bluuebunny/crossref_metadata_2025_split huggingface dataset:
Satisfaction of care in a tertiary level diabetes clinic: Correlations with diabetes knowledge, clinical outcome and health‐related quality of life
Authors: Koves Ildiko H , Boucher Andrew , Ismail Dunia , Donath Susan , Cameron Fergus J 
Published: June 2008

Aim:  Patient satisfaction is regarded as an integral component of the quality of medical care. Therefore, as part of an ongoing process of outcome assessment, we analysed levels of satisfaction of care among patients and parents in our diabetes clinic and its relationship to short‐term metabolic control outcome, diabetes knowledge and health‐related quality of life (HRQOL).Methods:  In 2004, parents and their children aged 5–18 years attending the Royal Children's Hospital (RCH) diabetes clinic completed questionnaires reporting their satisfaction with care provided, HRQOL and diabetes knowledge. Concurrent HbA1c levels were also recorded. The reporting profile was 83 patients, 24 fathers and 110 mothers.Results:  Generally, both patients and parents were satisfied with diabetes care provided at our tertiary centre. Satisfaction of care was not associated with the clinical outcome of metabolic control (measured by HbA1c levels), diabetes knowledge or HRQOL measures.Conclusion:  Most patients and their parents in the RCH diabetes clinic appear generally satisfied with their diabetes care. The degree of satisfaction of care cannot be presumed according to clinical outcome, diabetes knowledge or HRQOL measures.
Peripheral precocious puberty: A retrospective study for six years in Hangzhou, China
Authors: Zou Chao Chun , Liang Li , Dong Guan Ping , Zhao Zheng Yan 
Published: June 2008

Aim:  To evaluate the clinical and aetiopathogenesis of peripheral precocious puberty (PPP) in Chinese children.Methods:  A total of 91 PPP children were reviewed. Clinical features including age, gender, stage of pubertal development, presenting symptoms, features and aetiopathogenesis were investigated.Results:  They were 65 girls (71.4%) and 26 boys (28.6%) with a median age of 3.6 years. The median age of girls and boys were 3.7 and 3.4 years, respectively, with a significant difference (P = 0.048). Congenital adrenal cortical hyperplasia (CAH) patients with a median age of 0.2 years were younger than other patients. The major complaint was the appearance of breast buds (56.6%), followed by menstruation (5.5%), vaginal discharge (5.5%) and vomiting (4.4%). Heterosexual PPP was common in CAH girls (10 cases) while exogenic sexual steroid exposure was common in boys (10 cases). Major cause of PPP was gonadal abnormalities (34.1%), including 24 girls with autonomous isolated ovarian cysts, one with Sertoli's cell ovarian tumour, five with testicular tumours and one with testotoxicosis. CAH was the most common cause of PPP in boys. Exogenous sexual steroid exposure was the third cause. MeCune–Albright syndrome was also found in three cases. It was noted that the causes of 24 cases (26.4%), including 20 girls and 4 boys, were still unknown.Conclusion:  The results imply that PPP is a common matter of children in the department of endocrinology. It is more frequently in girls. History, physical examination, clinical suspicion and imaging detection should be considered carefully to diagnose and investigate the aetiopathogenesis.
Health information seeking by parents in the Internet age
Authors: Khoo Kaylyn , Bolt Penny , Babl Franz E , Jury Susan , Goldman Ran D 
Published: June 2008

Aim:  Studies have shown increasing Internet use for health information. We aimed to broadly examine parents' utilisation of information sources for their children's health, their trust in them and to define the role of the Internet for children's health informationMethods:  Interview of a convenience sample of parents of patients presenting to a tertiary paediatric emergency department (ED) (Royal Children's Hospital, Melbourne, Australia) in 2006/2007.Results:  A total of 360 parents completed the interview. Parents had used on average five sources of health information for their children in the previous 6 months. In the previous 6 months and immediately prior to the ED visit, general practitioners were consulted for health information by 87% and 39%, chemists by 44% and 2%, the Internet by 43% and 6% and telephone advice health lines by 30% and 10%, respectively. Of these sources, parents ‘greatly trusted’ Royal Children's Hospital ED doctors and nurses 82% (n = 112) their regular general practitioners in 73% (n = 303), chemists in 45% (n = 160), telephone advice health lines (Nurse‐On‐Call) in 42% (n = 90) and the Internet in general in 10% (n = 112). Overall, 52% had sought health information for their children on the Internet. Only 20% knew and 11% had ever used the regional children's hospital web site (http://www.rch.org.au/kidsinfo), but 97% of the Internet users reported they would trust this information.Conclusion:  While using numerous different sources, parents in this study mostly use and trust traditional sources of health information. Scores of respondents use the Internet to seek health information for their children and would value easier access to Internet sources that they trust.
Measuring sensorineural disability in preterm children using a public health screening strategy: A randomised controlled trial
Authors: Pritchard Margo A , Colditz Paul B , Tudehope David I , Gray Peter H , Cartwright David , Wigg Neil R , Beller Elaine M 
Published: June 2008

