bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Survey of Workplace Violence Across 65 U.S. Emergency Departments
Authors: Kansagra Susan M. , Rao Sowmya R. , Sullivan Ashley F. , Gordon James A. , Magid David J. , Kaushal Rainu , Camargo, Jr. Carlos A. , Blumenthal David 
Published: December 2008

AbstractObjectives:  Workplace violence is a concerning issue. Healthcare workers represent a significant portion of the victims, especially those who work in the emergency department (ED). The objective of this study was to examine ED workplace violence and staff perceptions of physical safety.Methods:  Data were obtained from the National Emergency Department Safety Study (NEDSS), which surveyed staff across 69 U.S. EDs including physicians, residents, nurses, nurse practitioners, and physician assistants. The authors also conducted surveys of key informants (one from each site) including ED chairs, medical directors, nurse managers, and administrators. The main outcome measures included physical attacks against staff, frequency of guns or knives in the ED, and staff perceptions of physical safety.Results:  A total of 5,695 staff surveys were distributed, and 3,518 surveys from 65 sites were included in the final analysis. One‐fourth of surveyed ED staff reported feeling safe sometimes, rarely, or never. Key informants at the sampled EDs reported a total of 3,461 physical attacks (median of 11 attacks per ED) over the 5‐year period. Key informants at 20% of EDs reported that guns or knives were brought to the ED on a daily or weekly basis. In multivariate analysis, nurses were less likely to feel safe “most of the time” or “always” when compared to other surveyed staff.Conclusions:  This study showed that violence and weapons in the ED are common, and nurses were less likely to feel safe than other ED staff.
National Study of Emergency Department Visits for Acute Exacerbation of Chronic Obstructive Pulmonary Disease, 1993–2005
Authors: Tsai Chu‐Lin , Sobrino Justin A. , Camargo Jr Carlos A. 
Published: December 2008

AbstractObjectives:  Little is known about recent trends in U.S. emergency department (ED) visits for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) or about ED management of AECOPD. This study aimed to describe the epidemiology of ED visits for AECOPD and to evaluate concordance with guideline‐recommended care.Methods:  Data were obtained from National Hospital Ambulatory Medical Care Survey (NHAMCS). ED visits for AECOPD, during 1993 to 2005, were identified using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD‐9‐CM) codes. Concordance with guideline recommendations was evaluated using process measures.Results:  Over the 13‐year study period, there was an average annual 0.6 million ED visits for AECOPD, and the visit rates for AECOPD were consistently high (3.2 per 1,000 U.S. population; Ptrend = 0.13). The trends in the use of chest radiograph, pulse oximetry, or bronchodilator remained stable (all Ptrend > 0.5). By contrast, the use of systemic corticosteroids increased from 29% in 1993–1994 to 60% in 2005, antibiotics increased from 14% to 42%, and methylxanthines decreased from 15% to <1% (all Ptrend < 0.001). Multivariable analysis showed patients in the South (vs. the Northeast) were less likely to receive systemic corticosteroids (odds ratio [OR] = 0.6; 95% confidence interval [CI] = 0.4 to 0.9).Conclusions:  The high burden of ED visits for AECOPD persisted. Overall concordance with guideline‐recommended care for AECOPD was moderate, and some emergency treatments had improved over time.
Valproic acid blocks adhesion of renal cell carcinoma cells to endothelium and extracellular matrix
Authors: Jones Jon , Juengel Eva , Mickuckyte Ausra , Hudak Lukasz , Wedel Steffen , Jonas Dietger , Hintereder Gudrun , Blaheta Roman A. 
Published: December 2008

