bluuebunny/crossref_metadata_2025_split huggingface dataset:
Inhaled Corticosteroids and Asthma Control in Children: Assessing Impairment and Risk
Authors: Rachelefsky Gary 
Published: December 2008

OBJECTIVE. To review the use of inhaled corticosteroids on asthma control in children by using the new therapeutic paradigm outlined in the Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma.
METHODS. A systematic review of the literature was performed by using the Medline and Embase databases (January 1996 to October 2007).
RESULTS. A total of 18 placebo-controlled, clinical trials in &gt;8000 children (aged 0–17 years) with asthma met the criteria for evaluating monotherapy with inhaled corticosteroids: 13 double-blind studies of inhaled corticosteroids versus placebo and 5 controlled studies that compared inhaled corticosteroids to a nonsteroid antiinflammatory agent. The findings can be summarized as follows: (1) Compared with placebo, inhaled corticosteroid treatment was associated with reductions in both the impairment and risk domains. (2) Improvements in impairment and risk observed with inhaled corticosteroids were generally greater than those observed with nonsteroid antiinflammatory comparator medications. (3) Inhaled corticosteroids were well tolerated. (4) Small reductions in growth rates were evident when compared with placebo and/or comparator nonsteroid antiinflammatory medication use in the long-term (&gt;1-year) studies, but when measured, the reductions diminished with time.
CONCLUSIONS. Treatment with inhaled corticosteroids improves the asthma-control domains of impairment and risk in children. Differences in study protocols make detailed comparisons difficult. Specific needs for additional trials include (1) more studies using appropriate indicators for impairment (eg, rescue-medication use; symptoms scores; asthma/episode-free days) and risk (eg, forced expiratory volume in 1 second in children who can perform spirometry; exacerbations requiring oral corticosteroids; urgent care usage) and (2) more studies evaluating adolescents; the majority of the data reported were for children up to the age of 12 years, and data for adolescents are often lost (either grouped with adults [eg, studies in patients ≥12 years old] or not included [eg, studies of school-aged children ≤12 years old]). Attention should be given to standardizing variables that will permit comparison of outcomes between trials.
How Well Can Hospital Readmission Be Predicted in a Cohort of Hospitalized Children? A Retrospective, Multicenter Study
Authors: Feudtner Chris , Levin James E. , Srivastava Rajendu , Goodman Denise M. , Slonim Anthony D. , Sharma Vidya , Shah Samir S. , Pati Susmita , Fargason Crayton , Hall Matt 
Published: December 2008

BACKGROUND. Children with complex chronic conditions depend on both their families and systems of pediatric health care, social services, and financing. Investigations into the workings of this ecology of care would be advanced by more accurate methods of population-level predictions of the likelihood for future hospitalization.METHODS. This was a retrospective cohort study. Hospital administrative data were collected from 38 children's hospitals in the United States for the years 2003–2005. Participants included patients between 2 and 18 years of age discharged from an index hospitalization during 2004. Patient characteristics documented during the index hospitalization or any previous hospitalization during the preceding 365 days were included. The main outcome measure was readmission to the hospital during the 365 days after discharge from the index admission.RESULTS. Among the cohort composed of 186856 patients discharged from the participating hospitals during 2004, the mean age was 9.2 years, with 54.4% male and 52.9% identified as non-Hispanic white. A total of 17.4% were admitted during the previous 365 days, and among those discharged alive (0.6% died during the admission), 16.7% were readmitted during the ensuing 365 days. The final readmission model exhibited a c statistic of 0.81 across all hospitals, with a range from 0.76 to 0.84 for each hospital. Bootstrap-based assessments demonstrated the stability of the final model.CONCLUSIONS. Accurate population-level prediction of hospital readmissions is possible, and the resulting predicted probability of hospital readmission may prove useful for health services research and planning.
Latent Tuberculosis Diagnosis in Children by Using the QuantiFERON-TB Gold In-Tube Test
Authors: Lighter Jennifer , Rigaud Mona , Eduardo Roger , Peng Chia-Hui , Pollack Henry 
Published: December 2008

