bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pediatric Eye Injury–Related Hospitalizations in the United States
Authors: Brophy Megan , Sinclair Sara A. , Hostetler Sarah Grim , Xiang Huiyun 
Published: June 2006

OBJECTIVE. An estimated 2.4 million eye injuries occur in the United States each year, with nearly 35% of injuries among persons aged 17 years or less. Although previous research has identified some of the characteristics of pediatric eye injuries, many studies focused only on a specific patient population or type of eye injury or relied on self-reported data. In addition, little information has been reported on the total charges associated with treating pediatric eye injuries. Using a large national database, our aim was to examine hospitalizations for the treatment of pediatric eye injuries in the United States, including the demographic, medical care, and financial characteristics associated with major categories of eye injury.
METHODS. Cross-sectional data were derived from the 2000 Kids' Inpatient Database of the Healthcare Cost and Utilization Project. Eye injury–related hospitalizations were identified by using International Classification of Disease, Ninth Revision, Clinical Modification codes. Discharges were selected if the eye injury was the principal or secondary diagnosis. Guidelines from the Centers for Disease Control and Prevention were used to group external-cause-of-injury codes into broader categories to allow meaningful comparison with previous studies. The reported charges for the treatment of eye injuries and the expected primary payer were determined. Cases were statistically weighted to produce national estimates of hospitalizations for pediatric eye injuries and to determine the characteristics of these injuries.
RESULTS. Data were collected by the Kids' Inpatient Database for 3834 actual eye injury–related hospitalizations. These records represent an estimated 7527 eye injury–related hospitalizations among children aged 20 years or less in the United States during 2000. Inpatient charges for the treatment of these injuries were more than $88 million. The rate of hospitalization for pediatric eye injuries in the United States in 2000 was 8.9 per 100000 persons aged 20 years or less. Young adults aged 18 to 20 years accounted for the highest percentage of hospitalizations (23.7%). Males accounted for 69.7% of hospitalizations. A majority of hospitalizations were for open wounds of the ocular adnexa. Motor vehicle crash was the most common cause of injury, followed by being struck by or against an object and being cut or pierced.
CONCLUSIONS. These findings illustrate the considerable morbidity, financial burden, and proximal causes for pediatric eye injury–related hospitalizations. Our data support the need for eye injury prevention efforts that consider the age, gender, and developmental stage of children. Educating parents and children about the potential for eye injuries at home and during hazardous activities is an important public health goal. In addition, promoting the use of appropriate protective eyewear by children during activities with a high risk of ocular trauma will help prevent future eye injuries.
The Impact of Extremely Low Birth Weight on the Families of School-Aged Children
Authors: Drotar Dennis , Hack Maureen , Taylor Gerry , Schluchter Mark , Andreias Laura , Klein Nancy 
Published: June 2006

OBJECTIVE. The purpose of this study was to document the impact and burden of extremely low birth weight (&lt;1000 g) and associated problems on the families of school-aged children in a controlled study. The study was also designed to document the salient predictors of individual differences of family impact within the extremely low birth weight group.METHODS. A prospective study was completed at 8 years of a cohort of 219 children with extremely low birth weight born 1992–1995 and 176 children with normal birth weight. Measures included the following predictor variables: socioeconomic status and parent risk, birth risk, neonatal risk, neurodevelopmental outcome, impairment in adaptive abilities, and functional impact of chronic conditions. The primary outcome measure was the Impact on Family scale. A measure of family stressors and resources (the Life Stressors and Social Resources Inventory) was also obtained.RESULTS. The primary finding was that the total family impact was greater in the extremely low birth weight group compared with controls. Moreover, the negative impact on family in specific domains was greater in the extremely low birth weight group in financial impact, caretaker burden, and familial burden. These differences were not attributable to general family stressors, socioeconomic status, child, gender, or race. Higher parent/socioeconomic risk, neurodevelopmental outcomes, and the functional impact of chronic conditions predicted greater family impact within the extremely low birth weight group, whereas birth and neonatal risk scores did not.CONCLUSIONS. Extremely low birth weight was associated with a negative impact on families. Socioeconomic parental risk, but most especially child-related factors such as neurodevelopmental and the functional impact of chronic conditions, predicted the negative family impact within the extremely low birth weight group. Findings underscore the need to develop and test interventions to provide support for families of extremely low birth weight infants to ameliorate the burden of extremely low birth weight and associated risk factors on families.
Neurodevelopmental and Respiratory Follow-up Results at 7 Years for Children From the United Kingdom and Ireland Enrolled in a Randomized Trial of Early and Late Postnatal Corticosteroid Treatment, Systemic and Inhaled (the Open Study of Early Corticosteroid Treatment)
Authors: Wilson Trevor T. , Waters Lorraine , Patterson Chris C. , McCusker Chris G. , Rooney Nichola M. , Marlow Neil , Halliday Henry L. 
Published: June 2006