Aim: To assess the efficacy of a preterm‐targeted screening programme against the routine Australian National Health Medical Research Council (NHMRC) universal child health screening programme to detect disability in a general practice setting in children born ≤31 weeks gestation at 12‐months of age.Methods: Multi‐centred trial involving 202 preterm children randomised to receive the preterm‐targeted or NHMRC programme. Primary outcome, correct identification of neurosensory disability by general practitioners assessed against gold standard paediatric assessments. Sensitivity analysis estimated interrater agreement and screening accuracy. Secondary outcomes, post natal depression (PND), parental stress, health service use, screening programme helpfulness and correct identification of levels of disability severity.Results: Of the 195 infants with data on the primary outcome in the preterm‐targeted group, their general practitioners correctly identified the disability status of 61/93 (65.6%) children, as compared with 69/102 (67.6%) in the NHMRC group (odds ratios (OR) 0.91 95% confidence interval (CI) 0.50, 1.65). Responses where general practitioners were unsure of a child's disability status were coded as incorrect and not paired for sensitivity analysis. Sensitivity analysis for 180 diagnostic pairs showedfairinterrater agreement for both groups (preterm‐targetedk = 0.30 vs. NHMRCk = 0.29) with screening test results favouring the preterm‐targeted group with greater sensitivity (73% vs. 33%) but lower specificity (70% vs. 92%) resulting in more over referrals (30% vs. 8%); however, these had a significantly lower mean Developmental Quotient (DQ) score compared with non‐disabled children. PND scores were higher in preterm‐targeted group (OR 1.33 95% CI 0.01, 2.66).Conclusion: The preterm‐targeted programme used by general practitioners: (i) did not improve overall identification of disability status compared to the NHMRC universal programme (Australian New Zealand Clinical Trails Registry number, ACTRN 12606000472572); however (ii) it did demonstrate greater efficacy as a screening tool in accurately identifying disabled children.
Use of the Massachusetts Youth Screening Instrument to assess mental health problems in young people within an Australian youth detention centre
Authors: Stathis Stephen , Letters Paul , Doolan Ivan , Fleming Robyn , Heath Karla , Arnett Amanda , Cory Storm 
Published: June 2008

Aim:  To screen for mental health problems in an Australian adolescent forensic population, evaluate the Massachusetts Youth Screening Instrument Version 2 (MAYSI‐2) in providing a preliminary assessment of those needs, and to explore the level of mental health problems in vulnerable populations within detention.Methods:  Over a 6‐month period, all young people admitted into detention were referred for screening by the MAYSI‐2, a 7‐scaled instrument developed to identify young people within the youth justice system at greatest risk for serious mental, emotional or behavioural disorders.Results:  High levels of mental health problems and trauma were reported, with 75.0% of males and 90.0% of females, and 81.2% of Indigenous and 75.0% of non‐Indigenous youth screening above the clinical cut‐off for at least one scale. Males screened highest on the Alcohol and Drug Use (58.9%), Angry–Irritable (28.2%) and Somatic Complaints (28.2%). Females screened highest on the Alcohol and Drug Use (67.5%), Somatic Complaints (45.0%), Depressed–Anxious (42.5%) and Suicide Ideation (30.0%) scales, with significantly higher rates than males on the Depressed–Anxious, Somatic Complaints and Suicide Ideation scales. No significant differences in screening rates were reported between Indigenous and non‐Indigenous youth.Conclusions:  This study confirmed the high rates of mental health problems in adolescents within youth detention. Appropriate use of screening tools improves our understanding and targets treatment of mental health problems in this cohort. We have reservations in recommending the MAYSI‐2 as a valid screening tool for Indigenous young people in youth detention and recommend the development of a more appropriate screening tool.
Paediatric pedestrian trauma: The danger after school
Authors: Newbury Clinton , Hsiao Kai , Dansey Rangi , Hamill James 
Published: June 2008

