bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of Health Care Services by Inner-city Infants in an Early Discharge Program
Authors: Cooper William O. , Kotagal Uma R. , Atherton Harry D. , Lippert Carrie A. , Bragg Elizabeth , Donovan Edward F. , Perlstein Paul H. 
Published: December 2021

Objective. To assess the use of health care services by inner-city infants enrolled in an early discharge program who received care in a tertiary care children's hospital primary care clinic.
Design. Retrospective cohort study.
Setting. Large, metropolitan university hospital and a children's hospital.
Patients. Term infants cared for in a single full-term nursery, before and after implementation of a coordinated early discharge program, who received primary care at the children's hospital.
Intervention. The coordinated Early Discharge Program was characterized by in-hospital visits by hospitalbased coordinating nurses, home visits by nurses from a home nursing agency, and communication with physicians for necessary adjustments in postdischarge care.
Methods. After linking birth hospital records and the children's hospital medical records, a retrospective chart review was performed to obtain maternal demographic information and birth hospital length of stay, as well as the infants' attendance at primary care clinic, immunizations, emergency department visits, and rehospitalization.
Main Outcome Measures. Number of primary care visits in the first 3 months of life, completion of one series of immunizations by 3 months of life, and number of emergency department visits and rehospitalization during the first 3 months of life.
Results. The early discharge group (n = 253) had a significantly shorter birth hospital length of stay (35 ± 24 hours, mean ± SD) when compared with the control group (n = 212) (52 ± 14 hours). The early discharge group was also younger than the control group at the first primary care visit, with significantly more infants visiting the primary care clinic in the first month of life. There was also a significant difference between the groups in the mean number of emergency department visits (early discharge = .61 visits/patient, control = .79 visits/patient) and the proportion of patients with no emergency department visits during the first 3 months of life (early discharge = 57%, control = 43%). There was no difference between the two groups in the proportion of infants completing one series of immunizations or in the number of infants rehospitalized during the study period.
Conclusions. Coordinated early discharge with home nursing visits for inner-city infants may result in earlier use of primary care services. Furthermore, there is a significant decrease in use of the emergency department during the first 3 months of life, and no increase in rehospitalization.
Automatic Garage Door Openers: Hazard for Children
Authors: Kriel Robert L. , Gormley Mark E. , Krach Linda E. , Luxenberg Michael G. , Bartsh Shawn M. , Bertrand Jolene R. 
Published: December 2021

Objectives. Despite significant advances in automatic garage door opener design, automatic garage door openers continue to severely injure or kill children. In this investigation, we sought to determine the frequency and circumstances of accidents that have caused severe injury or death to children. We also tried to develop a means by which homeowners can evaluate their door openers.
Methods. We present the histories of three children severely injured or killed by automatic garage door openers. We reviewed national data of similar accidents primarily published by the US Product Safety Commission and Underwriters Laboratories. Also, we evaluated 50 automatic door openers for safety of operation. The reversing mechanisms of door openers were tested using a cardiopulmonary resuscitation mannequin, a roll of paper towels, and a block of wood.
Results. In the United States, at least 85 children have had permanent brain injury or have died since 1974 as a result of accidents involving automatic door openers. A review of circumstances of the accidents illustrates that accidents are caused both by use of the openers by children and by faults in design. Most accidents have occurred when children have found access to the activation devices and have been entrapped under closing doors that failed to reverse. However, in one case, an adult activated the opener and left the premises before the door completely closed. Our evaluation of 50 garage door openers showed that although 88% percent reversed when encountering a block of wood, 40% failed to reverse when coming down on a supine, child-sized cardiopulmonary resuscitation mannequin.
Conclusions. Automatic garage door openers pose a serious risk of severe injury or death to children. It is probable that many doors would not reverse if they came down on a young child. Therefore, we have devised a way for homeowners to test their door openers that closely mimics our evaluations using the mannequin by using a large roll of paper towels. If the door fails to reverse using this test, we suggest that homeowners disconnect their openers and operate the doors manually until the openers are serviced or replace their automatic openers with one that meets the latest Underwriters Laboratory standards. We also have other recommendations regarding the safe operation of the doors, including improving the safety standards for openers in apartment complexes. Compliance with these recommendations should reduce the number of injuries to children caused by garage door openers.
Letter To The Editor
Authors: Judelsohn Richard 
Published: December 2021

Dr Schneider raises many cogent points in his letter. Of utmost importance is the assessment, based on his personal experience, that a more complex vaccination schedule may decrease immunization rates, particularly in low socioeconomic and other disadvantaged populations. The outcome could be increased cases of vaccine-preventable diseases, in particular measles, pertussis, and polio.
Secondly, he emphasizes the increasingly significant role of cost factors in expenditures for health care. In the public health arena, local, state, and federal lawmakers and executives are frugal.
Advising Parents on Discipline: What Works
Authors: Howard Barbara J. 
Published: December 2021