BACKGROUND. The QuantiFERON-TB Gold test was the first blood test to be approved for the diagnosis of latent tuberculosis infection. Although it has been shown to be sensitive and specific in adults, limited data on its performance in children are available.
METHODS. This was a prospective study of children receiving health care in New York, New York. Each child was assessed for risk factors for Mycobacterium tuberculosis infection, underwent tuberculin skin testing, and had a QuantiFERON-TB Gold In-Tube test performed. The concordance between tuberculin skin test and QuantiFERON-TB Gold In-Tube test results was calculated, and the results were analyzed according to the likelihood of exposure to M tuberculosis.
RESULTS. Data for 207 children with valid tuberculin skin test and QuantiFERON-TB Gold In-Tube test results were analyzed. There was excellent correlation between negative tuberculin skin test results and negative QuantiFERON-TB Gold In-Tube test results; however, only 23% of children with positive tuberculin skin test results had positive QuantiFERON-TB Gold In-Tube test results. Positive QuantiFERON-TB Gold In-Tube test results were associated with increased likelihood of M tuberculosis exposure, and interferon γ levels were higher in children with known recent exposure to M tuberculosis, compared with children with older exposure histories. Younger children produced lower interferon γ levels in response to the mitogen (phytohemagglutinin) control used in the QuantiFERON-TB Gold In-Tube test, but indeterminant results were low for children of all ages. Performance characteristics were similar across all age groups.
CONCLUSION. The QuantiFERON-TB Gold In-Tube test is a specific test for M tuberculosis exposure in children, with performance characteristics similar to those for adults residing in regions with low levels of endemic disease. Concerns about test sensitivity, especially for children &lt;2 years of age, will require additional prospective long-term evaluation.
Finding the Optimal Postnatal Dexamethasone Regimen for Preterm Infants at Risk of Bronchopulmonary Dysplasia: A Systematic Review of Placebo-Controlled Trials
Authors: Onland Wes , Offringa Martin , De Jaegere Anne P. , van Kaam Anton H. 
Published: December 2008

CONTEXT. Postnatal dexamethasone therapy reduces the incidence of bronchopulmonary dysplasia in preterm infants but may be associated with an increased risk for adverse neurodevelopmental outcome.OBJECTIVE. Our goal was to determine if the effects of dexamethasone on mortality and pulmonary and neurodevelopmental sequelae in preterm infants are modified by the cumulative dose given.METHODS. Randomized, controlled trials comparing dexamethasone with placebo in ventilated preterm infants &gt;7 days old were identified by searching the electronic databases and the abstracts from the Pediatric Academic societies and by performing manual reference searches. Two reviewers independently assessed eligibility and quality of trials and extracted data on study design, patient characteristics, and relevant outcomes. Original trialists were asked to provide additional data.RESULTS. Sixteen trials including 1136 patients were analyzed by using meta-analysis and metaregression. Additional data were provided by 12 original trialists. Trials with a moderately early (7- to 14-day) or delayed (&gt;3-week) postnatal treatment onset were analyzed separately. Higher dexamethasone doses reduced the relative risk for the combined outcome, mortality or bronchopulmonary dysplasia, with the largest effect in trials that used a cumulative dose of &gt;4 mg/kg. No effect was found of doses on the risk of neurodevelopmental sequelae in the delayed treatment studies, but in the moderately-early-treatment studies the risk of mortality or cerebral palsy decreased by 6.2%, and the risk of a Mental Developmental Index below −2 SDs decreased by 6.6% for each incremental mg/kg cumulative dexamethasone dose.CONCLUSIONS. Higher cumulative dexamethasone doses administered after the first week of life may decrease the risk for bronchopulmonary dysplasia without increasing the risk for neurodevelopmental sequelae in ventilated preterm infants. A large randomized trial is needed to confirm or refute these findings.
Obesity and Excessive Daytime Sleepiness in Prepubertal Children With Obstructive Sleep Apnea
Authors: Gozal David , Kheirandish-Gozal Leila 
Published: December 2008

