bluuebunny/crossref_metadata_2025_split huggingface dataset:
Skin-to-Skin Contact and/or Oral 25% Dextrose for Procedural Pain Relief for Term Newborn Infants
Authors: Chermont Aurimery Gomes , Falcão Luis Fábio Magno , de Souza Silva Eduardo Henrique Laurindo , de Cássia Xavier Balda Rita , Guinsburg Ruth 
Published: November 2009

OBJECTIVE: The goal was to compare the efficacy of oral 25% dextrose treatment and/or skin-to-skin contact for analgesia in term newborns during intramuscular injection of a hepatitis B vaccine.
METHODS: A prospective, randomized, partially blinded, clinical trial was performed with 640 healthy term newborns. Infants at 12 to 72 hours of life were assigned randomly to receive an intramuscular injection of hepatitis B vaccine in the right thigh according to 4 analgesia groups, that is, no analgesia (routine); oral 25% dextrose treatment, given 2 minutes before the injection; skin-to-skin contact, initiated 2 minutes before the injection and persisting throughout the procedure; and a combination of the oral dextrose treatment and skin-to-skin contact strategies. For all groups, Neonatal Facial Coding System and Neonatal Infant Pain Scale scores were evaluated before the procedure, during thigh cleansing, during the injection, and 2 minutes after the injection. Premature Infant Pain Profile scores also were assessed for all infants. Pain scores were compared among the 4 groups.
RESULTS: The use of oral 25% dextrose treatment reduced the duration of procedural pain in the studied population. Skin-to-skin contact decreased injection pain and duration. The combination of the 2 analgesic measures was more effective than either measure separately for term newborns.
CONCLUSIONS: Nonpharmacologic analgesic measures were effective for the treatment of procedural pain in term infants. The combination of oral 25% dextrose treatment and skin-to-skin contact acted synergistically to decrease acute pain in healthy neonates.
The Effect of State Early Intervention Eligibility Policy on Participation Among a Cohort of Young CSHCN
Authors: McManus Beth , McCormick Marie C. , Acevedo-Garcia Dolores , Ganz Michael , Hauser-Cram Penny 
Published: November 2009

OBJECTIVE: This purpose of this study was to describe differences in early intervention (EI) participation according to state among a cohort of young children with parent-reported developmental delays and disabilities.METHODS: Data were obtained from the 2005–2006 National Survey of Children With Special Health Care Needs to describe state differences in EI participation. Multilevel modeling was used to estimate the relative contributions of child sociodemographic and developmental characteristics, and state EI eligibility policy on EI participation.RESULTS: The overall rate of EI participation was 45.7% (23.1%–83.3% across the states). EI participants were less likely to be Hispanic, live in a multiracial family, be poor, have a developmental delay, or have a less severe condition/delay. The predicted probability of receiving EI was lower for children who lived in states with more strict EI eligibility criteria than those with liberal criteria (.43 vs .52). Poverty influenced this association, with the adjusted probabilities of receiving EI for poor (&lt;100% federal poverty level) and nonpoor (&gt;185% federal poverty level) children being .18 and .36, respectively (P &lt; .05). Among nonpoor children, those who lived in states with strict eligibility criteria were nearly as likely as poor children who lived in states with liberal eligibility criteria to receive EI (.33 vs .36; P &lt; .05).CONCLUSIONS: The results of this study reveal marked disparities and unmet needs in EI participation as a function of both characteristics of the child and the state program. Improving developmental services for vulnerable populations requires addressing these sources of disparity.
What Factors Are Associated With State Performance on Provision of Transition Services to CSHCN?
Authors: Kane Debra J. , Kasehagen Laurin , Punyko Judy , Carle Adam C. , Penziner Andy , Thorson Sarah 
Published: November 2009