Aim:  To examine the demographics of road pedestrian trauma in children in the Auckland region and to provide data that can help target prevention strategies.Methods:  A retrospective analysis was conducted of all children (0–14 years) in the Auckland region admitted to the hospital or killed following a pedestrian versus vehicle injury for the 6‐year period 2000–2005. Excluded were pedestrians injured in a driveway.Results:  Over the 6‐year period, 364 children were involved in pedestrian crashes resulting in 25 deaths. The median age was 7 years. Males comprised 63%. Pacific Islanders and Maori were over‐represented. Three hundred seventeen patients had injury times recorded. Of these, 49% occurred between 3 and 7 pm. Injury peaks for school days showed a tri‐modal pattern with injury peaks at 8–9 am, 3–4 pm and 5–6 pm with the 3–4 pm after‐school peak predominating.Conclusion:  Prevention strategies should concentrate on the hours after school finishes and should be tailored for Maori and Pacific Island communities.
The prevalence of autism in Australia. Can it be established from existing data?
Authors: Williams Katrina , MacDermott Sarah , Ridley Greta , Glasson Emma J , Wray John A 
Published: June 2008

Aim:  To assess whether existing data collection mechanisms can provide accurate and sufficient information about the prevalence of autism in Australia.Methods:  Summary data about the number of children aged 0–16 years known to have an autism spectrum disorder (ASD) were gathered from State and Territory health, disability, education sources and autism associations. Summary data were also provided by national sources. Initial contact was made by letter, and follow‐up was undertaken by telephone or email.Results:  For the years 2003–2004, the estimated prevalence of autism for 6‐ to 12‐year‐olds ranged from 9.6 to 40.8/10 000 for the State and Territory data, and from 12.1 to 35.7/10 000 for the national data. There was a similar variation in prevalence estimates for children aged 0–5 and 13–16 years. There was also a variation in prevalence estimates between age groups.Conclusion:  Inconsistencies in autism prevalence estimates calculated from existing data sources suggest that further efforts are needed to ensure the collection of reliable information about the prevalence of ASD for national, State and Territory use. Existing data systems need to be improved or additional data systems need to be developed to ensure the collection of reliable information. Reliable and consistent ASD prevalence data would ensure that services are being provided to those who need them and would enhance the opportunities to undertake meaningful population‐based research.
Secrets to success: A qualitative study of perceptions of childhood immunisations in a highly immunised population
Authors: Tarrant Marie , Thomson Neil 
Published: June 2008

Aim:  The aim of this study was to explore childhood immunisations with a sample of parents from a population where children have high vaccination coverage and to identify factors which might encourage uptake in other populations.Methods:  This research was conducted as part of a larger study on childhood immunisations in Hong Kong. In‐depth interviews were conducted with a subsample of parents (n = 15) to further explore general perceptions and health beliefs about childhood immunisations. Interview data were analysed using content analysis techniques.Results:  Three core themes emerged from the data: individual influences factors, family and social factors, and system factors. [Correction added after online publication 21/8/08: sentence corrected from “Four core themes emerged from the data: individual influences, family influences and system influences.”] Parents readily admitted knowledge deficits concerning childhood vaccines but believed that the benefits of immunisation outweighed the risks. Family members and peers were a source of pro‐immunisation advice and comprehensive public health programmes and mandatory vaccination requirements for school entry ensured that childhood immunisation recommendations were followed.Conclusions:  Overall, Hong Kong parents are highly supportive of immunisation programmes and insight gained from this study could prove helpful to providers trying to improve uptake rates among other populations.
Emergency department management of gastro‐enteritis in Australia and New Zealand
Authors: Schutz Jacquie , Babl Franz E , Sheriff Nisa , Borland Meredith ,   the Paediatric Research in Emergency Departments International Collaborative (PREDICT)
Published: June 2008