INTRODUCTION. The epidemic of childhood obesity has prompted remarkable changes in the relative proportions of symptomatic overweight or obese children being referred for evaluation of habitual snoring. However, it remains unclear whether obesity modifies the relative frequency of daytime symptoms such as excessive daytime sleepiness.
METHODS. Fifty consecutive, nonobese, habitually snoring, otherwise-healthy children (age range: 6–9 years) and 50 age-, gender-, and ethnicity-matched obese children (BMI z score: &gt;1.67) underwent an overnight polysomnographic evaluation, followed by a multiple sleep latency test the following day.
RESULTS. The mean obstructive apnea/hypopnea index values for the 2 groups were similar (nonobese: 12.0 ± 1.7 episodes per hour of total sleep time; obese: 10.9 ± 1.5 episodes per hour of total sleep time). However, the mean sleep latency for obese children was significantly shorter (12.9 ± 0.9 minutes) than that for nonobese children (17.9 ± 0.7 minutes). Furthermore, 21 obese children had mean sleep latencies of ≤12.0 minutes, compared with only 5 nonobese children. Although significant associations emerged between mean sleep latency, obstructive apnea/hypopnea index, proportion of total sleep time with oxygen saturation of &lt;95%, and respiratory arousal index for the whole cohort, the slopes and intersects of the linear correlation of mean sleep latency with any of these polygraphic measures were consistently greater in the obese cohort.
CONCLUSIONS. The likelihood of excessive daytime sleepiness for obese children is greater than that for nonobese children at any given level of obstructive sleep apnea severity and is strikingly reminiscent of excessive daytime sleepiness patterns in adults with obstructive sleep apnea.
Patient Teenagers? A Comparison of the Sexual Behavior of Virginity Pledgers and Matched Nonpledgers
Authors: Rosenbaum Janet Elise 
Published: December 2008

OBJECTIVE. The US government spends more than $200 million annually on abstinence-promotion programs, including virginity pledges. This study compares the sexual activity of adolescent virginity pledgers with matched nonpledgers by using more robust methods than past research.
SUBJECTS AND METHODS. The subjects for this study were National Longitudinal Study of Adolescent Health respondents, a nationally representative sample of middle and high school students who, when surveyed in 1995, had never had sex or taken a virginity pledge and who were &gt;15 years of age (n = 3440). Adolescents who reported taking a virginity pledge on the 1996 survey (n = 289) were matched with nonpledgers (n = 645) by using exact and nearest-neighbor matching within propensity score calipers on factors including prepledge religiosity and attitudes toward sex and birth control. Pledgers and matched nonpledgers were compared 5 years after the pledge on self-reported sexual behaviors and positive test results for Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis, and safe sex outside of marriage by use of birth control and condoms in the past year and at last sex.
RESULTS. Five years after the pledge, 82% of pledgers denied having ever pledged. Pledgers and matched nonpledgers did not differ in premarital sex, sexually transmitted diseases, and anal and oral sex variables. Pledgers had 0.1 fewer past-year partners but did not differ in lifetime sexual partners and age of first sex. Fewer pledgers than matched nonpledgers used birth control and condoms in the past year and birth control at last sex.
CONCLUSIONS. The sexual behavior of virginity pledgers does not differ from that of closely matched nonpledgers, and pledgers are less likely to protect themselves from pregnancy and disease before marriage. Virginity pledges may not affect sexual behavior but may decrease the likelihood of taking precautions during sex. Clinicians should provide birth control information to all adolescents, especially virginity pledgers.
Physical Fitness and Physical Activity at Age 13 Years as Predictors of Cardiovascular Disease Risk Factors at Ages 15, 25, 33, and 40 Years: Extended Follow-up of the Oslo Youth Study
Authors: Kvaavik Elisabeth , Klepp Knut-Inge , Tell Grethe S. , Meyer Haakon E. , Batty G. David 
Published: December 2008