OBJECTIVE: To examine whether individual, condition-related, and system-related characteristics are associated with state performance (high, medium, low) on the provision of transition services to children with special health care needs (CSHCN).METHODS: We conducted descriptive, bivariate, and multivariable analyses of 16876 children aged 12 to 17 years by using data from the 2005–2006 National Survey of Children With Special Health Care Needs. Polytomous logistic regression was used to compare the characteristics of CSHCN residing within high-, medium-, and low-performance states, with low-performance states serving as the reference group.RESULTS: Compared with non-Hispanic white CSHCN, Hispanic (adjusted odds ratio [aOR]: 0.25 [95% confidence interval (CI): 0.17–0.37]) and non-Hispanic black (aOR: 0.44 [95% CI: 0.30–0.62]) CSHCN were less likely to reside in a high-performance than in a low-performance state. Compared with CSHCN who had a medical home or adequate insurance coverage, CSHCN who did not have a medical home or adequate insurance coverage were less likely to reside in a high-performance than in a low-performance state (aOR: 0.73 [95% CI: 0.57–0.95]; aOR: 0.73 [95% CI: 0.58–0.93], respectively).CONCLUSIONS: Key factors found to be important in a state's performance on provision of transition services to CSHCN were race/ethnicity and having a medical home and adequate insurance coverage. Efforts to support the Maternal and Child Health Bureau's integration of system-level factors in quality-improvement activities, particularly establishing a medical home and attaining and maintaining adequate insurance, are likely to help states improve their performance on provision of transition services.
Understanding Factors Associated With Work Loss for Families Caring for CSHCN
Authors: Okumura Megumi J. , Van Cleave Jeanne , Gnanasekaran Sangeeth , Houtrow Amy 
Published: November 2009

OBJECTIVE: Parents of children with special health care needs (CSHCN) are at risk for work loss as a result of the complex health needs of their children. Our objective was to determine how child- and family-level factors and the medical home are associated with work loss for these families.
METHODS: We performed secondary data analyses of the National Survey of Children With Special Health Care Needs (NS-CSHCN) 2005–2006. This is a nationally representative sample of CSHCN in the United States. The primary outcome measure was having any family member report work loss to care for a CSHCN. We calculated survey-weighted unadjusted and adjusted odds ratios by using independent variables that included child demographic factors, functional limitation, condition stability, insurance status/type, family income, and criteria of the medical home.
RESULTS: Overall, 23.7% of the parents of CSHCN reported work loss as a result of their child's health care needs. Greater functional limitation and condition instability were associated with increased odds of family work loss. The presence of a medical home in the multivariate model was associated with a 50% reduction in the odds of reported family work loss.
CONCLUSIONS: Approximately 24% of families with CSHCN have experienced work loss to meet the medical needs of their child. Availability of a system of care support, such as the medical home, is associated with lower work loss reported by families. Therefore, improved systems of care for CSHCN may have the potential to optimize work productivity for families.
Household Language Use and Health Care Access, Unmet Need, and Family Impact Among CSHCN
Authors: Yu Stella M. , Singh Gopal K. 
Published: November 2009

OBJECTIVES: We examined the association of household language use and access to care among children with special health care needs (CSHCN). From this study we describe the demographics of children and the prevalence of selected access characteristics according to their primary household language and examine the independent effects of household language on health care access, unmet needs, and family impact while controlling for confounding variables.METHODS: Data from the 2005–2006 National Survey of Children With Special Health Care Needs, a nationally representative telephone survey of 40723 CSHCN, were analyzed. Bivariate and multivariable analyses were used to examine disparities and estimate adjusted odds ratios of health care access, satisfaction, and family-impact measures for CSHCN from non–English-primary-language (NEPL) versus English-primary-language (EPL) households.RESULTS: Nearly 14% of all US children live in NEPL households. NEPL CSHCN were significantly more likely to be Hispanic or other race, be poor, have less educated parents, and reside in metropolitan areas and larger households and yet were less likely to be on cash assistance from welfare. Logistic regression showed that NEPL CSHCN were twice as likely to lack access to a medical home, a usual source of care, and family-centered care. They were 4 times as likely to lack health insurance, and their family members were also more likely to lack adequate insurance. Family members of NEPL children were almost twice as likely to have to stop employment as a result of their child's condition.CONCLUSIONS: Although limited by program eligibility contingent on immigrant status and state policies, increased referrals to programs such as the State Children's Health Insurance Program and Medicaid can improve access while utilization can be improved by the availability of interpreters, community health workers, linguistically concordant providers, and outreach education efforts of NEPL parents.
Care Coordination for CSHCN: Associations With Family-Provider Relations and Family/Child Outcomes
Authors: Turchi Renee M. , Berhane Zekarias , Bethell Christina , Pomponio Amber , Antonelli Richard , Minkovitz Cynthia S. 
Published: November 2009