Objective:  Comparison of clinical practice guideline (CPG) recommendations and reported physician management of gastro‐enteritis at Paediatric Research in Emergency Departments International Collaborative (PREDICT) network sites as a baseline for further randomised controlled trials.Methods:  Two part survey comprising: (i) review of CPGs from PREDICT sites for gastro‐enteritis; and (ii) survey of senior emergency department physicians regarding the management of gastro‐enteritis.Results:  All 11 PREDICT sites participated. Nine CPGs were available with three sites using a common CPG. For moderate dehydration, eight CPGs advocated nasogastric (NG) rehydration in preference to intravenous (IV) rehydration. The IV route was reserved for severe dehydration or failed NG rehydration. In the second component of the survey, 78 of 83 (94%) physicians responded. In moderate dehydration, 82% of respondents used NG rehydration. In severe dehydration, 86% used IV fluids; 12% used NG and 3% an initial IV bolus followed by NG fluid. Serum electrolytes were measured universally with IV fluid use and by 22% using NG rehydration. The IV fluid bolus was with normal saline (86%). Fifty‐four per cent used anti‐emetics ‘rarely’ or ‘sometimes’. The commonest agents were ondansetron (60%) and metoclopramide (29%).Conclusions:  CPG recommendations and physician practice for the management of gastro‐enteritis were similar across PREDICT sites with a focus on NG for moderate dehydration and IV for severe dehydration. A variety of fluids and administration rates were used. Anti‐emetics were used infrequently. The efficacy and safety of newer anti‐emetics should be explored in collaborative studies. Collaborative development of new CPGs should be considered to simplify fluid regimens.
Congenital lobar emphysema: Differential diagnosis and therapeutic approach
Authors: Ulku Refik , Onat Serdar , Ozçelık Cemal 
Published: June 2008

AbstractBackground: Congenital lobar emphysema (CLE) is a rare anomaly of lung development that usually presents in the neonatal period with respirator distress and pulmonary lobar hyperinflation. It is commonly confused with pneumothorax. The aim of the present paper was to review the authors’ experience in order to emphasize the importance of differential diagnosis with pneumothorax.Methods: Children with CLE treatment at Department of Thoracic Surgery, Dicle University School of Medicine, Turkey, between January 1993 and June 2004, were reviewed.Results: Ten children consisting of six boys and four girls (age range, 6 h–12 months) had CLE. Major presenting symptoms were tachypnea(n = 100%) and respiratory distress in (n = 80%). On chest radiograph, emphysema was seen in all patients, and shift‐herniation to the opposite lung, atelectasis were observed. Computed tomography was performed in all patients, which indicated emphysema in the affected lobes in all cases. Pulmonary perfusion scan was performed in two patients, showing loss of perfusion in the affected lobe. The most common affected lobe was the left upper lobe (50%). In the present series, three patients were mistakenly diagnosed as pneumothorax and intercostal drains were inserted in the emergency department. Eight patients underwent lobectomy, and postoperative course was uneventful. Two patients were followed conservatively. Emphysema was detected in all pathological specimens. One patient was lost to follow up. Mean follow‐up duration of all patients was 26.8 ± 29.24 months (range, 1–89 months).Conclusions: CLE is established on combined clinical, radiological and scintigraphic imaging. Surgical excision of the affected lobe is the appropriate treatment. Particularly, differential diagnosis should be made between CLE and pneumothorax.
PHENOTYPIC CHARACTERISTICS OF HEREDITARY NON‐POLYPOSIS COLORECTAL CANCER BY THE AMSTERDAM CRITERIA: AN ASIAN PERSPECTIVE
Authors: Chew Min‐Hoe , Koh Poh‐Koon , Ng Kheng‐Hong , Lim Jit‐Fong , Ho Kok‐Sun , Ooi Boon‐Swee , Tang Choong‐Leong , Eu Kong‐Weng 
Published: June 2008