OBJECTIVE. Few studies have examined the association of childhood physical activity and physical fitness with cardiovascular disease risk factors in adulthood. Furthermore, interpretation of these findings is hampered by methodologic shortcomings. In a population-based cohort study, we explored the influence, if any, of childhood physical activity and physical fitness on later cardiovascular disease risk factors.
METHODS. Data were taken from the Oslo Youth Study, a prospective cohort study that began in 1979, when 1016 students (mean age: 13 years; range: 11–15 years) who were attending 6 schools were invited to participate in a health education intervention. Cardiovascular disease risk factor data were collected at baseline and again in 1981 (mean age: 15 years; range: 13–17 years), 1991 (mean age: 25; range: 23–27 years), 1999 (mean age: 33; range: 31–35 years), and 2006 (mean age: 40; range: 38–42 years).
RESULTS. At baseline, physical fitness was inversely related to BMI, triceps skinfold thickness, and blood pressure (systolic and diastolic; N = 716). These associations were also present in prospective analyses at ages 15 (N = 472), 25 (N = 280; except for systolic blood pressure), and 33 years (N = 410, only BMI measured)—albeit with progressively diminishing magnitude—but were lost at 40 years (N = 294). There were fewer relationships with cardiovascular disease risk factors when physical activity was the exposure of interest. Controlling for educational attainment of both the parent and the study member had little impact on these associations.
CONCLUSIONS. Although childhood physical fitness seems to reveal some inverse associations with obesity and blood pressure in early adulthood, these effects diminished markedly into middle age.
Planning for Health Care Transitions: Results From the 2005–2006 National Survey of Children With Special Health Care Needs
Authors: Lotstein Debra S. , Ghandour Reem , Cash Amanda , McGuire Elizabeth , Strickland Bonnie , Newacheck Paul 
Published: December 2008

OBJECTIVES. Many youth with special health care needs have difficulties transferring to adult medical care. To address this, the Maternal and Child Health Bureau has made receipt of transition services a core performance outcome for community-based systems of care for youth with special health care needs. In this article we describe the results for the transition core outcome from the 2005–2006 National Survey of Children With Special Health Care Needs. We also describe changes in the measurement strategy for this outcome since the first National Survey of Children With Special Health Care Needs in 2001.
METHODS. In the nationally representative, cross-sectional 2005–2006 National Survey of Children With Special Health Care Needs, parent or guardian respondents of 18198 youth with special health care needs (aged 12–17) were asked if they have had discussions with their child's health care providers about (1) future adult providers, (2) future adult health care needs, (3) changes in health insurance, and (4) encouraging their child to take responsibility for his or her care. All 4 components had to be met for the youth to meet the overall transition core outcome. Those who had not had transition discussions reported if such discussions would have been helpful.
RESULTS. Overall, 41% of youth with special health care needs met the core performance outcome for transition. Forty-two percent had discussed shifting care to an adult provider, 62% discussed their child's adult health care needs, and 34% discussed upcoming changes in health insurance. Most (78%) respondents said that providers usually or always encourage their child to take responsibility for his or her health. Non-Hispanic black or Hispanic race/ethnicity, lower income level, not speaking English, and not having a medical home reduced the odds of meeting the transition core outcome.
CONCLUSIONS. Current performance on the transition core outcome leaves much room for improvement. Many parents feel that having transition-related discussions with their health care providers would be helpful. Future clinical and policy-level research should be directed at identifying barriers to, and recommending content for, health transition discussions.
Juggling Work and Breastfeeding: Effects of Maternity Leave and Occupational Characteristics
Authors: Guendelman Sylvia , Kosa Jessica Lang , Pearl Michelle , Graham Steve , Goodman Julia , Kharrazi Martin 
Published: December 2008

OBJECTIVES. Juggling breastfeeding and paid work can challenge breastfeeding success. We examined the relationship between breastfeeding and maternity leave before and after delivery among working mothers in Southern California. California is 1 of only 5 states in the United States providing paid pregnancy leave that can be extended for infant bonding.
PATIENTS AND METHODS. Drawing from a case-control study of preterm birth and low birth weight, 770 full-time working mothers were compared on whether they established breastfeeding in the first month. For those who established breastfeeding, we examined duration. Eligible women participated in California's Prenatal Screening Program; delivered live births between July 2002 and December 2003; were ≥18 years old; had a singleton birth without congenital anomalies; and had a US mailing address. We assessed whether maternity leave and other occupational characteristics predicted breastfeeding cessation and used multivariate regression models weighted for probability of sampling to calculate odds ratios for breastfeeding establishment and hazards ratios for breastfeeding cessation.
RESULTS. A maternity leave of ≤6 weeks or 6 to 12 weeks after delivery was associated, respectively, with a fourfold and twofold higher odds of failure to establish breastfeeding and an increased probability of cessation after successful establishment, relative to women not returning to work, after adjusting for covariates. The impact of short postpartum leave on breastfeeding cessation was stronger among nonmanagers, women with inflexible jobs, and with high psychosocial distress. Antenatal leave in the last month of pregnancy was not associated with breastfeeding establishment or duration.
CONCLUSIONS. Postpartum maternity leave may have a positive effect on breastfeeding among full-time workers, particularly those who hold nonmanagerial positions, lack job flexibility, or experience psychosocial distress. Pediatricians should encourage patients to take maternity leave and advocate for extending paid postpartum leave and flexibility in working conditions for breastfeeding women.
Concepts musicaux en pensée politique : l'analogie est-elle féconde ?
Authors: Heard Mélanie 
Published: December 2008