OBJECTIVE: To examine the association between receiving adequate care coordination (CC) with family-provider relations and family/child outcomes.
METHODS: We analyzed data from the 2005–2006 National Survey of Children With Special Health Care Needs. Eligible subjects were the 88% of families asked about experience with CC, service use, and communication. Respondents also reported on demographic characteristics, health status, family-provider relations, and family/child outcomes. Weighted, multivariate logistic regression models were constructed to assess independent associations of adequate CC with outcomes.
RESULTS: Among families with children with special health care needs asked about CC, 68.2% reported receiving some type of CC help. Of these, 59.2% reported receiving adequate CC help, and 40.8% reported inadequate CC. Families that reported adequate compared with inadequate CC had increased odds of receiving family-centered care, experiencing partnerships with professionals, and satisfaction with services. They had decreased odds of having problems with referrals for specialty care, missing &gt;6 school days because of illness (previous year), and visiting the emergency department more than twice in the previous 12 months (P &lt; .001). Those who reported adequate compared with inadequate CC had decreased odds of the following: more than $500/y of out-of-pocket expenses, family financial burden, spending more than 4 hours/week coordinating care, and stopping/reducing work hours.
CONCLUSIONS: Parental report of adequate CC was associated with favorable family-provider relations and family/child outcomes. Additional efforts are needed to discern which aspects of CC are most beneficial and for which subgroups of children with special health care needs.
Access to Genetic Counseling for Children With Autism, Down Syndrome, and Intellectual Disabilities
Authors: McGrath Robert J. , Laflamme David J. , Schwartz Amy P. , Stransky Michelle , Moeschler John B. 
Published: November 2009

OBJECTIVE: We examined the need for genetic counseling services (GCS) for families of children with autism spectrum disorder (ASD), Down syndrome (DS), and/or mental retardation (MR) and factors that influence the receipt of needed GCS for those children relative to other children with special health care needs (CSHCN).
METHODS: Analysis was conducted on the 2005–2006 National Survey of Children With Special Health Care Needs, a nationally representative sample. Bivariate analyses were conducted by examining need for and receipt of GCS for children with ASD, DS, and/or MR and other CSHCN as well as differences by contextual variables using the health belief model (HBM). Logistic regression analyses were conducted to assess the relative impact of receipt of needed GCS by HBM constructs.
RESULTS: Families of children with diagnoses of ASD, DS, and/or MR perceive significantly higher need for GCS than other CSHCN. The presence of a medical home is the single most important factor in facilitating access to GCS, together with the presence of insurance, particularly private or a combination of private and public insurance. As income and education attainment decrease, barriers to GCS rise.
CONCLUSIONS: This analysis supports strategies for improving linkages between specialty providers and the medical home at which primary care is delivered. Increased effort should be made to attend to those who experience barriers that result from lack of insurance, poverty, low education, or racial or ethnic differences. Health professionals need to collaborate in developing solutions to underinsurance or lack of insurance for CSHCN.
Cost of Universal Influenza Vaccination of Children in Pediatric Practices
Authors: Yoo Byung-Kwang , Szilagyi Peter G. , Schaffer Stanley J. , Humiston Sharon G. , Rand Cynthia M. , Albertin Christina S. , Vincelli Phyllis , Blumkin Aaron K. , Shone Laura P. , Coleman Margaret S. 
Published: November 2009

