bluuebunny/crossref_metadata_2025_split huggingface dataset:
Children who refuse anesthesia or sedation: a survey of anesthesiologists
Authors: LEWIS IAN , BURKE CONSTANCE , VOEPEL‐LEWIS TERRI , TAIT ALAN R. 
Published: September 2007

SummaryBackground:  Few articles have addressed the issue of the child who refuses anesthesia or sedation for surgery. A survey of members of the Society for Pediatric Anesthesia in the USA was conducted regarding their experience with pediatric refusal and assent for surgery.Methods:  Structured response and open‐end questions were used in a confidential postal survey to assess the following: details of cancellations, the use of, and attitudes to, physical restraint at induction, premedication, the management of a hypothetical case of child refusal and individual techniques used for uncooperative children.Results:  Surveys were received from 453/852 anesthesiologists for a 57% response rate. Nine percent and 45% of respondents had cancelled one or more cases for child refusal in the past year and during their entire career respectively. Forty‐four percent of respondents used restraint in the majority of children <1 year of age, whereas only 2% did so in children >11 years. Respondents were more uncomfortable with restraint in older children and less likely to proceed with induction. Twelve years was the median age when respondents would respect the child’s refusal to proceed.Conclusions:  Cancellation of planned surgery because of child refusal is not uncommon. It is important to recognize the potentially uncooperative child, particularly older children with developmental delay or a lack of understanding. Discussion with child and parents, selective use of premedication and different induction agents, distraction, play techniques, gentle restraint and the option of cancellation and review should all be considered.
Premedication in children: a comparison of oral midazolam and oral clonidine
Authors: ALMENRADER NICOLE , PASSARIELLO MAURIZIO , COCCETTI BRUNO , HAIBERGER ROBERTA , PIETROPAOLI PAOLO 
Published: September 2007

SummaryBackground:  Oral premedication is widely used in pediatric anesthesia to reduce preoperative anxiety and ensure smooth induction. Midazolam is currently the most commonly used premedicant, but good results have also been reported with clonidine. The aim of the present study was to compare clinical effects of oral midazolam and oral clonidine.Methods:  We performed a prospective open study in 64 children who were randomly assigned to receive either oral midazolam 0.5 mg·kg −1 (group M) or oral clonidine 4 μg·kg −1 (group C) prior to mask induction. Drug acceptance, preoperative sedation and anxiolysis, quality of mask acceptance, recovery profile and parental satisfaction were evaluated.Results:  The taste of oral clonidine was judged as significantly better; 14% of children rejected oral midazolam. Onset of sedation was significantly faster after premedication with midazolam (30 ± 13.1 min) than with clonidine (38.5 ± 14.6 min), but level of sedation was significantly better after premedication with clonidine. Quality of mask induction was equally successful in both groups. A steal‐induction was performed in 66% of patients of group C, but none in group M. We observed a trend towards an increased incidence of emergence agitation after premedication with midazolam. Parental satisfaction was significantly higher in group C.Conclusions:  In this study, premedication with oral clonidine appeared to be superior to oral midazolam. Quality of mask acceptance was comparable between groups, but oral clonidine was better accepted by the child, produced more effective preoperative sedation, showed a trend towards better recovery from anesthesia and had a higher degree of parental satisfaction.
Intentional use of intra‐arterial medications when venous access is not available
Authors: JOSHI GAYATRI , TOBIAS JOSEPH D. 
Published: September 2007

SummaryThe difficult or impossible establishment of venous access is occasionally encountered in the pediatric population, especially in patients exposed to repeated surgical procedures or those with underlying comorbid features. Potential options in such situations include the intramuscular, intraosseous (IO), and intratracheal administration of medications. Although IO access is accepted as the route of choice in emergency situations, its use is not universally accepted in the operating room setting when the administration of medications is nonemergent. We report the intentional and elective use of the intra‐arterial (IA) administration of vecuronium, atropine, fentanyl, and fluid during the provision of anesthesia for two infants with severe cyanotic congenital heart disease in whom venous access could not readily be obtained. The potential role of IA administration of medications is discussed and previous reports from the literature are reviewed.
Sensory phenotype assessment in a young girl affected by congenital insensitivity to pain (CIPA)
Authors: BACHIOCCO VALERIA , ROSALBA BERGAMASCHI , CRISTINA MONDARDINI MARIA , GABRIELE BRONZETTI 
Published: September 2007

