bluuebunny/crossref_metadata_2025_split huggingface dataset:
Febrile Infants at Low Risk for Serious Bacterial Infection—An Appraisal of the Rochester Criteria and Implications for Management
Authors: Jaskiewicz Julie A. , McCarthy Carol A. , Richardson Amy C. , White Kathleen C. , Fisher Donna J. , Powell Keith R. , Dagan Ron ,   Febrile Infant Collaborative Study Groups
Published: December 2021

Objective. Prospective studies were conducted to test the hypothesis that infants unlikely to have serious bacterial infections (SBI) can be accurately identified by low risk criteria.
Methods. Febrile infants (rectal T ≥ 38°C) ≤60 days of age were considered at low risk for SBI if they met the following criteria: 1) appear well; 2) were previously healthy; 3) have no focal infection; 4) have WBC count 5.0-15.0 x 109 cells/L (5000-15 000/mm3), band form count≤ 1.5 x 109 cells/L (≤1500/mm3), ≤10 WBC per high power field on microscopic examination of spun urine sediment, and ≤5 WBC per high power field on microscopic examination of a stool smear (if diarrhea). The recommended evaluation included the culture of specimens of blood, cerebrospinal fluid, and urine for bacteria. Outcomes were determined. The negative predictive values of the low risk criteria for SBI and bacteremia were calculated.
Results. Of 1057 eligible infants, 931 were well appearing, and, of these, 437 met the remaining low risk criteria. Five low risk infants had SBI including two infants with bacteremia.
The negative predictive value of the low risk criteria was 98.9% (95% confidence interval, 97.2% to 99.6%) for SBI, and 99.5% (95% confidence interval, 98.2% to 99.9%) for bacteremia.
Conclusions. These data confirm the ability of the low risk criteria to identify infants unlikely to have SBI. Infants who meet the low risk criteria can be carefully observed without administering antimicrobial agents.
LIFETIME COST OF TREATING AIDS PATIENTS GOING DOWN
Authors: L. J. F. 
Published: December 2021

The estimated cost of treating a person with the human immunodeficiency virus (HIV) from the time of infection until death is $119,000, but the cost is declining, according to a new study by the Agency for Health Care Policy and Research. Study author Fred J. Hellinger, Ph.D., director of AHCPR's Division of Cost and Financing, Center for General Health Services Extramural Research, used data from the AIDS Cost and Service Utilization Survey (ACSUS) to estimate the monthly cost of treatment for persons in various disease stages ...
The study projects that the average survival time of a person with AIDS (PWA) diagnosed in 1993 would be 25 months.
HEALTH REFORM CAN'T CURE HIGH COSTS
Authors: L. J. F. 
Published: December 2021

These facts prove that, contrary to widespread belief, no health care system offers a magic cure for rising costs. Something else is going on.
The "something else" is that health care, like education and police work, is a "handicraft service." Characteristically, these activities can't be automated or sped up and made more productive. Doctors, for instance, simply cannot work much faster than they do without cutting into quality. True, technological advances can and do add some productivity to these fields, but not that much ...
This important phenomenon is called "the cost disease of the handicraft services" and it undermines a basic assumption of some health reforms. If, by its craft nature, health care is condemned to low productivity growth and rapidly rising costs, then these inherent limits will simply not be correctable by price controls or other reforms of the system. In other words, cost increases are in the nature of the health care beast. Efforts to alter this nature will be fruitless or harmful.
The Increased Rate of Stimulant Treatment for Hyperactive/Inattentive Students in Secondary Schools
Authors: Safer Daniel J. , Krager John M. 
Published: December 2021

