bluuebunny/crossref_metadata_2025_split huggingface dataset:
Failure of Current Guidelines for Cholesterol Screening in Urban African-American Adolescents
Authors: Rifai Nader , Neufeld Ellis , Ahlstrom Promise , Rimm Eric , D'Angelo Lawrence , Hicks Jocelyn M. 
Published: December 2021

Objective. The National Cholesterol Education Program (NCEP) and the American Academy of Pediatrics recommend selective screening to detect children and adolescents with hypercholesterolemia. We compared the effectiveness of these guidelines with other potential screening strategies in urban African-American adolescents.
Subjects and Methods. Two hundred sixty African-American adolescents and young adults (192 females and 68 males; age range, 12 to 20 years) who were free from illnesses or medications that disrupt lipid metabolism were included in the study. Participants completed a questionnaire regarding their smoking habits, blood pressure, contraceptive pill use, and family history of early heart disease and high cholesterol and had their blood lipids, lipoproteins, and apolipoproteins measured (152 fasting and 108 nonfasting).
Results. Nineteen percent of participants reported family histories of hypercholesterolemia; 26% reported family histories of premature heart disease; and 8% had family histories of both hypercholesterolemia and premature heart disease. Therefore, 37% of these participants would have been targeted for cholesterol screening, compared with the 25% predicted by the NCEP. Less than 50% of the participants with low-density lipoprotein cholesterol (LDL-C) levels greater thane 110 or 130 mg/dL would have been detected by selective screening. Total cholesterol was superior as a screening test to apolipoprotein B in predicting LDL-C levels greater than 110 mg/dL (sensitivity, 92% vs 59%). However, total cholesterol minus high-density lipoprotein cholesterol showed better positive predictive value (100%) at LDL-C levels greater than 110 mg/dL than total cholesterol in the fasting (80%) and total groups (90%).
Conclusions. In this population, selective screening with total cholesterol, as recommended by the NCEP, has such poor sensitivity and positive predictive value that other options may be superior. As an alternative, we recommend the measurement of high-density lipoprotein cholesterol together with total cholesterol at the initial screening step in adolescents and universal screening for those older than 16 years to capture a greater proportion of young adults with increased LDL-C. Furthermore, we recommend using the less stringent treatment guidelines established by the Adult Treatment Panel II for premenopausal women and men younger than 35 years for older adolescents and young adults.
Breastfeeding Practices Among Resident Physicians
Authors: Miller Nancy H. , Miller David J. , Chism Melissa 
Published: December 2021

Objective. To determine how employment as a resident physician (resident) affects breastfeeding practices and experiences.
Design. Cross-sectional questionnaire survey.
Setting. US resident physicians in the second half of their postgraduate year three (PGY3).
Participants. 1500 questionnaires were mailed at random to female 1990 graduates of American medical schools. After eliminating unusable surveys, an adjusted response rate of 45% produced 450 surveys; 60 delivered a child during residency.
Interventions. None.
Measurement/Main Results. Forty-eight (80%) of 60 residents who delivered initiated breastfeeding, and continued for the duration of their maternity leave (mean, 7 weeks). With a return to residency half (24) of those who had initiated breastfeeding discontinued breastfeeding. The breastfeeding rate dropped to 15% (9/60) at 6 months. Residency work schedule was the most common reason (80%) for discontinuing breastfeeding. Of the 24 residents who continued breastfeeding while working, 83% pumped breast milk during their work shifts; 79% felt there was insufficient time during work, and 42% reported no appropriate place at work to express milk. Only 54% who continued felt supported by their attending physicians for their efforts to breastfeed; 67% felt colleagues were supportive.
Conclusions. The breastfeeding initiation rate for resident mothers was in compliance with the Healthy People 2000 guidelines, but the rate at infant age 6 months fell well below the goal of 50%. Modifiable factors in residents' work sites include both physical and emotional accommodations to encourage resident mothers to breastfeed.
Baseball Injuries: A Little League Survey
Authors: Pasternack Joel S. , Veenema Kenneth R. , Callahan Charles M. 
Published: December 2021