SummarySensory phenotype was assessed in a young girl affected by congenital insensitivity to pain (CIPA) scheduled for an open surgical drainage. The sensory profile showed that only the Aβ fibers were functioning normally, whereas Aδ and C fibers did not respond to nociceptive stimuli. On the basis of these findings and the results of cardiovascular reflexes, she was submitted to abscess incision and debridement under midazolam sedation alone. She did not report pain or other discomfort during surgery. The sensory (and sympathetic) assessment may have a high potential value in planning anesthesia and analgesia in children with CIPA. This psychophysical procedure could be introduced as standard component of clinical evaluation before surgery.
REGIONAL INTEGRATION IN POST‐APARTHEID SOUTHERN AFRICA
Authors: GIBB RICHARD 
Published: September 2007

ABSTRACTRegional integration is a fashionable, but far from novel phenomenon, in southern Africa. This paper compares regional integration during the apartheid period with that which has occurred subsequently. South Africa's regional strategy has consistently been the single most important factor affecting the nature, character and evolution of regional integration. It was only after South Africa's successful all‐race election in April 1994 could southern African regionalism move away from the politics of separation to integration. Since 1994, all the regional institutions in southern Africa have changed their institutional structures and integrative ambitions in order to respond to changed national, international and regional environments. There is no doubt that the policy environment affecting regional integration in post‐apartheid southern Africa has changed beyond all recognition when compared to the late‐apartheid period. However, a central contention of this paper is that many of the key challenges facing southern African regionalism remain fundamentally the same as in the apartheid period; intra‐regional trade remains imbalanced and limited, regional inequalities continue to be intense and the institutional structure of regional integration is complex, confusing and contradictory.
ANOTHER LOST DECADE: THE FAILURES OF SOUTH AFRICA'S POST‐APARTHEID MIGRATION POLICY
Authors: CRUSH JONATHAN , DODSON BELINDA 
Published: September 2007

ABSTRACTDespite the political and social transformation set in motion by the collapse of apartheid and the advent of democracy in 1994, South Africa's migration policy remained mired in the past. The Aliens Control Act of 1991 continued to govern the country's policy until the passage of the Immigration Act of 2002. After amendment in 2004, the Act finally came into force in July 2005. This paper focuses on the implications for South Africa and the SADC region of persisting with a policy framework devised in the apartheid period. First, the mine migrant labour system has remained intact despite a prolonged economic crisis in the mining industry. Second, the national introspection of the first democratic government led to a major decline in legal migration and immigration to South Africa. Third, apartheid‐era tactics of migration enforcement intensified through a process of ‘violent othering’. Fourth, the old framework was sexist as well as racist, and while the new policy is gender neutral in language, it is not gender equal in effect. Finally, for a decade, South Africa successfully resisted SADC attempts to develop a regionally harmonised approach to cross‐border migration. Recent changes in South African Government policy, particularly the new JIPSA initiative, suggest that the ‘lost decade’ may finally be over. However, without major policy transformation, the unseemly history of post‐apartheid migration policy will continue.
BETWEEN NON‐RACIALISM AND MULTICULTURALISM: INDIAN IDENTITY AND NATION BUILDING IN SOUTH AFRICA
Authors: RAMSAMY EDWARD 
Published: September 2007