Objective. To describe trends in medication use for hyperactive/inattentive (HA/I) secondary school students from 1975 through 1993 and to present differences in the treatment of HA/I relative to school grade.
Design. A comprehensive survey of the HA/I treatment of public elementary and secondary school students has been conducted biennially by school nurses in Baltimore County, MD since 1975.
Results. Although only 11% of all public school students on medication for HA/I were in secondary schools in 1975, the proportion gradually rose such that in the 1990s, 30% of all medicated students were attending secondary schools. Also in secondary schools, the gender ratio for students on medication for HA/I narrowed from a 1:12 female/male ratio in 1981 to a 1:6 female/male ratio in 1993.
Conclusions. Many more elementary school students are now remaining on stimulant medication for HA/I into their teens. Compared with a decade ago, relatively more girls are on stimulant treatment for HA/I during their secondary school years.
Biological Rhythmicity in Normal infants During the First 3 Months of Life
Authors: Glotzbach Steven F. , Edgar Dale M. , Boeddiker Margaret , Ariagno Ronald L. 
Published: December 2021

Objective. The mammalian "biological clock," which resides in the hypothalamic suprachiasmatic nucleus, has an important role in both the timing and organization of sleep and in the coordination of sleep with other physiological rhythms such as temperature regulation and respiratory control. We wished to describe the development of the circadian system in normal infants during the first 3 months of life.
Methods. Ten healthy full term infants were studied in the infant's home for three consecutive days at 1 month and 3 months postnatal age. Rectal temperature, abdominal skin temperature, heart rate, and activity were recorded at 2-minute intervals during each study using a small microcomputer.
Results. Circadian periodicity for most variables was seen at 1 month of age and significantly increased at 3 months. Differences in the pattern of rhythmicity during these two developmental periods were highlighted by an increase in activity during the subjective day and a decrease in Trecduring the subjective night at 3 months compared to 1 month. Correlational analysis revealed that all pairs of variables, exclusive of Tsk, showed a significantly higher association at 3 months relative to 1 month. The lengthening of the interfeeding interval at 3 months of age corresponded with an increased consolidation of sleep during the night and a relatively lower nocturnal body temperature minima compared to 1 month of age.
Conclusion. The results of this study underscore the subtle changes in the nature and interaction of several infant variables during this critical developmental period, which may reflect maturation of the circadian system and its coupling with homeostatic effector systems that are developing in parallel.
BRITAIN TO PROBE CLINIC THAT ALLOWS COUPLES TO CHOOSE INFANT'S GENDER
Authors: Hawthorne Stephanie 
Published: December 2021

LONDON—The Health Department said yesterday it would investigate a private clinic that allows would-be parents to determine their baby's sex.
The London Gender Clinic, which opened on Thursday, charges couples $980 to use a technique that isolates the sperm that produce the desired sex so it can then be implanted into the woman.
APGAR STAMP
Authors: Butterfield L. J. 
Published: December 2021

On Monday, October 24, 1994 at 2:00 PM, a definitive stamp will be dedicated to Dr Virginia Apgar at the American Academy of Pediatrics (AAP) annual meeting in Dallas. A definitive stamp lasts for years while the commemorative stamp is printed just one year.
The United States Postal Service announced the 1994 stamp program on December 7, 1993 during a press conference at the National Postal Museum.
Dr Apgar was nominated for a stamp in 1987 by the AAP. The initiative was spawned by the Perinatal Section at the 1985 annual meeting of the AAP in San Antonio.
Violence Prevention: A Call to Action
Authors: Spivak Howard 
Published: December 2021

The Landscape Of Children's Health Issues Is Changing. While This Is Obvious To Most Pediatricians, Few Would Have Predicted, Even A Decade Ago, The Prominence Of Violence And Violent Injuries In The Present Landscape Facing Children And Youth. What Was Once Seen And Addressed As A Problem Confined To Certain Populations, Particularly Poor And Minority Youth, Is Now Increasingly Visible Throughout The Nation, Crossing All Socioeconomic Boundaries, Affecting Rural, Suburban, And Urban Communities. In Just A Few Years, If Current Trends Continue, Guns Will Kill More Us Children And Youth Than Automobiles.1 Pediatricians And Other Health Professionals Concerned About Children Must Face This Issue Head-On And Must Participate In Efforts To Turn The Tide On Violence And Its Effects On Children. The Key Is To Better Understand The Underlying Risks And Contributing Factors Surrounding This Growing Epidemic And To Clearly Define Our Role, As Individual Pediatricians And At The Professional Organizational Level, In Working To Reduce Those Risks.
The Papers Contained In This Supplement Present A Broad Overview Of Some Of The Key Factors Related To Violence As Well As An Overview Of What Is Known About The Responses To These Factors. Four Of The Papers Specifically Focus On How Violent Behavior Is Learned By And Reinforced In Children At Home,2,3 In The Community,4 And Through The Media.5 One Paper Takes A Look At The Role Of Firearms, Particular Hand-Guns, In This Epidemic.6 The Last Three Papers Describe And Review Strategies For Reduction Of Violence In The Community,7 In The Media,8 And Through Advocacy At The State And National Levels.9
FISH SWIM WHERE THE FOOD IS
Authors: Student  
Published: December 2021