Résumé Les analogies musicales en philosophie politique ne sont pas nécessairement intuitives pour le profane car elles s’inscrivent dans des problématiques de théorie musicale dont la richesse est souvent méconnue. L’article se propose d’explorer l’idée d’une contribution des dissonances à l’harmonie, que Montesquieu applique par analogie au champ politique. Pour être éclairante en pensée politique, cette analogie implique une compréhension riche de l’usage harmonieux des dissonances en musique, où la théorisation leibnizienne de l’usage baroque des dissonances apparaît fondamentale. La prise en compte de cet apport leibnizien permet d’identifier un enjeu essentiel de l’analogie selon Montesquieu : l’identification, dans les dissonances, d’un exercice énergique et heureux de la liberté et de l’harmonie politiques.
Musique, politique et sécularisation
Authors: Moysan Bruno 
Published: December 2008

Résumé Penser la relation entre musique, politique et sécularisation conduit à questionner au préalable la nature même de la musique. Dans quelle mesure cet art du sonore, peut-il prendre en charge une signification politique et religieuse, se socialiser et s’historiciser ? Pour tenter de répondre à cette question, l’article interroge d’abord la nature de la musique en proposant une brève théorie du signe musical et de la signification en musique, pour se concentrer ensuite sur deux moments : la naissance de l’opéra au début du 17 e siècle et la révolution romantique de 1830. L’étude des trois versions du Lamento d’Ariane de Monteverdi et de deux pièces pour piano de Liszt ( Lyon et Sposalizio ) montre que la musique, pleinement acteur des débats d’idée qui l’entourent, est susceptible de produire un langage sonore agissant où le politique ne se sépare pas du poétique.
La musique « dégénérée » sous l'Allemagne nazie
Authors: Schnapper Laure 
Published: December 2008

Résumé La politique musicale nazie reflète une opposition manichéenne, typique des totalitarismes, entre œuvres jugées conformes à l’idéologie du régime et celles qui ne l’étaient pas : d’un côté la musique « allemande », de l’autre la musique « dégénérée », dont l’absence de définition précise permettait d’interdire tout ce qui semblait suspect. Une œuvre était acceptée à condition que son auteur ne fût ni juif ni opposant au régime, la musique étant, en l’absence de paroles, peu dangereuse en soi. Le langage musical devait aussi répondre à un idéal de clarté et de sensibilité, et l’opéra mettre en scène les symboles archétypaux de l’idéologie nazie (puissance, courage et supériorité raciale). Si le public resta peu convaincu par ce répertoire néo-wagnérien, cette politique suscita un appauvrissement artistique durable en Europe longtemps après la guerre, de nombreux artistes ayant été anéantis physiquement ou artistiquement.
Le quartier, lieu de réinvention des relations Etat-société en Chine urbaine : l'exemple des comités de résidents à Pékin
Authors: Audin Judith 
Published: December 2008

Résumé Depuis la fin des années 1990, un nouveau système émerge en Chine, issu du déclin du système de l'unité de travail (danwei) et de la pluralisation de la vie citadine en une mosaïque d'individus et de situations. Dans le contexte d'une exigence accrue de bien-être et de la nouvelle symbolique du lieu de résidence, la « communauté de quartier » (shequ) investit le quartier en vue de légitimer le pouvoir politique chinois. Les comités de résidents, situés à l'échelon le plus local des institutions de gestion urbaine, participent de cette évolution, en combinant des nouvelles formes de surveillance et d'assistance sociale.