ABSTRACTThe paper examines the rhetoric of nation‐building in South Africa with particular reference to the incorporation of South Africans of Indian descent into the post‐1994 political order. During its years as a protest movement, the ANC came to embrace ‘non‐racialism’, a doctrine emphasising a common South African identity, in order to provide a counter‐rhetoric to the racially exclusive doctrine of apartheid. However, the organisation had difficulty in garnering support from the Indian and Coloured communities during the transition to democratic rule. It increasingly adopted a multiculturalist conception of the South African nation and promoted the idea of the ‘rainbow nation’ in order to foster a sense of unity among South Africa's diverse population groups. This multicultural conception of the South African nation has met with some success. The majority of Indians voted for the ANC in the 2004 elections, shifting their political loyalties from the National and Democratic Parties in previous elections. This trend demonstrates an increasing identification among Indians with the African majority government. However, in spite of the ANC's success in courting the Indian vote in the 2004 elections, Indian‐African tensions have been fuelled by recent anti‐Indian rhetoric. The paper argues that a multiculturalism that does not address the material conditions that fuel class antagonisms will prove to be shallow in the present neo‐liberal policy climate.
MARKETING SUSTAINABLE FOOD PRODUCTION IN EUROPE: CASE STUDY EVIDENCE FROM TWO DUTCH LABELLING SCHEMES
Authors: ILBERY B. , MAYE D. 
Published: September 2007

ABSTRACTRecent years have witnessed a proliferation of food labelling schemes that claim to promote sustainable forms of food production. Viewed as a process of reterritorialisation or, more specifically, ecological localisation, such initiatives potentially provide constructive tools to re‐address some of the environmental problems connected with agricultural restructuring and to re‐organise production and consumption relations in the food system. This paper first examines the approaches and motives behind 24 food labelling schemes in selected European countries. It then uses this empirical material to conceptualise two development rationales: ‘territorial’ (place‐based) and ‘critical’ (process‐based). The rationales are explored through a comparative assessment of two Dutch case studies – Waterland and Milieukeur strawberries. The paper argues that producer involvement requires a clear economic incentive and that most food labelling schemes need significant institutional support if participation in more sustainable modes of production is to be fully realised.
Regional distribution of psoriasis in Italy
Authors: Saraceno R , Mannheimer R , Chimenti S 
Published: September 2007

AbstractBackground  Psoriasis is a chronic disease affecting skin and joints; the prevalence varies considerably within ethnic groups and countries.Objective  The aim of this study was to examine the prevalence of psoriasis across Italy and to identify regional differences.Methods  The study was conducted in February 2006. A questionnaire was created to survey the prevalence and the geographical distribution of psoriasis in Italy. A representative sample of 3500 families from the contiguous 20 Italian regions was interviewed by a telematic panel.Results  A total of 4109 individuals were interviewed. The research showed that 2.9% of Italians declared suffering from psoriasis (regional range: 0.8–4.5%); that 52% knew somebody with psoriasis; that 33% knew well the meaning of psoriasis; and that 31% of individuals affected from psoriasis defined the effect on quality of life as high.Conclusion  In association with the socio‐cultural data, this is the first study describing the variation in prevalence of psoriasis among Italian regions.
Parenting, attention and externalizing problems: testing mediation longitudinally, repeatedly and reciprocally
Authors: Belsky Jay , Pasco Fearon R.M. , Bell Brian 
Published: September 2007

Background:  Building on prior work, this paper tests, longitudinally and repeatedly, the proposition that attentional control processes mediate the effect of earlier parenting on later externalizing problems.Methods:  Repeated independent measurements of all three constructs – observed parenting, computer‐tested attentional control and adult‐reported externalizing problems – were subjected to structural equation modeling using data from the large‐scale American study of child care and youth development.Results:  Structural equation modeling indicated (a) that greater maternal sensitivity at two different ages (54 months, ∼6 years) predicted better attentional control on the Continuous Performance Test (CPT) of attention regulation two later ages (∼6/9 years); (2) that better attentional control at three different ages (54 months, ∼6/9 years) predicted less teacher‐reported externalizing problems at three later ages (∼6/8/10 years); and (3) that attentional control partially mediated the effect of parenting on externalizing problems at two different lags (i.e., 54 months→∼6 years→∼8 years; ∼6 years→∼9 years→∼10 years), though somewhat more strongly for the first. Additionally, (4) some evidence of reciprocal effects of attentional processes on parenting emerged (54 months→∼6 years; ∼6 years→∼8 years), but not of problem behavior on attention.Conclusions:  Because attention control partially mediates the effects of parenting on externalizing problems, intervention efforts could target both parenting and attentional processes.
The effect of social disadvantage on motor development in young children: a comparative study
Authors: McPhillips Martin , Jordan‐Black Julie‐Anne 
Published: September 2007