Objectives. To determine the patterns of injury in youth baseball and apply the data to estimate the value of proposed safety equipment.
Design. Prospective population-based injury survey.
Participants. 2861 Little League baseball players (ages 7 to 18) for 140 932 player-hours.
Measurements. An injury was included in the data only if it was serious enough to require medical/dental care, caused missing a game, or disallowed playing a certain position. The injuries were subdivided into acute or overuse. The acute injuries were classified as either catastrophic, severe, or minor. Injuries were categorized according to mechanism, area injured, and whether the player was on offense or defense.
Results. There were 81 total injuries, of which 66 (81%) were acute and 15 (19%) were overuse. Of the acute injuries, 11 were severe and 55 were minor. The overall injury rate was .057 injuries per 100 player-hours. The severe injury rate was .008 injuries per 100 player-hours, of which 46% were ball-related injuries and 27% were collisions. The most frequent mechanism of injury was being hit by the ball, which represented 62% of the acute injuries. Of the 41 ball-related injuries, 28 (68%) occurred to players on defense. Of the 18 ball-related facial injuries, 16 occurred to players on defense.
Conclusions. 1) Little League baseball is a safe activity with a low injury rate and a particularly low rate of severe injury;
2) impact by the ball causes more than half the acute injuries, thus safety interventions should be directed towards decreasing these injuries, especially on defense;
3) facemasks on batters can safely eliminate facial injuries to offensive players, but would only moderately reduce the incidence of ball-related facial injuries as most of these injuries are sustained by defensive players.
Papillary Thyroid Cancer: A Pediatric Perspective
Authors: Flannery Timothy K. , Kirkland John L. , Copeland Kenneth C. , Bertuch Alison A. , Karaviti Lefkothea P. , Brandt Mary L. 
Published: December 2021

A less-invasive approach to the evaluation of papillary carcinoma in children and adolescents recently has been proposed, based on reports of the accuracy and reliability of fine-needle aspiration biopsy (FNAB) in this population.1-4 Such confidence may be ill-founded, as the following clinical histories will illustrate. Functioning nodules, Hashimoto's thyroiditis (HT), and goiter-associated lymphadenopathy are unusual but significant presentations of papillary carcinoma in children and young adults, likely to be missed by the standard diagnostic approach in adults, which is reliant on FNAB, 123I scintiscans, or clinical response to suppressive doses of L-thyroxine (T4).
CASE REPORTS
Case 1
A thyroid nodule developed in a 12-year-old girl, first observed 1 month before evaluation in an endocrine clinic.
"It Takes a Whole Village": Working With Community Coalitions to Promote Positive Parenting and Strengthen Families
Authors: Chamberlin Robert W. 
Published: December 2021

RATIONALE FOR AN ECOLOGIC APPROACH
This conference brings me back full circle to where I started my academic career in the mid-1960s studying the effects of different child-rearing styles on the behavior and development of children. At that time I was interested in the studies of Lewin et al1 that demonstrated how different leadership styles affect child behavior in groups. I used that model to develop an interview method for identifying different approaches to child rearing by having mothers describe how they handled many common rearing situations with young children.2 Those mothers who made frequent use of unmodified directives and physical and/or psychological punishment for noncompliance were identified as authoritarian and those who responded with reasoning and more flexible approaches to discipline, such as using distraction and time out, were identified as accommodative.3 I was interested to see whether pediatricians could identify high-risk styles that would be harmful to children and then work with the parents to change those styles. This led me to develop a longitudinal study that followed a group of 135 2-year-olds experiencing different parenting styles into first grade.4 The parents of these children were recruited from two suburban pediatric group practices. The first observation we made was that even with this middle class population it was difficult to find an adequate sample of parents of 2-year-olds who did not use a lot of unmodified directives and spanking. We did, after considerable effort, find a suitable contrast group in a highly educated subsample of the population. As for corporal punishment, the parents using an authoritarian style generally reported using physical punishment once a day or more to control behavior and those with an accommodative style once a week or less.
Spanking and the Making of a Violent Society
Authors: Straus Murray A. 
Published: December 2021

