which may account for differences between these two gestational age determination methods. Single live‐born deliveries (n = 10 794) were selected from a 1982–1986 medical university perinatal information data system for analysis. The Ballard assessment overestimates the LMP at earlier gestational ages and underestimates in the post‐term range. The discrepancy between LMP and Ballard varies across the range of gestational age values and the extent of variation differs by several maternal and infant risk factors. These findings suggest considerable bias may result from the indiscriminate case mixing of LMP and Ballard values for use in gestational age research or in standardising developmental tests. We highlight the deficiencies in using correlation coefficients or mean differences to assess agreement between these measures.
Malignant hepatic tumours in children: incidence, clinical features and aetiology
Authors: Mann J.R. , Kasthuri N. , Raafat F. , Pincott J.R. , Parkes S.E. , Muir K.R. , Ingram L.C. , Cameron A.H.
Published: April 2008

Summary. Congenital defects and other disorders have been reported in association with malignant liver tumours. In order to assess their significance, a population‐based survey was undertaken on children aged less than 15 years diagnosed with malignant liver tumours during the 30 years 1957–1986. The cases were identified from information collected by the West Midlands Regional Children's Tumour Registry. Pertinent data were extracted from their clinical records, and the original biopsy and any necropsy material were reviewed by a panel of three paediatric pathologists. Of the 50 eligible cases registered, eight were excluded because histology review showed that they had non‐malignant conditions (3) or malignancies of extra‐hepatic origin (4) or because no pathological material was available (1). The diagnoses in the remaining 42 cases were hepatoblastoma (27), hepatocellular carcinoma (3), rhabdomyosarcoma (6), rhabdoid tumour (3) and yolk sac tumour (3). The incidence of primary malignant liver tumours was 1.20 per 106 person years and that of the hepatoblastoma sub‐group was 0.77 (average childhood population of the West Midlands for the time period being 1166500). The presenting clinical, radiological and biochemical features were similar to those reported in other series and the ethnic and social class distributions were unremarkable compared with the local population. Congenital defects or other possibly related features were present in nine (21%) patients. Our results, taken with other reports, suggest
Birth defects monitoring in California: a resource for epidemiological research
Authors: Croen Lisa A. , Shaw Gary M. , Jensvold Nancy G. , Harris John A.
Published: April 2008

Summary. The California Birth Defects Monitoring Program maintains a population‐based birth defects registry of structural congenital malformations, monitoring over 600000 resident births annually. Cases are actively ascertained from hospitals and genetic centres throughout California and from selected facilities in adjacent states. Field staff identify presumptive cases from careful review of medical records. Diagnostic and demographic information is collected from in‐patient and genetic centre medical charts for children diagnosed with major structural malformations between conception and 1 year of age. The application of these data to epidemiological investigations of birth defects is described in the context of prevalence studies, aetiological studies and evaluative studies, and the strengths and limitations of the registry data are discussed.
An educational intervention on promotion of breast feeding
Authors: Neyzi Olcay , Olgun Pervin , Kutluay Türkan , Uzel Nedret , Saner Günay , Gökçay Gülbin , Taşdelen Emel , Akar Ugur
Published: April 2008

Summary This study was designed to search for an effective method to promote exclusive breast feeding among Turkish city women delivering in hospitals. Four hundred and forty‐two primiparae with uncomplicated deliveries and with healthy infants with birthweights of > 2500 g were exposed to a group educational session on breast feeding after birth, followed by one repeat session at home. Four hundred and ninety‐nine women served as controls. All homes were visited monthly for 6 months by independent observers and data relevant to the feeding of the infants were collected. Weight measurements of 176 infants were taken at age 4 months. The study and control mothers were similar in sociodemographic characteristics which reflected a low socio‐economic/educational background but relatively good housing conditions. Although significant differences in frequency of exclusive breast feeding were found between the study and control groups, the impact of the intervention was much lower than our expectations and short‐lived. Type of feeding was not related to sex or birthweight of the infant, nor to maternal variables. Weight at age 4 months was within normal limits and similar in the study and control groups. It was concluded that lack of up‐to‐date information on infant feeding was the main obstacle to breast feeding in urban groups in Turkey, and that the impact of an educational intervention limited to the first week after delivery was lost within the first 2 months.
A review of child health in the 1958 birth cohort: National Child Development Study
Authors: Power Chris
Published: April 2008