Discipline for children is one of the most common behavioral issues encountered when providing health care for children, and 90% of pediatricians report that they include advice about discipline most of the time when providing anticipatory guidance to families.1 Although we should provide advice for discipline strategies that have evidence of being effective, this goal is quite complex because of the broad scope of what constitutes discipline and the multifactorial etiology of behavior problems.
THE BROAD SCOPE OF DISCIPLINE
Discipline refers to systems of teaching, learning, and nurturing that are used in child rearing. These systems include procedures that encourage appropriate behavior and deter misbehavior according to the child's developmental abilities. The systems' ultimate goals are for the child to achieve competence, self-control, and self-direction.2 Some children make these teaching tasks more difficult than others, often due to differences in temperament.3 Children who have aspects of their personality defined as "difficult" are both more likely to have behavior problems and to present a challenge for caregivers trying to be consistent and positive in their discipline teaching. Children with diagnosable mental health problems or developmental disabilities, including attention deficit hyperactivity disorder, often have their own additional special difficulties with socialization and learning. Conversely, children with higher intelligence and better language skills are more resilient to stress, have fewer behavior problems, and respond better to parent-mediated behavior training and therefore are easier to discipline.
Many other factors affect a caregiver's ability to conceive of, establish, and maintain a system of discipline. Many of the same parental factors that interfere with establishing optimal discipline and responding to parent intervention programs are the ones that make it more likely that the child will have problematic behaviors.
FOREWORD
Authors: Sanders Joe M. 
Published: December 2021

Effective disciplining of children has been one of the most perplexing issues of parenting since time immemorial. In order to grow into a responsible, capable adult, a child must learn how to function within his immediate and extended environment, to learn right from wrong and good from bad, to be respected by others, and to be respectful of others. Children learn by following examples set by parents and other authority figures, by testing the standards society imposes upon them, and by simple acts of trial and error. They will inevitably make mistakes along this long and complex journey as they learn to control their impulses and funnel their boundless energy into appropriate channels of activity. A major challenge of parenthood is how best to ensure the lesson is learned. Is this best achieved by a thoughtful discussion or by disciplinary spanking?
The controversial subject of corporal punishment—defined as spanking or some other form of physical discipline—was addressed at an invitational conference in February 1996. Although no definite conclusions were reached, an important series of consensus statements have been developed that should form the basis for further study of this obligatory function of parenting.
As a co-sponsor of this conference, the American Academy of Pediatrics would like to acknowledge the following whose efforts contributed immeasurably to the success of this endeavor:
The Department of Pediatrics at the Montefiore Medical Center, Albert Einstein College of Medicine, and specifically to Dr Stanford B. Friedman and Dr S. Kenneth Schonberg, who conceived the idea, organized the program, and served as conference co-chairs.
Nonprotein-bound Iron in Postasphyxial Reperfusion Injury of the Newborn
Authors: Dorrepaal Caroline A. , Berger Howard M. , Benders Manon J.N.L. , van Zoeren-Grobben Diny , Van De Bor Margot , Van Bel Frank 
Published: December 2021

Objective. To investigate if the availability of nonprotein-bound iron after birth asphyxia is related to the severity of the postasphyxial injury and neurodevelopmental outcome.
Methods. Nonprotein-bound iron (bleomycin assay) and thiobarbituric-acid-reactive species, an index of oxidative lipid damage, were measured in plasma of 50 newborn infants (gestational age &gt; 34 weeks) between 0 to 8 hours, 8 to 16 hours, and 16 to 24 hours after birth. Three groups were compared: healthy infants (n = 20), moderately asphyxiated infants (n = 15), who were neurologically normal during the first 24 hours after birth and severely asphyxiated infants (n = 15), who developed abnormal neurological signs in the first 24 hours after birth.
Results. In the severely asphyxiated infants, liver enzymes, creatinine, urea, and uric acid concentrations were significantly elevated. Eleven severely asphyxiated infants were brain-damaged, 9 of them died during the neonatal period. Nonprotein-bound iron was detectable in 30% of the control, 60% of the moderately asphyxiated, and 80% of the severely asphyxiated infants. During the whole study period nonprotein-bound iron concentration was significantly elevated in severely asphyxiated infants as compared with controls. Three of the four severely asphyxiated infants who had a normal outcome at 1 year of age, had no detectable nonprotein-bound iron during the study period. Stepwise logistic regression analysis with neurodevelopmental outcome at 1 year of age (normal versus adverse/death) as dependent variable and all the measured parameters for organ damage as independent variables revealed that the nonproteinbound iron concentration at 0 to 8 hours after birth was the most significant variable and at the same time the only variable that entered the model, in relation to neurodevelopmental outcome. Thiobarbituric-acid-reactive species tended to be higher in severely asphyxiated infants, suggesting oxidative lipid damage.
Conclusion. Nonprotein-bound iron may play an important role in oxidative damage-mediated postasphyxial brain injury and subsequent neurodevelopmental outcome.
Pediatric Trauma: Impact on Work and Family Finances
Authors: Osberg J. Scott , Kahn Paul , Rowe Katherine , Brooke Marvin M. 
Published: December 2021