OBJECTIVES: The goals were to estimate nationally representative pediatric practices' costs of providing influenza vaccination during the 2006–2007 season and to simulate the costs pediatric practices might incur when implementing universal influenza vaccination for US children aged 6 months to 18 years.METHODS: We surveyed a stratified, random sample of New York State pediatric practices (N = 91) to obtain information from physicians and office managers about all practice resources associated with provision of influenza vaccination. We estimated vaccination costs for 2 practice sizes (small and large) and 3 geographic areas (urban, suburban, and rural). We adjusted these data to obtain national estimates of the total practice cost (in 2006 dollars) for providing 1 influenza vaccination to children aged 6 months to 18 years.RESULTS: Among all respondents, the median total cost per vaccination was $28.62 (interquartile range: $18.67–45.28). The median component costs were as follows: clinical personnel labor costs, $2.01; nonclinical personnel labor costs, $7.96; all other (overhead) costs, $10.43. Vaccine purchase costs averaged $8.22. Smaller practices and urban practices had higher costs than larger or suburban practices. With the assumption of vaccine administration reimbursement for all Vaccines for Children (VFC)-eligible children at the current Medicaid median of $8.40, the financial loss across all US pediatric practices through delivery of VFC vaccines would be $98 million if one third of children received influenza vaccine.CONCLUSION: The total cost for pediatric practices to provide influenza vaccination is high, varies according to practice characteristics, and exceeds the average VFC reimbursement.
Underinsurance and Adolescent Immunization Delivery in the United States
Authors: Smith Philip J. , Lindley Megan C. , Shefer Abby , Rodewald Lance E. 
Published: November 2009

OBJECTIVE: The goal was to explore the association of being underinsured and receiving doses at a health department clinic (HDC) with not receiving all recommended adolescent vaccine doses.
METHODS: A total of 5657 adolescents, 13 to 17 years of age, were sampled in the National Immunization Survey-Teen in 2006–2007.
RESULTS: A total of 63.9% of all adolescents were covered by private health insurance. Among privately insured adolescents, ∼31.3% were underinsured. Compared with fully insured adolescents, underinsured adolescents were more likely to receive doses at an HDC for tetanus-diphtheria toxoids/tetanus toxoids-reduced diphtheria toxoids-acellular pertussis vaccine (25.1% vs 6.2%; P &lt; .05), tetravalent meningococcal conjugate vaccine (11.5% vs 2.5%; P &lt; .05), and quadrivalent human papillomavirus vaccine (16.2% vs 3.4%; P &lt; .05). Also, compared with fully insured adolescents, underinsured adolescents who received doses at an HDC had lower estimated rates of vaccination coverage for tetanus-diphtheria toxoids/tetanus toxoids-reduced diphtheria toxoids-acellular pertussis vaccine (58.5% vs 70.9%; P &lt; .05), tetravalent meningococcal conjugate vaccine (10.8% vs 25.8%; P &lt; .05), and quadrivalent human papillomavirus vaccine (7.8% vs 14.3%; P &lt; .05).
CONCLUSION: Underinsured adolescents who receive doses at an HDC have lower rates of vaccination coverage than do fully insured adolescents.
Role of Health Insurance in Financing Vaccinations for Children and Adolescents in the United States
Authors: Shen Angela K. , Hunsaker John , Gazmararian Julie A. , Lindley Megan C. , Birkhead Guthrie S. 
Published: November 2009