Background:  Hereditary non‐polyposis colorectal cancer (HNPCC) is an autosomal disease with a 68–82% lifetime risk of colorectal cancer (CRC). This study examined the phenotypic characteristics of CRC in Amsterdam criteria‐positive Asian patients from the Singapore Polyposis Registry.Methods:  Hereditary non‐polyposis CRC patients, defined by the Amsterdam I and II criteria, prospectively monitored in the Singapore Polyposis Registry over a 16‐year period were reviewed. Clinical data were obtained from a computerized database and parameters, such as age of diagnosis, type and location of CRC, other associated cancers in the pedigree, cancer recurrence and survival were analysed.Results:  Fifty‐two patients (31 men and 21 women) from 42 unrelated families, with a median age of 44.5 years (range 27–73 years), fulfilled either Amsterdam I or II criteria and were included in our analysis. The racial distribution was 91% (n = 47) Chinese and 9% (n = 5) Malays, with a median follow up of 44.9 months (range 2–183 months). Significantly, 69% of tumours in this Amsterdam‐defined cohort were left sided, with most being sigmoid cancers. Sixty per cent of all the tumours presented at a late stage (Dukes’ C or D). Left‐sided tumours presented with more advanced Dukes’ stage (P = 0.096) and a higher rate of metastatic disease (P = 0.08) compared with right‐sided lesions. There were, however, no significant differences in either disease‐free or overall survival between right‐sided and left‐sided tumours.Conclusion:  This study emphasized the significant left‐sided predominance of CRC in Amsterdam I and II‐defined patients from our predominantly Chinese population, in contrast to those classically described in Lynch syndrome. Amsterdam criteria thus may not be suitable for diagnosing HNPCC in Asian populations and a greater emphasis should be made towards routine molecular diagnosis of mismatch repair gene defects in suspected HNPCC patients of Asian decent.
TRENDS IN EMBOLECTOMY OF THE EXTREMITIES: A POPULATION‐BASED STUDY
Authors: Ponosh Stefan , Broadhurst Robyn , Semmens James , Norman Paul E. 
Published: June 2008

Background:  There is anecdotal evidence that fewer brachial and femoral embolectomies are being carried out. This may be because of the greater use of anticoagulation in patients with atrial fibrillation. The aim of the present study was to assess community‐wide temporal trends in embolectomy of the extremities and of warfarin usage.Methods:  The Western Australian Linked Data System was used to identify cases of extremity embolectomy with a combination of diagnosis (upper or lower limb embolus) and procedure (embolectomy and revascularization) codes. Trends in age‐specific and age‐standardized rates were assessed over the period 1992–2003. Data regarding warfarin prescriptions were acquired from the Pharmaceutical Benefits Schedule database for the period 2000–2005.Results:  One thousand and five patients aged 30 years and more underwent an embolectomy of the extremity during the study period. The age‐specific rate of embolectomy increased from 0.78 per 100 000 in the 30‐ to 49‐year‐old group to 46.1 per 100 000 for those aged 80 years and more. There was a significant downward trend between 1992 and 2003 (Cuzik’s trend test P = 0.015). This pattern was seen for all age groups. Prescriptions for warfarin increased by 50.4% over the period 2000–2005.Conclusion:  The rates of embolectomy of the extremity appear to be falling. Although the cause for this trend is not known, one possible explanation is increasing prescription of warfarin.
INLINE BIPOLAR RADIOFREQUENCY ABLATION DEVICE‐ASSISTED PARTIAL NEPHRECTOMY IN A PORCINE MODEL
Authors: Yao Peng , Gunasegaram Aravin , Ladd Leigh A. , Morris David L. 
Published: June 2008

Background:  Nephron‐sparing surgery has become an acceptable alternative to radical nephrectomy in the treatment of renal tumours. Control of intraoperative blood loss can be an important challenge during partial nephrectomy. InLine radiofrequency ablation (ILRFA) device has shown promising results of significant reduction of intraoperative blood loss in liver resection. In this study, we tested ILRFA‐assisted partial nephrectomy in a porcine model.Methods:  Eight landrace pigs were used in this study. Every pig underwent 2–3 partial nephrectomies. The proposed line of parenchymal incision was circumferentially scored with a diathermy. Then, ILRFA was deployed into this resection plane. After complete coagulation, the resection was then simply carried out using the scalpel. For the control resection, we used diathermy to transect the other pole, further sutures were then used to secure the residual bleeding.Results:  The ILRFA deployments were set to 3 cm power algorithm. The average radiofrequency ablation coagulation time was 5 min. The mean intraoperative blood loss 35 ± 7 mL in the ILRFA and 152 ± 94 mL in the control, a 77.0% reduction (P = 0.024). The mean blood loss per centimetre of resection area was 2.09 ± 1.41 mL/cm2 in the ILRFA compared with 12.79 ± 1.68 mL/cm2 in controls; the reduction was 79.0% (P = 0.019).Conclusion:  Our study indicates that ILRFA for partial nephrectomy in a porcine model is effective in reducing blood loss. Precoagulation before parenchymal transection appears to be a valid concept in nephron‐sparing surgery.