Summary.In the week 3–9 March 1958, 98% of all births in England, Scotland and Wales (approximately 17000) were studied in the Perinatal Mortality Survey. The follow‐up of surviving children, known as the National Child Development Study, comprises four major sweeps at ages 7, 11, 16 and 23. Medical examinations were conducted at each age, except at 23 when health was self‐reported. Details of the child's family background and socio‐economic circumstances were recorded, together with assessments of their social development and educational attainment. Seventy‐six per cent of the target population were interviewed at age 23. The health of subjects in the 1958 cohort has been described in over 200 publications but there is no comprehensive account of findings from birth to age 23. This overview attempts to redress this. As new data are gathered from the study subjects at age 33, opportunities will exist to investigate associations between childhood factors and health in midlife. Data on their partners and children will be included, allowing studies of inter‐generational and family health. Further indications of changing illness patterns will be possible from comparisons with data collected on earlier and later born cohorts.
Importance of the first day death rate in infant mortality
Authors: Hansen Holger , Kiely Michele
Published: April 2008

Summary. The conventional partition of infant mortality into neonatal and postneonatal deaths, with the 28th day postpartum as the dividing line, has lost much of its epidemiological rationale in countries with low infant death rates. Infant deaths are concentrated increasingly at the start of the neonatal period: one out of three infant deaths in the United States occurs during the first 24 hours. Circumstances of early neonatal deaths differ considerably from those of later neonatal deaths. Failure to monitor separately early and late neonatal mortality can compromise the recognition of distinct epidemiological patterns. Racial disparities in the US tend to be larger for first day deaths than for any other infant deaths. Total US infant mortality declined rapidly in the 1950s and 1960s but first day deaths rose at a steady pace. Surveillance of infant mortality, whether on the national or the community level, should encompass first day, first month and first year death rates.
Violence, pregnancy and birth outcome in Appalachia
Authors: Dye Timothy D. , Tolliver Nancy J. , Lee Richard V. , Kenney Catherine J.
Published: April 2008

Summary. Few studies have followed pregnant women prospectively to examine the impact of violence on birth outcome. We included such an assessment in a prospective study of pregnancy among low‐income women. Nurses and social workers interviewed pregnant women (n = 364) and asked if they had been the object of violence since they became pregnant. These prenatal interviews were linked with information from perinatal records and with birth and death information. In total, 15.9% of women in the study indicated they had been abused since they became pregnant. Abused women were more likely to be teenagers and to have partners who were teenagers. Abused women were more likely to be primiparous, to smoke during pregnancy and to have physical problems related to stress. Women battered during pregnancy were more likely to suffer fetal distress or fetal death [Odds Ratio (OR) 3.68; 95% Confidence Interval (CI) 1.36,9.94], even after adjusting for maternal age and smoking status. Finally the infants of abused women were more likely to remain in hospital after their mother's discharge (OR: 3.75; 95% CI: 1.38, 10.23). Our findings suggest that fetuses may be compromised in utero, as shown by higher rates of fetal distress and fetal death found among women physically abused during pregnancy.
Time trends of child development in a Jerusalem community
Authors: Gofin Rosa , Adler Bella , Palti Hava
Published: April 2008

Summary. The study of the Development Quotient (DQ ‐ according to the Brunet‐Lezine test) of two‐year‐olds living in a geographically defined area in Western Jerusalem was carried out for the birth cohorts of 1971 to 1989 (n= 4314). An ‘Early Stimulation’ programme was implemented from 1975 through the Mother and Child Health Clinic. The stimulation programme provided mothers with skills to enhance the development of their children through social interaction, play and verbal stimulation from birth to two years of age. The mean DQ at 2 years old increased significantly from 104.6 (SD = 9.8) for the 1972 cohort to 108.9 (SD = 9.1) for those born in 1989. Coordination and posture subscores followed the trends of the total DQ while the trends in language development were less marked. There is indication that children whose mothers had 9–11 years of schooling benefited more than other children. Better achievement on the developmental test as expressed in the mean DQ was probably related to changing socio‐demographic characteristics of the population, and the implementation of the ‘Early Stimulation’ programme. The widening gap of the DQ after an initial decrease among children whose mothers had ≤ 8 years of schooling and those in higher educational groups during the 80s may have been caused by the fact that the latter are a very disadvantaged group of families compared with the rest of the population.
Use of androgen deprivation therapy for metastatic prostate cancer in older men
Authors: Keating Nancy L. , O’Malley A. James , McNaughton‐Collins Mary , Oh William K. , Smith Matthew R.
Published: April 2008

OBJECTIVE

To assess factors associated with early or delayed androgen deprivation therapy (ADT) among men diagnosed with metastatic prostate cancer, and to assess the relationship between ADT and overall survival, as there is uncertainty about the ideal timing for initiating ADT in men with metastatic prostate cancer.