Most of the world's societies are violent in the sense that they have high rates of physical assault, homicide, and war. The United States (US) is the most violent of the advanced industrial societies. The current US homicide rate of 8.5 per 100 000 is three times the Canadian rate of 2.3 per 100 000, and about eight times the rate of Western European countries. Nevertheless, many societies are even more violent. The Mexican homicide rate of 19.4 is more than double that of the US, and the rate for the cities of Columbia (110.4 per 100 000) is more than ten times higher.
Most of the world's societies also bring up children violently through the use of corporal punishment. Perhaps the correspondence between the preponderance of violence and that of corporal punishment is just a coincidence. Obviously, corporal punishment and assaults and murders differ in severity, and also in the cultural definition that makes one legitimate and the other criminal. However, there is also a correspondence between the behavior involved in corporal punishment and the behavior involved in criminal assaults and homicides that is seldom perceived. Everyone understands that corporal punishment is carried out to correct or control misbehavior. What is not understood is that almost all assaults by adults and about two thirds of homicides are also carried out to correct what the offender perceives as misbehavior. Typical examples include a confrontation between two men over a loan of $50 that is to be paid back in 1 week.
Iatrogenic Scald Burn: A Consequence of Institutional Infection Control Measures
Authors: Mirowski Ginat W. , Frieden Ilona J. , Miller Carol 
Published: December 2021

Accidental burns are common, causing signficant morbidity and mortality in all age groups, but they occur most frequently in young children. Each year, tap water burns result in approximately 2600 visits to emergency rooms in the United States1 and cause approximately 200 deaths,2 but these burns are rare in the hospital setting. We describe a case of scald injury in a newborn during routine postnatal bathing that occurred shortly after an increase in the temperature of the hospital water supply due to a Legionella outbreak and discuss precautions that should be used by hospitals to avoid scald injuries.
CASE REPORT
Increased Methylphenidate Usage for Attention Deficit Disorder in the 1990s
Authors: Safer Daniel J. , Zito Julie M. , Fine Eric M. 
Published: December 2021

Objective. To estimate the increased use and the prevalence of methylphenidate (Ritalin) treatment of youth with attention deficit disorder (ADD) during the 1990s.
Design. Using time-trend findings from two large population-based data sources, three pharmaceutical databases, and one physician audit, a best-fit estimate of the usage and the usage trends for methylphenidate treatment over the half decade from 1990 through 1995 was sought.
Setting. Five regions in the United States (US) and the nation as a whole.
Patients. Youths on record as receiving methylphenidate for ADD.
Results. The findings from regional and national databases indicate that on average, there has been a 2.5-fold increase in the prevalence of methylphenidate treatment of youths with ADD between 1990 and 1995. In all, approximately 2.8% (or 1.5 million) of US youths aged 5 to 18 were receiving this medication in mid-1995. The increase in methylphenidate treatment for ADD appears largely related to an increased duration of treatment; more girls, adolescents, and inattentive youths on the medication; and a recently improved public image of this medication treatment.
Conclusion. The database findings presented serve to correct exaggerated media claims of a 6-fold expansion of methylphenidate treatment, although they do not clarify the issue of the appropriateness of this treatment.
Motor Vehicle Driving Competencies and Risks in Teens and Young Adults with Attention Deficit Hyperactivity Disorder
Authors: Barkley Russell A. , Murphy Kevin R. , Kwasnik Denise 
Published: December 2021

Purpose. To evaluate the motor vehicle driving knowledge, skills, and negative driving outcomes of older teens and young adults with attention deficit hyperactivity disorder (ADHD).
Location. A university medical center clinic for adult ADHD.
Subjects. A total of 25 young adults with ADHD and 23 young adults without ADHD 17 to 30 years old drawn from the community and equated for age, gender, and educational level.
Measures. Structured interview, behavior ratings by self and others, video test of driving knowledge, computer simulated driving test, and official motor vehicle records.
Results. ADHD young adults were cited more often for speeding, were more likely to have had their licenses suspended, were involved in more crashes, were more likely to have had crashes causing bodily injury, and were rated by themselves and others as using poorer driving habits. Official driving records corroborated these negative outcomes. Although no group differences in driving knowledge were evident, young adults with ADHD had more crashes, scrapes, and erratic steering during the computer-simulated driving test than did the control subjects.
Conclusions. Findings supported previous research suggesting that greater driving risks are associated with ADHD and suggested that ADHD does not interfere with driving knowledge so much as with actual performance (motor control) during vehicle operation.
WHICH COUNTS MORE: ABILITY OR CLASS?
Authors: L. J. F. 
Published: December 2021