Objectives. National data now exist on incidence, prevalence, and cost of injury. However, the personal impact of injury on work and family finances has not been thoroughly studied. We examine the extent and nature of work and financial problems after pediatric trauma and identify predictors. Clinicians are alerted so they can better counsel parents about potential postinjury work and financial difficulties.
Methods. Staff collected comprehensive data on the acute care and short-term rehabilitation of 182 Massachusetts children with injuries. Consenting parents were surveyed and their children were given a battery of medical, functional, and psychosocial tests. Information on work and financial impact at 1 and 6 months postinjury was available from 120 parents.
Results. Given these children's generally mild injuries, the impact on work and family finances was remarkable. For many families work and financial problems were short-lived; however, for others serious problems remained at 6 months postdischarge. Families whose children were severely injured were at highest risk for work and financial problems. Middle-class parents and parents on public assistance or in our other insurance category reported more work and financial problems than those in health maintenance organizations. Long acute hospital stay and four or more impairments at discharge were also strong predictors.
Conclusion. Childhood injury can lead to serious work and financial problems for families. Given the central role of the family in pediatric rehabilitation, clinicians and policymakers involved in acute trauma care and rehabilitation should pay greater attention to the financial repercussions of injury.
Interchangeability of Haemophilus influenzae Type b vaccines in the Primary Series: Evaluation of a Two-dose Mixed Regimen
Authors: Bewley Kathleen M. , Schwab Joel G. , Ballanco Gerard A. , Daum Robert S. 
Published: December 2021

Objective. To evaluate two- or threedose "mixed" regimens of Haemophilus influenzae type b conjugate vaccines in the priming series.
Design. Two randomized clinical trials with 140 and 181 infants, respectively.
Setting. Private practices in New Orleans and Chicago.
Methods. In trial I, infants received one of four regimens. Two were recommended regimens for polyribosylribitol phosphate (PRP)—meningococcal protein conjugate (M) and PRP—tetanus toxoid conjugate (T). Two mixed regimens consisted of M at 2 months followed by two doses of T or PRP—diphtheria toxoid conjugate (D) at 4 and 6 months. Trial II consisted of three groups. Two were recommended regimens for M and T. The third was a two-dose mixed regimen consisting of M at 2 months and T at 4 months. Parents were interviewed and instructed to record side effects after each vaccination. Serum was assayed for H influenzae type b anticapsular antibody (anti-PRP).
Results. Minor differences in safety profiles likely reflected α error. In trial I, M (lot 0884T, one of several known to have had decreased immunogenicity), probably primed for substantial increase in serum antibody when D or T was given at 4 and 6 months. In trial II, infants who received the two-dose mixed regimen (M from immunogenic lot 0116W at 2 months and T at 4 months) had a significantly higher mean area under the curve than recipients of the three-dose TIT regimen when antibody concentration was plotted against age, although the geometric mean anti-PRP antibody concentration for the MT-recipients was significantly lower at 7 months.
Conclusions. M used in trial I may have primed infants despite poor immunogenicity. The two-dose mixed regimen (MT-) in trial II produced a mean anti-PRP antibody concentration with higher sustained anti-PRP concentrations from 2 to 7 months, as judged by the area under the curve, but a lower mean anti-PRP antibody concentration at 7 months.
Some Unchanging Values of Pediatric Education During a Time of Changing Technology and Practice
Authors: Behrman Richard E. 
Published: December 2021