PATIENTS AND METHODS

We studied a population‐based cohort of American men aged ≥66 years diagnosed with metastatic prostate cancer during 1992–2002 and followed to 2003. We assessed the receipt of ADT early (≤4 months from diagnosis), delayed (>4 months), or not at all, using multinomial logistic regression to identify factors associated with treatment, and Cox proportional‐hazard models to assess whether treatment was associated with survival.

RESULTS

Overall, 69.5% of men received early ADT and 7.3% delayed. Adjusted rates of early ADT were lower for black than white men (58.3% vs 71.0%), and of delayed ADT were higher for black than white men (12.7% vs 6.2%). Receipt of ADT was associated with improved survival (adjusted hazard ratio 0.69, 95% confidence interval 0.66–0.73). The benefit of early treatment did not differ from delayed treatment (P = 0.58).

CONCLUSIONS

A large minority of men with metastatic prostate cancer, particularly black men, receive delayed or no ADT. Early or delayed ADT was associated with similarly prolonged survival. After controlling for patient and tumour characteristics, survival did not differ by race, and receipt of ADT did not contribute to racial differences in survival.
Loss to follow‐up in an international, multicentre observational study
Authors: Mocroft A , Kirk O , Aldins P , Chies A , Blaxhult A , Chentsova N , Vetter N , Dabis F , Gatell J , Lundgren JD ,   for the EuroSIDA study group
Published: April 2008

Objective

The aim of this work was to assess loss to follow‐up (LTFU) in EuroSIDA, an international multicentre observational cohort study.

Methods

LTFU was defined as no follow‐up visit, CD4 cell count measurement or viral load measurement after 1 January 2006. Poisson regression was used to describe factors related to LTFU.

Results

The incidence of LTFU in 12 304 patients was 3.72 per 100 person‐years of follow‐up [95% confidence interval (CI) 3.58–3.86; 2712 LTFU] and varied among countries from 0.67 to 13.35. After adjustment, older patients, those with higher CD4 cell counts, and those who had started combination antiretroviral therapy all had lower incidences of LTFU, while injecting drug users had a higher incidence of LTFU. Compared with patients from Southern Europe and Argentina, patients from Eastern Europe had over a twofold increased incidence of LTFU after adjustment (incidence rate ratio 2.16; 95% CI 1.84–2.53; P<0.0001). A total of 2743 patients had a period of >1 year with no CD4 cell count or viral load measured during the year; 743 (27.1%) subsequently returned to follow‐up.

Conclusions

Some patients thought to be LTFU may have died, and efforts should be made to ascertain vital status wherever possible. A significant proportion of patients who have a year with no follow‐up visit, CD4 cell count measurement or viral load measurement subsequently return to follow‐up.
Characteristics of traditional Croatian ewe's cheese from the island of Krk
Authors: MIKULEC N , KALIT S , HAVRANEK J , ANTUNAC N , HORVAT I , PRPIC Z
Published: April 2008

Krk cheese is a hard, full‐fat cheese made from raw sheep's milk, characterized by a delicate, full and strong flavour. The aim of this study was to determine farm influence on the chemical composition of sheep's milk for Krk cheese production, and the chemical characteristics of Krk cheese during ripening. Gross composition of the milk used complies with the average sheep's milk composition from the Croatian Adriatic region. During ripening, fat, protein, salt content and lactic acid concentration increased (P < 0.01), as well as the water‐soluble nitrogen fraction and the 12%‐trichloroacetic‐acid‐soluble nitrogen fraction (P < 0.05). Degradation of β‐casein could be an indicator of the ripening quality of Krk cheese.
Minimization of aflatoxin M1 content in Iranian white brine cheese
Authors: MOHAMMADI H , ALIZADEH M , BARI M R , KHOSROWSHAHI A , TAJIK H
Published: April 2008