A scientist who is really exploring the unknown has no idea where the research is going. That makes it difficult to predict. . .But, on the other hand scientists who are actually exploring the unknown are very rare. Most prefer to take whatever mission the NIH proposes and write their grants accordingly.
Dr. Ponzy Lu, Biochemist. Quoted in: Kolata G. Scientists fluff the answer to a billion-dollar question. The New York Times. November 1, 1992.
INTRODUCTION
Authors: Harvey Birt 
Published: December 2021

One of the ongoing objectives of the Johnson & Johnson Pediatric Institute is to provide pediatricians with practical information on issues whose importance is just becoming clear, issues that may not yet be adequately addressed in the usual pediatric reference sources. The prevention of violent behavior in children is one such issue. Recognizing that violent behavior has become part of the "new morbidity," that violence in adulthood may have its genesis in childhood, and that pediatricians can play an important role in preventing children from using violence, the Institute's board of trustees elected to explore the possibility of a conference on this topic. A group of experts—Jerome Hirschfeld, Howard Spivak, Don Schwarz, and Modena Wilson—was asked to advise the board of trustees on what general and specific content should be included in such a conference, which experts to invite for each subject, and how best to format a conference. Pleased with the suggestions of this group, who became a planning committee, the board agreed to support a conference that would offer recommendations for physician actions on both an individual and an organizational level.
The planning committee believed that the conference should focus on one of the things that pediatricians do best—prevention—and that it should be limited to primary prevention because of time considerations. Thus, the focus was on providing information that would help pediatricians in preventing violent behavior among all the children they care for, not only those children in families that may be at risk. These efforts would be in contrast to the secondary prevention efforts that would occur after a child has already been involved in violent activity or the tertiary efforts that might include special school or community programs or rehabilitative efforts for chronic violent offenders.
Patterns of Haemophilus influenzae type b Invasive Disease in New York State, 1987 to 1991: The Role of Vaccination Requirements for Day-Care Attendance
Authors: Schulte Elaine E. , Birkhead Guthrie S. , Kondracki Stan F. , Morse Dale L. 
Published: December 2021

Haemophilus influenzae type b (Hib) is the most common cause of bacterial meningitis in young children and is a major cause of other invasive bacterial disease.1 The case fatality rate for Hib meningitis is 1.0% to 3.4%.2,3 Also, 14% of meningitis cases result in persisting neurologic sequelae and 10% to 11% result in sensorineural hearing loss.4,5 With the introduction of Hib vaccines in 1985, what was once a potentially devastating disease is now preventable by vaccination.6
The risk of Hib in day-care centers (DCCs) is highest for younger children (≤23 months of age), during the first month of enrollment in day care, and for those children who attend larger day-care centers as opposed to home day-care settings.7 The incidence of Hib disease is higher for blacks, Hispanics, native Alaskans, American Indians, and children of lower socioeconomic status.8 Increasing enrollment in licensed DCCs throughout the country has provided an opportunity, through entrance requirements, to ensure that these children receive public health preventive measures such as vaccinations. Most states have laws requiring certain vaccinations before entry into DCCs; however, many states do not have a specific DCC entry requirement for Hib vaccination.9
The purposes of this article are to examine patterns of Hib incidence in New York State by gender, race, and age and to evaluate Hib disease within the DCC setting in New York State in relation to changing Hib vaccine requirements for DCCs.
METHODS
We conducted a retrospective study of invasive Hib disease in New York State outside New York City.
Injuries in Swedish Day-Care Centers
Authors: Sellström Eva , Bremberg Sven , Chang Albert 
Published: December 2021