AbstractTreatment strategies for metastatic renal cell carcinoma (RCC) have been limited due to chemotherapy and radiotherapy resistance. The development of targeted drugs has now opened novel therapeutic options. In the present study, anti‐tumoral properties of the histone deacetylase inhibitor valproic acid (VPA) were tested in vitro and in vivo on pre‐clinical RCC models. RCC cell lines Caki‐1, KTC‐26 or A498 were treated with various concentrations of VPA to evaluate tumour cell adhesion to vascular endothelial cells or to immobilized extracellular matrix proteins. In vivo tumour growth was conducted in subcutaneous xenograft mouse models. VPA was also combined with low dosed interferon‐α (IFN‐α) and the efficacy of the combination therapy, as opposed to VPA monotherapy, was compared. VPA significantly and dose‐dependently prevented tumour cell attachment to endothelium or matrix proteins, accompanied by elevated histones H3 and H4 acetylation. VPA altered integrin‐α and ‐β subtype expression, in particular α3, α5 and β3, and blocked integrin‐dependent signalling. In vivo, VPA significantly inhibited the growth of Caki‐1 in subcutaneous xenografts with the 200 mg/kg being superior to the 400 mg/kg dosing schedule. VPA‐IFN‐α combination markedly enhanced the effects of VPA on RCC adhesion, and in vivo tumour growth was further reduced by the 400 mg/kg but not by the 200 mg/kg VPA dosing schedule. VPA profoundly blocked the interaction of RCC cells with endothelium and extracellular matrix and reduced tumour growth in vivo. Therefore, VPA should be considered an attractive candidate for clinical trials.
Clinical manifestations of infants with nutritional vitamin B12 deficiency due to maternal dietary deficiency
Authors: Zengin E , Sarper N , Çakı Kılıç S 
Published: December 2008

AbstractAim: In developing countries, nutritional vitamin B12 deficiency in infants due to maternal diet without adequate protein of animal origin has some characteristic clinical features. In this study, haematological, neurological and gastrointestinal characteristics of nutritional vitamin B12 deficiency are presented.Methods: Hospital records of 27 infants diagnosed in a paediatric haematology unit between 2000 and 2008 were evaluated retrospectively.Results: The median age at diagnosis was 10.5 months (3–24 months). All the infants were exclusively breast fed and they presented with severe nonspecific manifestations, such as weakness, failure to thrive, refusal to wean, vomiting, developmental delay, irritability and tremor in addition to megaloblastic anaemia. The diagnosis was confirmed by complete blood counts, blood and marrow smears and serum vitamin B12 and folic acid levels. The median haemoglobin level was 6.4 g/dL (3.1–10.6) and mean corpuscular volume (MCV) was 96.8 fL (73–112.3). Some patients also had thrombocytopaenia and neutropaenia. All the infants showed clinical and haematological improvement with vitamin B12 administration. Patients with severe anaemia causing heart failure received packed red blood cell transfusions as the initial therapy.Conclusion: Paediatricians must consider nutritional vitamin B12 deficiency due to maternal dietary deficiency in the differential diagnosis of some gastrointestinal, haematological, developmental and neurological disorders of infants with poor socioeconomic status. Delay in diagnosis may cause irreversible neurological damage.
Cow's milk allergic children can present sensitisation to probiotics
Authors: Bruni Francesca M , Piacentini Giorgio L , Peroni Diego G , Bodini Alessandro , Fasoli Erica , Boner Attilio L. 
Published: December 2008

AbstractAim: To evaluate sensitivity to different probiotics in children with cow's milk allergy.Methods: Eighty‐five patients (age range: 4 months –12 years) presenting atopic dermatitis (AD) were enrolled. Skin prick test (SPT) responses to three different probiotics preparations (Fiorilac®, Dicoflor® and Reuterin®) were evaluated in addition to relevant food allergens.Results: Thirty‐nine patients out of 85 (45.8%) had a positive skin response to prick test for cow's milk (3 with reaction <3 mm). Of the thirty‐six patients with a cow's milk weal reaction >3 mm, twenty‐eight (77.8%) had a skin response to Fiorilac®, four patients (11%) to Dicoflor® and four (11%) to Reuterin®. The proportion of SPT reaction to all the investigated probiotics preparations was significantly lower than cow's milk (r = 9.406; p = 0.002). A significantly higher sensitization was observed for Fiorilac® versus Dicoflor® (r = 30.916; p < 0.001) and versus Reuterin® (r = 34.133; p < 0.001).Conclusion: Probiotic use in patients with cow's milk allergy has to be limited to products that do not contain milk. This should be clearly reported in the label. In selected patients, it is advisable to perform a screening SPT with the product to evaluate its potential contamination with milk.
The upper arm muscle and fat area of Santal children: an evaluation of nutritional status
Authors: Chowdhury Sutanu Dutta , Ghosh Tusharkanti 
Published: December 2008