There is plenty of evidence about social mobility in Britain. The best is the National Child Development Survey, which has analyzed all the children born in a single week in 1958 at various points in their lives. In "Two Nations? The Inheritance of Poverty and Affluence," the Institute for Fiscal Studies, an independent research group, analyzed this data. It found that by 1991, 34% of those in the highest income quintile had fathers who were also in the top income group; 11%, however, had fathers in the poorest quintile. In a society with full equality of opportunity, and ability distributed equally across the population, 20% of the richest quintile would have had fathers from the richest quintile, and 20% from the poorest. This suggests that opportunity is dispersed in Britain, but not fully equalized.
But what if ability is not in fact distributed equally amongst the population? This question is explored, using the same data as the Institute for Fiscal Studies, in "Unequal but Fair?", a pamphlet by Peters Saunders, a sociologist at Sussex University, published last month by the Institute of Economic Affairs. He concludes that ability is greater at the top of the class/income pile than at the bottom, and that individual ability plays a crucial part in deciding where an individual will end up. Ability alone is well over twice as important as their class origins, three times more powerful than the degree of interest their parents showed in their schooling, and five times more powerful than their parents' level of education or the aspirations which their parents harbored for them while they were growing up.
Intentions to Use Violence Among Young Adolescents
Authors: DuRant Robert H. , Treiber Frank , Goodman Elizabeth , Woods Elizabeth R. 
Published: December 2021

Objective. Frequent violent behavior among adolescents has been found to be associated with previous exposure to violence, personal victimization, depression, hopelessness, and older age. Although young adolescents engage in less severe violent behavior than older adolescents, their perceived normative expectations to use violence to resolve conflicts may already be established by early adolescence. This study examined the influence of exposure to violence, depression, church attendance, multiple drug use, and demographic variables on young adolescents' intentions to use violence to resolve conflict.
Methods. Young adolescents (N = 225, males = 49.4%, black = 88.7%, mean age = 12.9 ± 1 years) in two middle schools serving low-income and working-class communities were administered a previously tested anonymous questionnaire. They were also asked how they would resolve conflict in 15 different hypothetical situations. Each situation had 10 possible responses ranging from humor or avoidance to severe violence (eg, use of a gun). The Intentions to Use Violence in Hypothetical Situations Scale had a high internal reliability (α = .88) and was correlated (r = .46) at the expected level for this age group with a standardized use of violence and weapon-carrying scale.
Results. The Intentions to Use Violence in Hypothetical Situations Scale was significantly correlated with age (r = .17), school grade (r = .14), lower church attendance (r = -.23), frequency of smoking (r = .24), alcohol use (r = .37), marijuana use (r = .36), crack cocaine use (r = .14), smokeless tobacco use (r = .20), injecting drug use (r = .16), depression (r = .12), and exposure to violence (r = .48). Based on multiple regression analysis, exposure to violence, marijuana use, frequency of church attendance, alcohol use, cocaine use, and tobacco use accounted for 36.6% of the variation in the Intentions to Use Violence in Hypothetical Situations Scale.
Conclusion. Although the intention to use violence was associated with previous exposure to violence and current drug use, adolescents who attended religious services more often were less likely to report that they would use violence to resolve interpersonal conflict.
Continuous Negative Extrathoracic Pressure in Neonatal Respiratory Failure
Authors: Samuels Martin P. , Raine Joseph , Wright Theresa , Alexander John A. , Lockyer Kate , Spencer S. Andrew , Brookfield David S. K. , Modi Neena , Harvey David , Bose Carl , Southall David P. 
Published: December 2021