In the developed countries, an increasing number of children are enrolled in day-care centers. When parents leave their child in a day-care center they expect high standards of health and safety. Accidental injuries are a major threat in this age group. In a comparable institution that serves children, the school, the risk of injury is higher than in the home environment.1-2 Thus, safety in day-care centers cannot be taken for granted. A few studies of injuries in day-care centers have been reported, from the Nordic countries2,3-5 and from the US.6-10 Most of these studies, however, have been small and most lack information on time of exposure.
Information about the risk of injury in Swedish day-care centers might be of interest as enrollment has been high for a long time. In Sweden, within the frame of a national injury program,11 a number of local hospital- and health center-based injury report systems have been set up. All have a basic common coding. These systems enable compilation of injuries in day-care centers on a national basis.
The aim of our study was to analyze child injuries in day-care centers as reported in 10 local injury registry systems in Sweden regarding incidence, type, and mechanism of injury.
METHOD
Data were compiled from 10 local injury registry systems, covering 1- to 2-year periods. The earliest registers were from the years 1983 to 1984 and the latest from 1991. These systems were set up in all medical institutions at a predefined level, covering all individuals in a total or a part of a county.
Child Care for Children With Special Needs
Authors: Cohen Herbert J. 
Published: December 2021

During the 1990s, requirements for child care for children with special needs will increase substantially. Parents of children with special needs face particular challenges in finding suitable child care for their children.
A major factor influencing future directions in child care for children with special needs is PL 99-457, the Early Intervention Amendments to the Education for All Handicapped Children Act.1 The component for 0- to 3-year-olds is Part H of the Individuals with Disabilities Education Act (IDEA).2 Almost all states have indicated their intent to provide early intervention services for children with disabilities and developmental delays. As each state moves toward implementation of its plan for 0- to 3-year-olds, federal fiscal incentives to expand such services will grow. The IDEA encourages integrated or inclusionary services for children with disabilities, as does the Americans with Disabilities Act (ADA).3 As a result of this stream of legislation, there will be growing pressure to serve children with special needs in generic child-care settings. Less certain is whether children with identifiable biological or social risks will have a similar entitlement under Part H, because only 10 states have, thus far, included an "at risk" group in their legislative mandate for early intervention.
WHO ARE CHILDREN WITH SPECIAL NEEDS AND HOW MANY ARE THERE?
The Technical Panel on Children with Special Needs of the American Public Health Association's and American Academy of Pediatrics' (APHA/AAP) National Health and Safety Performance Standards: Guidelines for Out-of-Home Child Care Programs4 defined the population with special needs as those children with developmental disabilities, mental retardation, emotional disturbance, and chronic illness, as well as those with sensory or motor impairments.
Effects of Child Care on Psychological Development: Issues and Future Directions for Research
Authors: Friedman Sarah L. , Brooks-Gunn Jeanne , Vandell Deborah , Weinraub Marsha 
Published: December 2021

Research about the effects of child care on the psychological development of children has been stimulated by social reality. Industrialized societies, including the US, have witnessed two simultaneous social trends: an increase in the number of mothers in the work force and a decrease in the age at which children enter child-care arrangements.1-3 These trends, in conjunction with cultural beliefs, psychological theories, and research findings emphasizing the important role of mothers in early child development,4-6 have motivated researchers to investigate the effects of maternal employment and of child care on the development of infants and older children.
Issues facing developmental psychologists who study child care and its effect on children's development are theoretical, methodological, and budgetary. The waves of psychological research about child care1 reflect changes in conceptual emphasis: Originally, it seemed sufficient to compare children reared in any child-care context with those reared by the mother as the primary care provider. As the results from these investigations were accumulating, investigators recognized a need to focus on variations in the quality of child-care arrangements and to relate these to children's psychological development. Because of issues of access to child-care arrangements, much of the research on quality of care that was generated pertained to center-based care. Most recently, investigators have turned their attention to the relationship between demographic characteristics of families and their choices of child-care arrangements for their children. Even though the research appeared in waves, they all continue to coexist and they all elaborate and enrich our knowledge. Investigators are now interested in weaving the earlier lines of research into a more comprehensive framework.
AMERICAN ACADEMY OF PEDIATRICS
Authors:   Johnson & Johnson Consumer Products, Inc.
Published: December 2021