Background:  Empirical research suggests that social disadvantage has a negative effect on the development of language, and related cognitive skills such as reading. There is, however, no corresponding body of research on the impact of social disadvantage on motor development. The primary purpose of this study was to investigate the impact of social disadvantage on motor development in young children. In addition, we explored a possible link between an early neuromotor indicator and attainments in language, and reading.Methods:  The Northern Ireland Multiple Deprivation Measure was used to identify two contrasting districts based on a composite measure of social disadvantage. We investigated the effect of social disadvantage on the motor attainments of a sample of 239 children aged 4–5 years, and 276 children aged 7–8 years attending mainstream schools in each district using a standardised motor assessment battery, and a motor neurodevelopmental measure. We used standardised receptive language and reading assessments to evaluate possible associations between motor and language/reading attainments.Results:  There was a significant negative effect of social disadvantage on motor skills, for both age groups, and for both males and females. A similar negative effect of social disadvantage on attainments in language, and reading was also found. Children from areas of social disadvantage had significant deficits in motor and receptive language attainments relative to their more advantaged peers. In addition, we revealed a significant predictive relationship between a neurodevelopmental measure of early motor development and reading attainment.Conclusions:  Children growing up in socially disadvantaged areas may be at particular risk of motor, including neurodevelopmental, delay, as well as language and reading difficulties. The determinants of motor and neuromotor deficits in children from disadvantaged backgrounds should be explored, and the relationship between early neuromotor development and language/reading development requires further investigation.
MATHEMATICAL MODELLING OF THE RELATIONSHIP BETWEEN NEOLITHIC SITES AND THE RIVERS IN XI’AN (SHAANXI PROVINCE, CHINA)*
Authors: ZHANG H.‐Q. , ZHAO W.‐M. , LIU B. 
Published: September 2007

Based on analyses of the ecological environments of the Neolithic sites along the Chan and Ba Rivers in the Xi’an area (Shaanxi Province, China), it was found that the characteristic factors of the sites had a very close relationship with the nearby river. The characteristic factors of Neolithic sites have been analysed and defined as mathematical parameters by statistical methods. A mathematical model of the human–land relationship between Neolithic sites and rivers has been established using the stepwise regression procedure REGRESS in SPSS®. The mathematical model is Y = 496.153 – 4.833X1 + 113.692X3 + 725.097X5 – 27.683X3X4. It shows that the distance (Y) from a site to a river has a marked relationship with the site area (X1), the river flux (X3), the site location (X5) and river ratio drop (X4). The model shows that the relationship between the sites and the river is in accordance with the conclusions of archaeological research. The mathematical model not only offers theoretical guidance for the archaeological excavation of Neolithic sites in Xi’an, but also contributes to the archaeological environmental research of Xi’an Neolithic sites.
Similar effects of recombinant interferon‐α‐2b and natural interferon‐α when combined with intra‐arterial 5‐fluorouracil for the treatment of advanced hepatocellular carcinoma
Authors: Uka Kiminori , Aikata Hiroshi , Takaki Shintaro , Miki Daiki , Jeong Soo Cheol , Hiramatsu Akira , Kodama Hideaki , Shirakawa Hiroo , Kawakami Yoshiiku , Takahashi Shoichi , Toyota Naoyuki , Ito Katsuhide , Chayama Kazuaki 
Published: September 2007