A chemometric approach was used to minimize the aflatoxin M1 (AFM1) content of Iranian white brine cheese. The effects of processing factors such as renneting temperature (30–40°C), cutting size (0.5–1 cm), stirring time (10–20 min), press time (1–2 h), curd size (64–256 cm3) and saturated brine pH (4.6–6) on the AFM1 content of the cheese curds were explored. Renneting temperature, press time and saturated brine pH were, respectively, the most significant factors. The aflatoxin content of the cheese samples decreased with increasing renneting temperature and press time. Lowering of the saturated brine pH reduced AFM1 in the cheese curds. Taking account of all of the factors studied, optimum processing conditions for minimization of AFM1 in the cheese curds were: renneting temperature = 39.91°C, cut size = 0.51 cm, stirring time = 17.71 min, press time = 19.48 min, curd size = 73.27 cm3 and saturated brine pH = 4.79.
Grass pollen allergens
Authors: Hrabina M. , Peltre G. , Van Ree R. , Moingeon P.
Published: April 2008

To date, eleven groups of grass pollen allergens eliciting a specific IgE response in atopic individuals have been identified. Groups 1 and 5 allergens are the most critical (major) pollen allergens leading to the sensitization of 90% and 65–85% allergic patients, respectively. Other allergens frequently involved in the IgE response include groups 2/3, 4, 6, 7, 10–13 allergens. Allergens found in various Pooideae exhibit high homology in terms of their amino acid sequence composition, which translates into significant cross‐reactivity in terms of antibody (IgE and IgG) as well as T cell responses. Nevertheless, for a given allergen group, there is evidence of both interspecies (i.e. differences in amino acid sequences) and intraspecies (multigenes, post‐translational modification, mRNA splicing or editing) molecular variability.
Actions and possible hormonal functions of circulating neurotensin
Authors: Rosell Sune , Rökaeus Åke
Published: April 2008

Summary. Neurotensin is one of the new peptides of the CNS and of the gut. In the periphery neurotensin is found in endocrine cells scattered diffusely in the gut mucosa and also in sympathetic nerves. This distribution indicates that the peptide may function as a hormone of the paracrine or endocrine type and as a neurotransmitter or neuromodulator. The purpose of this review is to present studies related to the distribution of neurotensin in peripheral organs, its pharmacological actions and possible physiological function as an endocrine hormone. Wc will also shortly discuss some of the pathophysiological implications based on available experimental data.
Effect of nicotine on the formation of prostaglandins in the rabbit kidney
Authors: Alster Pawel , Wennmalm Åke
Published: April 2008

Summary. The effect of nicotine on the conversion of 14C‐labelled arachidonate (14C‐AA) to 14C‐labelled primary prostaglandins (PGs) was investigated in low‐speed super‐natants and high‐speed sediments of rabbit homogenized kidneys. Nicotine (2×10˜7 M‐2×10_4M) dose‐dependently inhibited the formation of the labelled PGs D2, E2 and F2a regardless of whether low‐speed supernatants or high‐speed sediments were the enzymatic source. The (I).0 of nicotine was about 10‐5M. Nicotine did not affect the distribution of the primary PGs formed in comparison to controls. Indomethacin also inhibited the formation of labelled PGs, being on a molar basis about 500 times more efficient than nicotine.

It is concluded that nicotine attenuates the bioformation of primary PGs in the rabbit kidney, probably by eliciting an inhibitory effect on the cyclo‐oxygenase that converts A A to PGendoperoxides.
Clinical ventilation‐perfusion scintigraphy
Authors: Fazio F. , Wollmer P.
Published: April 2008

Summary. Ventilation‐perfusion scintigraphy is an established procedure for the investigation of lung disease. Perfusion scans are commonly obtained with a y‐camera following injection of 99mTc‐labelled microspheres. For the assessment of regional lung ventilation, a number of techniques are now being employed, i.e. 133Xe and 127Xe single breath/ washout studies, continuous inhalation of 81mKr and inhalation of radioactive aerosols. The latter two methods are now gaining consideration in clinical practice.

Lung perfusion scanning is highly sensitive for detection of regional abnormalities of blood flow; the diagnosis of pulmonary embolism remains the most important clinical application of the technique. In this context, the use of a ventilation scan is required in order to increase the specificity of the procedure.