OBJECTIVES. The goals were to compare early school-age neurodevelopmental and respiratory outcomes for children who were treated with either early (&lt;3 days) or delayed selective (&gt;15 days) postnatal corticosteroid therapy and to compare systemic dexamethasone treatment with inhaled budesonide treatment.METHODS. One hundred twenty-seven (84%) of 152 survivors from the United Kingdom and Ireland who were recruited to the Open Study of Early Corticosteroid Treatment, a randomized trial of inhaled and systemic corticosteroid therapy to prevent chronic lung disease, were traced and assessed at a median age of 7 years. Outcome measures were level of disability, presence of cerebral palsy, cognitive ability, behavioral difficulties and competencies, growth, and respiratory symptoms. Results were adjusted for potential confounding variables (gestational age, birth weight, gender, prenatal steroid therapy, method of delivery, Apgar score at 5 minutes, and Clinical Risk Index for Babies score).RESULTS. There were no significant differences among the treatment groups in cognitive ability, behavioral competencies or difficulties, overall disability rates, cerebral palsy, combined outcomes of death or cerebral palsy and death or moderate/severe disability, growth, respiratory morbidity, or diastolic blood pressure. Those assigned to dexamethasone were more likely to have high systolic blood pressure and to have a diagnosis of asthma than were those assigned to budesonide.CONCLUSIONS. Although postnatal steroid therapy has been associated with poor long-term outcomes, this study failed to show significant differences in cognitive function between dexamethasone- and budesonide-allocated groups. There may be increased systolic blood pressure and a greater likelihood of developing asthma in childhood after postnatal dexamethasone treatment.
Attitudes Predict the Use of Physical Punishment: A Prospective Study of the Emergence of Disciplinary Practices
Authors: Vittrup Brigitte , Holden George W. , Buck Jeanell 
Published: June 2006

OBJECTIVE. We sought to track the emergence of discipline techniques by mothers of young children and assess the predictive validity of spanking attitudes with subsequent reports of spanking.METHODS. One hundred thirty-two mothers were surveyed every 6 months (beginning when their child was 12 months old until they were 4 years old) regarding how they disciplined their children. The discipline behaviors measured included physical punishment, noncoercive methods, and the use of time-outs and withdrawal of privileges. Attitudes toward spanking also were assessed several times.RESULTS. When their infants were 12 months old, mothers reported using 10 of the 12 discipline techniques assessed, and by the time the children were 24 months old, most mothers reported widespread use of the techniques. The frequency of use increased with age. Although the use of some discipline methods changed as the children got older, the mothers showed significant stability in their overall discipline strategy. Attitudes toward spanking (assessed when their children were 6 months old) were significantly correlated with subsequent spanking behavior, and the mothers’ attitudes showed stability over time as well.CONCLUSIONS. By the time infants are 12 months old, discipline is a frequent occurrence in many families. A variety of techniques are used, and attitudes toward spanking predict subsequent spanking behavior. This information is useful for pediatricians, because it provides parents with anticipatory guidance about disciplining young children.
Long-term Trends in the Incidence of Headache in Finnish Schoolchildren
Authors: Anttila Pirjo , Metsähonkala Liisa , Sillanpää Matti 
Published: June 2006