AbstractAims: The purpose of this study is to determine the growth pattern of upper arm muscle area (UAMA), upper arm fat area (UAFA) and upper arm muscle area by height (UAMAH) and assessment of magnitude of undernutrition on the basis of these parameters in Santal children.Methods: UAMA and UAFA of 890 (473 boys and 417 girls) Santal children aged 5–12 years were calculated from mid‐upper arm circumference and triceps skinfold.Results: Growth curves of UAFA‐for‐age and UAMA by height in Santal boys and girls are placed at lower level of reference curve indicating severe undernutrition. The growth curves of UAMA‐for‐age in Santal children of both sexes do not indicate severe undermutrition. 17.13% Santal boys and 20.63% girls were truly undernourished on the basis of three Z‐scores of height‐for‐age, weight‐for‐height and UAMAH of each subject. Santal children have more UAMA and less UAFA compared to similar undernourished children of Sugalis.Conclusion: Growth curves of UAFA‐for‐age and UAMA by height are good indicators of nutritional status in Santal children. UAMA and UAFA may not be similarly affected in undernourished children of every community. A comprehensive approach to identify the truly undernourished child has been suggested from this study.
The effect of passive smoking and breast feeding on serum antioxidant vitamin (A, C, E) levels in infants
Authors: Yılmaz Gonca , Isik Agras Pınar , Hizli Samil , Karacan Candemir , Besler H Tanju , Yurdakok Kadriye , Coskun Turgay 
Published: December 2008

AbstractAim: Toxic substances in tobacco smoke are known to have negative effects on the antioxidant capacity of human body. In order to investigate the effect of passive smoking on serum antioxidant levels in infants, serum vitamin A, E, C levels and urinary cotinine/creatinine levels were measured in 254 infants at the age of 6 months.Methods: The information about infants' nutrition and exposure to tobacco smoke was obtained from the mothers by the help of a questionnaire. The infants were grouped according to both smoking status of mother and urinary cotinine/creatinine levels.Results: The mean serum vitamin A, C and E levels of infants of smoking mothers were significantly lower than those of non‐smoking mothers (p < 0.05). Vitamin A, E and C levels were negatively correlated with urinary cotinine/creatinine levels (p < 0.05, r: −0.61, −0.42, −0.53, respectively). Multivariate analysis revealed independent factors determining the serum vitamin A, E and C levels of infants as maternal smoking and breast feeding (p < 0.05).Conclusion: Tobacco smoke exposure of infants significantly decreases their serum antioxidant vitamin A, C and E levels. However, breast feeding may help to prevent the decrement of antioxidant vitamin levels of passive smoking infants.
Incidence and clinical outcome of cytomegalovirus transmission via breast milk in preterm infants ≤31 weeks
Authors: Buxmann Horst , Miljak Ante , Fischer Doris , Rabenau Holger F , Doerr Hans W , Schloesser Rolf L 
Published: December 2008

AbstractAim: To evaluate incidence, timing and clinical relevance of acquired human cytomegalovirus (HCMV) infection in preterm infants.Methods: The prospective longitudinal study included preterm infants ≤31 weeks. Congenital HCMV infection was excluded by negative HCMV culture from urine or by HCMV‐PCR‐negative umbilical cord blood. Infants from HCMV‐IgG‐positive mothers received thawed frozen breast milk until 33 weeks. Urine samples were obtained weekly for HCMV culture. Data were collected regarding clinical course and milk‐intake.Results: Twenty‐nine mothers (29/48, 60%) of 35 infants were HCMV‐IgG‐positive. Five of 35 infants (14%) excreted HCMV in urine. Three of five children remained asymptomatic. One child developed a respirator‐dependent HCMV pneumonia, the other child an upper airway infection and a transient thrombocytopenia. HCMV infected children had a significant longer hospital stay (median 96 vs. 73 days, p = 0.025) and received more formula milk (89 vs. 44 mL/kg/day, p = 0.04). Mothers of infected children had significantly higher HCMV‐IgG levels than those of non‐infected children (mean 1557 vs. 921 AU/mL, p = 0.048).Nineteen of 48 mothers (40%) with 23 infants were HCMV‐IgG‐negative. These children remained HCMV negative.Conclusion: Feeding preterm infants ≤31 weeks of HCMV‐IgG‐positive mothers with thawed frozen breast milk until 33 completed weeks does not prevent symptomatic HCMV infection in all cases. These infections can be associated with a prolonged hospital stay.
Prevalence of overweight and obesity in 5‐ and 12‐year‐old Finnish children in 1986 and 2006
Authors: Vuorela Nina , Saha Marja‐Terttu , Salo Matti 
Published: December 2008