OBJECTIVE: The goal was to elicit perspectives of selected health insurance plan medical or quality improvement directors regarding factors related to coverage and reimbursement and perceptions of financing as a barrier to child and adolescent immunization.
METHODS: Medical or quality improvement directors from 20 plans selected by America's Health Insurance Plans were invited to complete an online survey in July 2007. Respondents who agreed to follow-up interviews were invited to participate in telephone interviews conducted by Centers for Disease Control and Prevention staff members in August 2007.
RESULTS: Fifteen plans (representing &gt;67 million enrollees) responded to the online survey. All respondents covered all Advisory Committee on Immunization Practices–recommended child and adolescent vaccines in all or most products. Advisory Committee on Immunization Practices recommendations were the most commonly cited criteria for coverage decisions (86.7%) and coverage modifications (100%). Factors affecting reimbursement that were cited most often were manufacturer's vaccine price (80%) and physician feedback (53.3%). In follow-up interviews with 10 self-selected respondents, manufacturer's price (7 of 10 plans) and physician feedback (4 of 10 plans) were identified as the most-important factors affecting reimbursement. Respondents said that reimbursement delays were most commonly attributable to providers' claim submission errors or patient ineligibility. Some respondents thought that vaccine financing was a barrier (4 of 10 plans) or somewhat a barrier (2 of 10 plans) to providing immunizations; others (4 of 10 plans) did not.
CONCLUSION: Although these data suggest that health insurance coverage for recommended vaccines is high, coverage is not universal across all products offered.
Survival and Dispersal of Hatchery Triploid Rainbow Trout in an Idaho River
Authors: High Brett , Meyer Kevin A. 
Published: November 2009

Abstract
Hatchery rainbow trout Oncorhynchus mykiss of catchable size (hereafter, “catchables”) are commonly released into streams to improve angler catch and harvest rates, but returns are often less than 50% and the fate of unharvested catchables is largely unknown, especially for sterilized hatchery trout. The survival and dispersal of triploid catchables were investigated using snorkel and telemetry techniques to quantify the persistence and dispersal of catchables stocked three times during the summer of 2006 (June, July, and August) into an Idaho river in which a minimum length regulation precluded harvest. Counts of catchables stocked with T-bar tags (n = 900) and catchables emitting active radio transmitter codes (n = 54) steadily declined throughout the three observation periods. Dispersal of T-bar-tagged catchables 30 d poststocking was generally downstream of the stocking point (median dispersal = 100 m). The median values of the maximum known downstream and upstream dispersal distances for catchables with radio transmitters were 5.0 and 1.2 km from the stocking point, respectively. Only four transmitter-implanted catchables were still alive on November 1, when the study ended. On average, 85% of catchables with radio transmitters were presumed dead at 30 d poststocking (average persistence = 14.3 d). A similar rate of decline was observed for T-bar-tagged catchables. Managers wishing to maximize return-to-creel rates of sterile catchables in lotic systems might do so by limiting stocking events to within 3 weeks of expected needs and limiting the stocking locations to within 1 km of areas frequented by anglers.
Comparative Effects of Rotenone and Antimycin on Macroinvertebrate Diversity in Two Streams in Great Basin National Park, Nevada
Authors: Hamilton Bryan T. , Moore Steve E. , Williams Tod B. , Darby Neal , Vinson Mark R. 
Published: November 2009

Abstract
We used rotenone and antimycin A to eradicate nonnative rainbow trout Oncorhynchus mykiss and brook trout Salvelinus fontinalis as part of a program to reintroduce Bonneville cutthroat trout O. clarkii utah in two streams in Great Basin National Park, Nevada. These treatments followed standard protocols for piscicide application and provided a unique opportunity to compare the effects of the two piscicides on macroinvertebrate diversity over a short spatial and temporal window. Antimycin A had minimal effects on macroinvertebrate diversity. Total species richness and that of Ephemeroptera, Plecoptera, and Trichoptera (EPT); total and EPT density; and Simpson index values were reduced significantly more with rotenone than with antimycin. The Hilsenhoff biotic index increased with rotenone but decreased with antimycin A. Rotenone also had greater effects on species composition. The proportions of EPT taxa, shredders, and filterers were less than expected when rotenone was used, whereas scraper proportions were greater than expected. The proportions with antimycin A did not differ from those expected. No taxa were lost from antimycin A–treated sites, but four taxa were still missing from rotenone-treated sites 1 year posttreatment. Of these four taxa, however, two were collected 3 years posttreatment. We suggest that antimycin A be used rather than rotenone if minimizing the effects on macroinvertebrates is important. Recovery was relatively rapid with both piscicides, however, and if the short-term impacts on macroinvertebrates are not a concern, the use of rotenone may be appropriate.