OBJECTIVE. To study changes over time in the incidence of migraine and frequent headache.
METHODS. A population-based study on migraine and other headaches in Finnish children starting school at age 7 years in the city of Turku was conducted in 1974, 1992, and 2002. The study design used in each study was virtually identical. The study population included 1927 children in 1974, 1436 children in 1992, and 1066 children in 2002. The corresponding response rates were 90%, 96%, and 81%.
RESULTS. An increasing trend in the incidence of migraine was found from 1974 to 2002 in both boys and girls. The incidence rates of migraine with aura increased from 5.2 per 1000 person-years in 1974 to 41.3 per 1000 person-years in 2002. The increase in the rates of migraine without aura was from 14.5 per 1000 person-years in 1974 to 91.9 in 2002. Similarly, a significant increase over time was seen in the incidence of frequent headache from 1974 to 2002 in both boys and girls.
CONCLUSIONS. The incidence of childhood migraine and frequent headache has substantially increased over the last 30 years. The increased incidence is alarming and reflects untoward changes in children's lifestyles. Additional studies are needed on causal associations with life changes.
Expanded Newborn Screening for Biochemical Disorders: The Effect of a False-Positive Result
Authors: Gurian Elizabeth A. , Kinnamon Daniel D. , Henry Judith J. , Waisbren Susan E. 
Published: June 2006

BACKGROUND. Newborn screening programs now identify children with &gt;30 biochemical genetic disorders. False-positive identifications may increase as disorders are added to screening panels. Concerns arise regarding the potential impact on parental stress, family relationships, and perceptions of the child's health.METHODS. Parents of 173 infants with false-positive screening results for a biochemical genetic disorder in the expanded newborn screening panel were compared with parents of 67 children with normal screening results. Parents completed an interview that elicited information about demographic features, child and parental health, and understanding of newborn screening. Parents also completed the parenting stress index.RESULTS. Parents in the false-positive group attained higher total scores on the PSI than did parents in the normal-screened group, scoring higher on the parent-child dysfunction subscale and the difficult child subscale. Only approximately one third of parents in the false-positive group reported knowing the correct reason for repeat screening. Mothers who reported knowing the correct reason for their child's repeat screening test experienced less total stress than did mothers who were misinformed, were not informed, or did not remember.CONCLUSIONS. False-positive screening results may affect parental stress and the parent-child relationship. Improved communication with parents regarding the need for repeat screening tests may reduce the negative impact of false-positive results.
Behavioral Outcome at 3 Years of Age in Very Preterm Infants: The EPIPAGE Study
Authors: Delobel-Ayoub Malika , Kaminski Monique , Marret Stéphane , Burguet Antoine , Marchand Laetitia , N′Guyen Sylvie , Matis Jacqueline , Thiriez Gérard , Fresson Jeanne , Arnaud Catherine , Poher Martine , Larroque Béatrice ,   for the EPIPAGE Study Group
Published: June 2006

OBJECTIVES. Our goal was to compare the prevalence of behavioral problems between very preterm children and term children at 3 years of age and examine the factors associated with behavioral problems in very preterm children.METHODS. We conducted a prospective population-based cohort study: the EPIPAGE (Étude Epidémiologique sur les Petits Ages Gestationnels) study. All infants born between 22 and 32 weeks of gestation in 9 regions of France in 1997 were included and compared with a control group of infants born at term. Sociodemographic status, obstetric, and neonatal data were collected at birth and in the neonatal units. At 3 years of age, the behavioral problems of 1228 very preterm singleton children without major neurodisabilities, and 447 term children were studied using the Strengths and Difficulties Questionnaire completed by the parents.RESULTS. Very preterm children were more likely than controls to have behavioral difficulties. Among very preterm children, several medical conditions were associated with a high total difficulty score: major neonatal cerebral lesions diagnosed by cranial ultrasonographic studies, hospitalization within the last year, poor health, and psychomotor delay. A high birth order and sociodemographic factors such as young maternal age and low educational level of the mother were also identified as risk factors for behavioral difficulties. The differences between very preterm children and controls remained significant after adjustment for sociodemographic characteristics, neonatal complications, and neurodevelopmental status, for a high total difficulties score, hyperactivity, conduct problems, and for peer problems. For emotional problems, the difference was at the limit of significance.CONCLUSIONS. Very preterm children have a higher risk of behavioral problems at 3 years of age compared with term-born children. Health and neurodevelopmental status of the child were significantly associated with behavioral difficulties.
Diarrhea- and Rotavirus-Associated Hospitalizations Among Children Less Than 5 Years of Age: United States, 1997 and 2000
Authors: Malek Mark A. , Curns Aaron T. , Holman Robert C. , Fischer Thea K. , Bresee Joseph S. , Glass Roger I. , Steiner Claudia A. , Parashar Umesh D. 
Published: June 2006