Objective. In uncontrolled clinical trials, negative extrathoracic pressure has been shown to be an effective respiratory support. We aimed to assess its role in the context of current neonatal intensive care.
Design. A randomized controlled trial, with sequential analysis of matched pairs of infants. Matching was undertaken by stratified randomization from 15 groups divided according to gestational age, oxygen requirement, and whether patients were intubated at 4 hours of age.
Setting. Two neonatal intensive care units.
Patients. Two hundred forty-four patients (birth weight 1.53 ± 0.69 kg (mean ± SD); gestational age 30.4 ± 3.5 weeks) with respiratory failure.
Interventions. Patients were randomized at 4 hours of age to receive either standard neonatal intensive care, or standard care plus continuous negative extrathoracic pressure (CNEP, -4 to -6 cmH2O) applied within a purpose-designed neonatal incubator.
Outcome Scores. Clinical scores were calculated for each infant at 56 days of age, or death if earlier. Scores included measures for mortality, respiratory outcome, the presence of cerebral ultrasound abnormalities, patent arterial duct, necrotizing enterocolitis, and retinopathy. The treatment given for the higher score for each pair was recorded and the cumulative net number of pairs favoring CNEP plotted in the sequential analysis to provide an ethical early termination strategy. Individual components of the outcome score and other secondary measurements were analyzed on completion of the trial.
Results. The sequential analysis reached a decision boundary after 122 out of a possible maximum of 124 pairs were completed. The overall outcome score showed an overall significant benefit for CNEP. Secondary analysis showed that the use of CNEP was associated with an increase in mortality, cranial ultrasound abnormalities, and pneumothoraces, which were not statistically significant. However, 5% fewer patients were intubated (95% confidence interval [CI], 0-10), and the total duration of oxygen therapy among surviving infants at 56 days was lower (20.5 days, compared with 38.9 in controls; difference 18.4 days, 95% CI 3.8 to 33.0). Among all infants, the mean total duration of oxygen therapy was 18.3 days among CNEP-treated infants compared with 33.6 days among the controls (difference -15.3 days, 95% CI -0.2 to -30.4). This reduction in mean levels is entirely attributable to substantially fewer patients requiring prolonged oxygen therapy, the median duration of treatment being very similar in the two groups. As a result, commensurately fewer surviving infants showed chronic lung disease of prematurity.
Conclusions. The use of continuous negative pressure improves the respiratory outcome for neonates with respiratory failure.
National Childhood Vaccine Injury Act: Revision of the Vaccine Injury Table
Authors: Evans Geoffrey 
Published: December 2021

The National Childhood Vaccine Injury Act of 1986 (the Act) established the National Vaccine Injury Compensation Program (VICP) as a federal "no-fault" compensation system for individuals who may have been injured by specific covered vaccines. Entering its ninth year of operation, the VICP has ensured childhood vaccine supplies by dramatically reducing vaccine companies' and providers' liability that threatened the production of vaccines during the 1980s. The VICP has received 5057 petitions filed for possible injury from vaccines covered under the VICP, including 4240 filed for vaccines administered before October 1988, and 817 for vaccines administered between October 1988 and August 1996. Over 3700 claims have been adjudicated, 985 of which have been found to be compensable, and the remainder have been dismissed.
The Vaccine Injury Table (the Table) lists specific injuries or conditions and timeframes after vaccination that may be compensated under the VICP. The Table establishes legal presumptions about causation, which are used by the US Court of Federal Claims (the Court) to adjudicate petitions. The VICP covers seven "childhood" vaccines: diphtheria, pertussis, tetanus, measles, mumps, rubella, and polio.
Effective March 10, 1995, the Table was revised to better reflect current scientific knowledge about vaccine injuries (Table 1). As part of the Act, Congress mandated a review of the scientific literature and other information on specific adverse consequences of pertussis and rubella vaccines. The Institute of Medicine (IOM) performed and published a report of this review in 1991, and a review of a follow-up study of the National Childhood Encephalopathy Study in 1994.