AbstractObjective: To investigate the prevalence and the trends of overweight and obesity in Finnish 5‐ and 12‐year‐old children in 1986 and 2006.Design: Retrospective cross‐sectional study.Subjects and methods: Anthropometric data were collected retrospectively from health examinations in Tampere and in three rural municipalities. The size of the 5‐ and 12‐year‐old cohorts were 2108 in 1986 and 4013 in 2006, respectively. The body mass index (BMI) was calculated. Overweight and obesity was estimated using the International Obesity Task Force cutoff values (ISO BMI).Results: The prevalence of overweight (ISO BMI >25) and obesity (ISO BMI >30) in 5‐year‐old boys in 2006 was 9.8% and 2.5% and in girls 17.7% and 2.5%, respectively. At the age of 12 years, the corresponding figures in boys were 23.6% and 4.7% and in girls 19.1% and 3.2%. Between 1986 and 2006, the prevalence of overweight in 12‐year‐old children had increased 1.8 fold in boys (p < 0.001) and 1.5 fold in girls (p = 0.008). Overweight was significantly more common in rural than in urban areas.Conclusion: During the last 20 years the prevalence of overweight has markedly increased in 12‐year‐old Finnish children, but remained nearly unchanged in 5‐year‐old children.
Therapy in a subtropical climate for children with cerebral palsy. Evidence of physical and psychosocial effects?
Authors: Skjeldal OH , Capjon H , Dahl A , Diseth TH 
Published: December 2008

AbstractAim: To assess a possible therapeutic effect in children and adolescents with cerebral palsy of a habilitation programme in a warm sunny climate.Methods: Fifty‐seven children and adolescents with cerebral palsy, all integrated with normal functioning children through mainstream schooling, received an individualized four‐week habilitation programme at a habilitation centre in Lanzarote in the Canary Islands. They were clinically assessed before and after treatment, and again after three and six months. The clinical tests included gross motor function measure (GMFM) and the paediatric evaluation of disability inventory (PEDI). Mental health and self‐esteem were assessed by using the youth self report (YSR), the child behaviour checklist (CBCL) and the Harter's self‐perception profile. We also used focus‐group interviews on all 57 parents by the end of the treatment period.Results: The study revealed some improvements in the level of physical performance. The most striking finding, however, was the lasting effect on behavioural and emotional parameters and the children's self‐esteem.Conclusion: Training in a warm climate may explain some of this positive effect. However, based on the focus‐group interviews and its quantitative findings a more plausible explanation may be the interaction in a social setting with others in a similar situation.
Overweight/obesity and factors associated with body mass index during adolescence: the VYRONAS study
Authors: Mihas Constantinos , Mariolis Anargiros , Manios Yiannis , Naska Androniki , Panagiotakos Demosthenes , Arapaki Angeliki , Alevizos Alevizos , Mariolis‐Sapsakos Theodoros , Tountas Yiannis 
Published: December 2008

AbstractAim: To describe overweight and obese adolescents and to determine any correlations between an adolescent's body mass index (BMI) with personal (age, gender), lifestyle (sedentary/sport activities, smoking status) and parental (smoking status, BMI, number of cars) characteristics.Methods: Cross‐sectional data on weight, height and various characteristics from 2008 Greek adolescents (12‐ to 17‐year olds, 50.85% boys), measured in 2005–2007, were used.Results: Almost 1 in 5 (19.2%) boys and 1 in 7 (13.2%) girls 12–17 years of age were overweight while 4.4% of the boys and 1.7% of the girls were obese. The adolescents’ age, mother's smoking status, father's and mother's BMI predicted boys’ and girls’ BMI (b = 0.551, 0.203, 0.110, 0.495 for boys, b = 0.233, 0.187, 0.180, 0.531 for girls, respectively, p ≤ 0.05). Univariate analysis revealed that television watching/using personal computer/playing video games and playtime were not correlated with BMI, while an inverse association of exercising for ≥ 5 h/week and BMI was found in both boys and girls (b =−1.098, −0.528, p = 0.005, 0.004 respectively).Conclusion: The results of our study underline the high prevalence of obesity during adolescence in Greece. Age and parental unhealthy behaviour (increased BMI and maternal smoking status) were positive predictors of increased BMI of adolescents in both genders.
Attitudes of Community Developmental Services Agency Staff Toward Issues of Inclusion for Individuals With Intellectual Disabilities
Authors: Jones Jessica , Ouellette‐Kuntz Hélène , Vilela Tania , Brown Hilary 
Published: December 2008