A few of the opportunities and difficulties of educating pediatric residents in a particular community-based setting, the managed care organization, are discussed in this article. Some of these organizations have deliberately recruited corporate employees with young families, offering relatively complete coverage. Quality problems remain, however. Children may benefit, because managed care arrangements may reduce overdiagnosis and overtreatment, but children may also be deprived, particularly in Medicaid managed care programs, of needed, appropriate care. Pediatric faculties must be confident about the quality of care, the quality of teaching, and the opportunity for residents to develop interpersonal skills before residents are placed in managed care settings.
First, however, important, broader aspects of contemporary pediatric education are discussed. These essentials of contemporary pediatric education apply in any setting, community based or not, and not only to physicians in training, but to those who are delivering ongoing care as well.
A case study illustrates the impact of technologic advances on medical diagnosis and management. Such advances may lead to the chance for better outcomes but also to confusion, including misperceptions about disease prevalence, the natural history of disease, and therapeutic effectiveness.
To meet patient needs and to provide a medically educated physician, the understanding of biology and disease that grows out of scientific advances must be balanced with the illness-related functions of the physician. Two approaches to this goal are suggested: (1) the epidemiologic and demographic anatomy of the health of populations and the socioeconomic kinetics of our society and its diverse value systems relevant to health care should be deliberately structured into all phases of medical education; and (2) the sites of the educational process should be diversified so that residents are placed, perhaps as much as half the time, in those settings in which most patients interact with physicians.
Métodos físicos para reducir inóculo de Sclerotium cepivorum en semilla de ajo morado (Allium sativum L.)
Authors: Gómez-Marroquín Magda Rocío , Torres-Jiménez Diana Marcela , Cruz-Castiblanco Ginna Natalia , Hernández-Guzmán Anngie Katherine , Kobayashi Sadao , Villarreal Andrea Del Pilar 
Published: December 2021

Introducción. En Colombia, la producción de ajo se ve afectada por patógenos, principalmente Sclerotium cepivorum, el cual se disemina por el material de siembra. Es necesario establecer tecnologías de bajo costo que permitan controlar este patógeno. Objetivo. Evaluar dos métodos de termoterapia, termoterapia por calor seco y termoterapia por inmersión en agua, para disminuir la presencia de S. cepivorum en semilla de ajo y su efecto sobre características agronómicas de plantas emergidas a partir de bulbillos tratados. Materiales y métodos. Este trabajo se llevó a cabo en el Centro de Investigación Tibaitatá de la Corporación Colombiana de Investigación Agropecuaria (AGROSAVIA), ubicado en Cundinamarca, Colombia, durante el primer semestre del 2019. Se evaluaron nueve tratamientos; cinco en termoterapia por calor seco: 35 ºC por 12 h, 35 ºC por 129,6 h, 50 ºC por 48 min, 5 ºC por 20 días, 38 °C por 1 h; dos en termoterapia por inmersión en agua caliente: 48 °C por 30 min, 50 °C por 20 min y dos controles: desinfección química (tebuconazol) y temperatura ambiente (20 ºC por 20 días), en un diseño en bloques completos al azar. Se evaluó brotación de bulbillos y crecimiento de las plantas de ajo después de aplicar termoterapia a la semilla y viabilidad de esclerocios de S. cepivorum. Resultados. El almacenamiento de la semilla a 5 ºC por 20 días aceleró su brotación, alcanzó una germinación de 80 % a los cinco días, mayor número de hojas y acumulación de biomasa. La germinación de esclerocios estuvo entre 33 y 67 %; el tratamiento que presentó la menor incidencia fue 35 ºC por 129,6 h (33 %). Conclusión. El tratamiento de termoterapia por calor seco a 35 °C por 129,6 h mostró potencial en la reducción del inóculo de S. cepivorum en semillas de ajo.
Ancora sul concetto di diritto soggettivo nell’ordinamento della Chiesa
Authors: Michowicz Przemysław 
Published: December 2021

The paper discuses one of the most commented topic in the contemporary science of canon law, that is the bill of subjective rights and obligations set by the ecclesiastical legislator in the Code of canon law for the Western Church. The author analyses the concept of those rights and obligations in the light of the Principles of revision elaborated by the first Synod of Bishops held in 1967. One of the commission’s first actions was to draft a set of principles to guide the work of rethinking the Code, especially the significance of rights and obligations of the Christian faithful. Given the nature of the Catholic Church developed by the Second Vatican Council (communion and participation), the examination of this document let the author to affirm that the main goal was to emphasise the exercise of authority that should have appear more clearly as service and should be free from abuse rather to define and safeguard the rights of persons. Furthermore, it was also possible to determine the correct intention of the Synod Fathers whose idea was to define the subjective rights in term of liberties in the same way in which they are obtainable in catalogues of human rights. Eventually, the author demonstrates consequences related to the new vision of rights and obligations highlighting for example the clear priority of obligations over rights.
Przyczyny i następstwa desakralizacji – problemy adaptacji obiektów sakralnych do nowych funkcji
Authors: Cora Dominika 
Published: December 2021

Problematyka związana z adaptacją obiektów sakralnych do nowych funkcji pojawia się w Europie coraz częściej. W artykule omówiono przyczyny desakralizacji – zjawiska sekularyzacji i laicyzacji społeczeństwa, a także jej następstwa ­– problematykę zniesienia święceń z kościoła czyli eskksekrację, która została zanalizowana w świetle zapisów Kodeksu Prawa Kanonicznego. Dokonano opisu adaptacji obiektów sakralnych do nowych funkcji na wybranych europejskich przykładach, które pozwoliły na przedstawienie tematyki w najszerszy możliwy sposób.