In general, lung ventilation‐perfusion scintigraphy is of great value for the management of patients with both primary lung disease and heart disease, by providing pathophysiological information of importance for the diagnosis, follow up and the functional evaluation of the patient.
51Cr‐EDTA clearance determined by one plasma sample
Authors: Groth Steffen , Aasted Michael
Published: April 2008

Summary. 51Cr‐EDTA clearance was measured in 99 consecutive patients. Based on the individual plasma activity at 180,200, 220, and 240 min after injection (normalized with respect to injected dose/body surface area), a nomogram and a formula were derived for the relation between clearance and the plasma activity in one sample drawn between 180 and 240 min after injection. The nomogram was tested by the activity in 141 plasma samples from 53 consecutive patients. The clearance values calculated by means of the nomogram were compared to the corresponding clearance value calculated by a conventional standard method. The correlation coefficient for this comparison was r=0–982.

It is recommended that the nomogram should only be used if clearance values above 30 ml/min are expected.
Conventional versus computer‐aided interpretation of long‐term ECG recordings–aspects of precision and economy
Authors: Pahlm Olle , Jonson Bjorn , Lukes Miroslav , Ringqvist Ivar , Engström Marie‐Louise , Foborg Marie‐Louise
Published: April 2008

Summary. In a sample of 60 12‐h long‐term ECG recordings we compared a computer‐aided analysis method to a conventional scanning technique for diagnostic precision and time consumption. As regards diagnostic precision no significant difference between the methods could be found. Both were considered efficient in detecting episodes of arrhythmia. Using the computer‐aided method a physician spent an average of 16 min on analyzing a recording and writing the diagnostic report. The conventional method required 69 min from an ECG technician and 9 min from a physician for each recording. From these figures we conclude that about 750 12‐h recordings/year are required to outweigh the extra annual cost for the computer, if it is used only for long‐term ECG analysis. If the computer can also be used for other purposes the system for long‐term ECG analysis is profitable with a smaller annual number of recordings.
Interstitial protein ‘wash‐down’, an early sign of cardiac failure?
Authors: Noddeland Harald , Fadnes Hans Olav , Aukland Knut
Published: April 2008

Summary. An increase of interstitial fluid volume (IFV) with or without clinical oedema is an important sign of congestive heart failure. Without entering into a discussion of forward versus backward failure, we will briefly analyse this alteration of trans‐capillary fluid balance in peripheral tissues: the rise in IFV must result either from a rise in net capillary filtration, or from a decrease of lymph flow. Since lymph flow is increased rather than decreased in congestive heart failure (Langgård, 1963), we must conclude that a rise in IFV is caused by increased net capillary filtration. According to the Starling equilibrium, a rise in net filtration could result from (a) a rise in average capillary pressure (Pc), (b) a reduction of interstitial fluid hydrostatic pressure (Pi), (c) a fall in plasma colloid osmotic pressure (COPP), or from (d) an increase of interstitial fluid colloid osmotic pressure (COPi), Since COPp and Pi are normal in most cases of congestive heart failure, and since COP; and Pi tend to change opposite to the required direction (see below), it follows that the rise in IFV results mainly from a rise in mean capillary pressure.
Blood gases in orthostatic and exercise tests in patients with hyperventilation syndrome
Authors: Sovijärvi A. R. A. , Karhumaki L. , Ahola T. , Lehtinen H. , Perämäki P. , Uusitalo A. J.
Published: April 2008

Summary. Arterial blood gases were analysed from eight patients with clinically typical hyperventilation syndrome (HVS^ and with no signs of organic diseases, and from eight control patients with no cardiopulmonary or metabolic disease; the blood samples were drawn at rest, during an orthostatic test and during and 10 min after maximal exercise. In all stages of the tests the arterial oxygen tension of the HVS patients was at a high normal level. By the end of the orthostatic test, during maximal exercise and 10 min after the exercise every HVS patient had moderate to marked hypocapnia. At every stage of the tests the arterial Pco2 of the HVS patients was significantly lower than that of the control patients; during standing and after exercise the arterial pH was significantly higher in the HVS group than in the control group. Either during the orthostatic test or 10 min after the exercise or at both situations all of the HVS patients, but none of the controls, showed respiratory alkalosis. The results indicate that standing up and heavy exercise can markedly stimulate the HVS patients to hyperventilate. Thus, orthostatic and exercise tests combined with blood gas analyses seem to be useful in diagnosing the HVS.