ABSTRACTIn many countries, the shift in policy surrounding intellectual disabilities (ID) from segregation to inclusion has resulted in the closure of large‐scale institutions in favor of integrated community programs and living accommodations. Because the success of the community inclusion movement lies in the hands of the staff who implement these programs, it is important to determine the consistency of their attitudes with the philosophies that underlie policy directions. Using the Community Living Attitudes Scale‐Mental Retardation, Short Form, the current study describes the attitudes of 241 staff working in the field of ID in Ontario, Canada, and examines demographic characteristics that are related to differences in their attitudes toward inclusion. The study found that male staff members' attitudes were less supportive of inclusion than were those of female staff. Moreover, staff members with only a high school education were less likely than those with university or college training to think that individuals with ID were similar to themselves. Finally, older staff members were more likely than younger staff to think that persons with ID should be sheltered from harm. The study showed that many community agency staff members do not hold attitudes that are entirely consistent with the inclusion philosophy and that differences in attitude are associated with their demographic characteristics. This study highlights the need for education and training targeted at particular “at‐risk” staff groups in order to ensure the successful implementation of the goals of the inclusion movement.
Relationships Among Risk, Sense of Coherence, and Well‐Being in Parents of Children With and Without Intellectual Disabilities
Authors: Olsson Malin B. , Larsman Pernilla , Hwang Philip C. 
Published: December 2008

ABSTRACTThe authors studied the nature and function of the relationships of the comparative level of risk, sense of coherence (SOC), and well‐being, over time, in mothers and fathers of preschool children with and without intellectual disabilities (IDs). The hypothesis that SOC functions as a moderator between risk and well‐being was tested. Parents of children with IDs (mothers: n = 62 (46 at follow‐up) and fathers: n = 49 (37 at follow‐up)) and control parents (mothers: n = 178 (131 at follow‐up) and fathers: n = 141 (97 at follow‐up)) answered self‐report measures on risk factors (i.e., child behavior problems, negative impact on the family and socioeconomic situation) and sense of coherence. Well‐being and quality of life were used as outcomes, and were measured at baseline and at a one‐year follow‐up. The hypothesis of moderation was tested conducting multiple linear regression analyses. The level of well‐being was moderately stable over the two time points, with parents of children with ID having lower level of well‐being than control parents both initially and after one year. Well‐being was also related to level of SOC and cumulative risk with parents experiencing lower SOC or more risk also reporting lower well‐being. The hypothesis of SOC acting as a moderator in the relation between cumulative risk and well‐being found some support in the longitudinal analyses, but only for well‐being (BDI‐2r) among control mothers.
Relationship Between Mobility Limitations and the Places Where Older Adults With Intellectual Disabilities Live
Authors: Cleaver Shaun , Ouellette‐Kuntz Hélène , Hunter Duncan 
Published: December 2008

ABSTRACTAs the population ages, mobility limitations are associated with increased mortality and negative health‐related states both in the general population and among people with intellectual disabilities. The influence of mobility limitations upon the lives and lifestyles of people with intellectual disabilities remains poorly understood. Specifically, the extent to which mobility limitations might limit residential options for individuals and families has not been evaluated. To determine the relationship between mobility limitations and place of residence for adults with intellectual disabilities, age 45 and older, a proxy‐response telephone survey was completed for 128 adults with intellectual disabilities in Southeastern Ontario. A participant's place of residence was categorized as being “high support” (group homes and nursing homes) or “low support” (living alone, with family, roommates, or host family). People with a score of 12 or less on the Rivermead Mobility Index were considered to have a mobility limitation. The relationship between mobility limitations and high‐support residential settings was analyzed using a multivariate logistic regression model. After adjusting for age, sex, and presence of cerebral palsy, communication problems and behavior problems, people with mobility problems had 3.6 times greater odds of living in high‐support settings. Authors concluded that mobility limitations are associated with residence in “high‐support” settings and that further investigation is needed to determine the direction of causality and to create programs and services that equalize opportunities.