AbstractAim: Intra‐arterial 5‐fluorouracil (5‐FU) plus interferon (IFN) combination therapy is effective against advanced hepatocellular carcinoma (HCC) with portal vein tumour thrombosis. In this study, we compared the efficiency and safety of recombinant IFN‐α‐2b with natural IFN‐α as components of the combination therapy.Methods: Consecutive HCC patients (n=31) with portal vein tumour thrombosis were enrolled in this prospective study. They received combination therapy of 5‐FU and either recombinant IFN‐α‐2b (R group, n=15) or natural IFN‐α (N group, n=16). We compared the two groups for the early response rate, adverse reactions, time to progression (TTP) and survival rates. In addition, we assessed the cost‐effectiveness of each protocol.Results: The early response rate (R: 26.7%, N: 31.2%), median TTP (R: 5.8 months, N: 5.6 months) and median survival time (R: 7.5 months, N: 6.5 months) were not significantly different between the R and N groups. There were no differences in adverse reactions between the two groups. The estimated cost‐effectiveness ratio of recombinant IFN‐α‐2b was better than natural IFN‐α.Conclusions: In our protocol of combination therapy, there were no significant differences between recombinant IFN‐α‐2b and natural IFN‐α with regard to early response to therapy, adverse effects, TTP and survival rates. 5‐FU could be combined with either recombinant IFN‐α‐2b or natural IFN‐α, although the cost‐effectiveness of the former warrants its use clinically.
Health‐related quality of life in patients with chronic hepatitis B
Authors: Bondini Silvia , Kallman Jillian , Dan Amy , Younoszai Zahra , Ramsey Lolita , Nader Fatema , Younossi Zobair M. 
Published: September 2007

AbstractAlthough chronic hepatitis C (CH‐C) has consistently been shown to impair patients' health‐related quality of life (HRQL), the impact of chronic hepatitis B (CH‐B) on HRQL has not been fully explored.Aim: Compare HRQL between patients with CH‐B, CH‐C, primary biliary cirrhosis (PBC) and healthy controls.Design: Three HRQL questionnaires [Chronic Liver Disease Questionnaire (CLDQ), Short Form 36 (SF‐36) and the Health Utility Index (HUI Mark‐2 and Mark‐3)] were administered prospectively. Additional clinical and laboratory data and normative data for healthy individuals, were available.Analysis: Scores were compared using analysis of variance and multiple regression.Results: One hundred and forty‐six patients with CH‐B, CH‐C and PBC were included [mean age 47.1 years (±11.6), 41% female, 33% cirrhosis]. CH‐C and PBC patients scored the lowest on all CLDQ, SF‐36 and HUI domains compared with CH‐B patients and healthy controls. CH‐B patients had scores similar to the healthy population, measured by most CLDQ and SF‐36 scales. However, the HUI scores for CH‐B patients showed more impairment than population norms. Having CH‐B and not having cirrhosis were predictive of utility and HRQL scores in multivariate models.Conclusions: CH‐B patients have better HRQL than CH‐C, PBC and population norms. CH‐B patients' overall utility scores are lower than population norms.
Branched‐chain amino acids improve insulin resistance in patients with hepatitis C virus‐related liver disease: report of two cases
Authors: Kawaguchi Takumi , Taniguchi Eitaro , Itou Minoru , Sumie Shuji , Oriishi Tetsuharu , Matsuoka Hisako , Nagao Yumiko , Sata Michio 
Published: September 2007

AbstractHepatitis C virus (HCV) infection causes insulin resistance. Because increased insulin resistance is a risk factor for development of hepatocellular carcinoma and reduced long‐term survival, insulin resistance is a therapeutic target in patients with HCV infection. Branched‐chain amino acids (BCAAs) are not only structural constituents of proteins but they are also considered as regulators of insulin signalling. We first describe two cases suggesting that administration of BCAAs improves insulin resistance associated with HCV‐related liver disease. Although there were no changes in body weight, plasma glucose concentration and haemoglobin A1c (HbA1c) value were decreased. Moreover, BCAAs caused a decrease in both fasting insulin concentration and the value of homeostasis model assessment for insulin resistance. Thus, BCAAs are a potential therapeutic agent for improving insulin resistance in patients with HCV‐related liver disease.