The American Academy of Pediatrics is requesting nominations for the 1995 E. H. Christopherson Lectureship on International Child Health. Nominees must be internationally recognized individuals (not necessarily physicians) who have made significant contributions to international child health. The nomination dead-line is January 31, 1995.
For additional information contact: Jean Dow, MEd, Director of the Division of Medical Journals, or Kyle Ostler, Division Secretary, American Academy of Pediatrics, 141 Northwest Point Boulevard, Elk Grove Village, IL 60007; 800/433-9016.
Comparison of Cefpodoxime Proxetil and Cefixime in the Treatment of Acute Otitis Media in Infants and Children
Authors: Asmar Basim I. , Dajani Adnan S. , Del Beccaro Mark A. , Mendelman Paul M. ,   Otitis Study Group
Published: December 2021

Objective. To compare the use of once-a-day cefpodoxime proxetil to once-a-day cefixime in the treatment of acute suppurative otitis media.
Design. Randomized, multicenter, investigator-blinded.
Setting. Outpatient.
Patients. A total of 368 patients (age 2 months to 17 years) were randomized to receive either cefpodoxime or cefixime in a 2:1 ratio (245 cefpodoxime, 123 cefixime); 236 patients (155 cefpodoxime, 81 cefixime) were evaluable for drug efficacy.
Interventions. Patients received either cefpodoxime proxetil oral suspension (10 mg/kg/day, once daily for 10 days) or cefixime oral suspension (8 mg/kg/day, once daily for 10 days).
Main outcome measures. Clinical evaluations were performed before treatment (study day 1), at an interim visit (study day 3 through 6), at the end of therapy (study day 12 through 15), and at final follow-up (study day 25 through 38). Microbiologic evaluations were performed at enrollment and whenever appropriate thereafter.
Results. End-of-therapy clinical cure rates in evaluable patients were 56% for the cefpodoxime group and 54% for the cefixime group. Clinical improvement rates were 27% for both groups. Clinical response rates were not significantly different between treatment groups (P = .541; 95% confidence interval = -8.1%, 15.2%). At long-term follow-up, 17% of patients in the cefpodoxime group and 20% in the cefixime group had a recurrence of infection. Drug-related adverse events (eg, diarrhea, diaper rash, vomiting, rash) occurred in 23.3% of cefpodoxime-treated patients and 17.9% of cefixime-treated patients (P = .282).
Conclusions. These findings suggest that cefpo-doxime proxetil administered once daily is as effective and safe as cefixime given once daily in the treatment of acute suppurative otitis media in pediatric patients.
A Classic Study of Infant Mortality—1911-1915
Authors: Yankauer Alfred 
Published: December 2021

A New York Times editorial in 1925 began with these words: "The human cost of poverty might have been the title of a report recently issued by the Children's Bureau of the United States Department of Labor." The editorial concluded with the words: "It is unfortunate that reports of this sort receive so little distribution. "A thorough knowledge of the causes of infant mortality', it is well stated in the introduction, "is the first step toward their complete control.' "2
The editorial was referring to the remarkably thorough investigations of infant mortality in eight cities, the combined results of which were analyzed by Robert Morse Woodbury.3
NATIONAL MEDICAL AGREES TO SETTLEMENT OF FRAUD CHARGES TOTALING $380 MILLION
Authors: L. J. F. 
Published: December 2021

"National Medical Enterprises, Inc detailed a broad settlement of fraud charges with the United States and 28 states involving payments of a record $380 million and federal guilty pleas on eight criminal counts by two of its units."
"The settlement total is more than three times the previous largest health-care-fraud payment, $111.4 million by National Health Laboratories, Inc in 1992. It is higher even than the nearly $300 million the government has recovered from ten defense contractors in its Ill Wind probe, the huge Pentagon fraud investigation that ended early this year."