OBJECTIVE. A new rotavirus vaccine may be licensed in the United States in early 2006. Estimates of the burden of severe rotavirus disease, particularly hospitalizations, will help evaluate the potential benefits of a national rotavirus immunization program.
DESIGN. The Kids' Inpatient Database, a robust sample of 10% of the uncomplicated births and 80% of other pediatric discharges was used to estimate the number and rate of diarrhea- and rotavirus-associated hospitalizations among US children &lt;5 years of age in 1997 and 2000.
RESULTS. In 1997 and 2000, diarrhea was coded in 13% of all childhood hospitalizations, for an estimated cumulative incidence of 1 diarrhea hospitalization per 23 to 27 children by age 5. Most diarrhea-associated hospitalizations (62%) were coded as unspecified etiology, and 35% as viral. Rotavirus was the most common pathogen recorded for 18% and 19% of diarrhea-associated hospitalizations in 1997 and 2000, respectively. Diarrhea-associated hospitalizations coded as unspecified or viral exhibited a marked winter peak similar to that of hospitalizations coded as rotavirus, suggesting that the rotavirus-specific code captures a fraction of all rotavirus hospitalizations. Using indirect methods, we estimated that rotavirus was associated with 51142–60155 and 46839–56820 hospitalizations in 1997 and 2000, respectively. By these estimates, rotavirus is associated with 4% to 5% of all childhood hospitalizations, and 1 in 67 to 1 in 85 children will be hospitalized with rotavirus by 5 years of age.
CONCLUSIONS. Diarrhea is an important cause of hospitalization in US children, and rotavirus is the most important etiology. Disease burden estimates have remained stable during the past decade. An effective rotavirus vaccine will likely reduce substantially the burden of severe rotavirus disease, estimated to account for 4% to 5% of all hospitalizations and ∼30% of hospitalizations for watery diarrhea among children &lt;5 years of age.
Associations Between Childhood Vaccination Coverage, Insurance Type, and Breaks in Health Insurance Coverage
Authors: Smith Philip J. , Stevenson John , Chu Susan Y. 
Published: June 2006

OBJECTIVES. This study explored how vaccination coverage is associated with not being insured and with insurance type among children who are insured and to show how these associations are modified by race/ethnicity.
METHODS. We determined whether 8324 children sampled in the National Immunization Survey in 2001 and 2002 were covered by private insurance only, Medicaid/State Children's Health Insurance Program, or another insurance type or were uninsured at the time of the National Immunization Survey interview or were uninsured at some time before the interview. Children were up to date if, by the date of the interview, their vaccination providers had administered ≥4 doses of diphtheria-tetanus toxoids-acellular pertussis vaccine, ≥3 doses of polio vaccine, ≥1 dose of measles-mumps-rubella vaccine, ≥3 doses of Haemophilus influenzae type b vaccine, and ≥3 doses of hepatitis B vaccine. To evaluate the association between insurance type and breaks in insurance with timely completion of the recommended vaccination schedule soon after 19 months of age, we restricted our analyses to children 19 to 24 months of age.
RESULTS. Nationally, 12.6 ± 1.6% of all children 19 to 24 months of age were uninsured at some time. Children who were uninsured at the time of the National Immunization Survey interview had significantly lower vaccination coverage than did children with Medicaid/State Children's Health Insurance Program coverage or children with private insurance only (52.6% vs 70.0% and 75.6%). Children who had never been insured and children who were insured but had a break in insurance coverage in the 12 months immediately preceding the National Immunization Survey interview had significantly lower vaccination coverage than did children who had been insured continuously (47.4% and 64.8% vs 73.5%).
CONCLUSIONS. Approximately 1 of 8 children were uninsured at some time, and those children were at greater risk of not being vaccinated on time as recommended.
Iron Fortification Reduces Blood Lead Levels in Children in Bangalore, India
Authors: Zimmermann Michael B. , Muthayya Sumithra , Moretti Diego , Kurpad Anura , Hurrell Richard F. 
Published: June 2006

OBJECTIVE. Chronic lead poisoning and iron deficiency are concentrated in urban children from lower socioeconomic strata, and both impair neurocognitive development. Our study objective was to determine if iron fortification reduces blood lead levels in urban, lead-exposed, iron-deficient children in Bangalore, India.DESIGN, SETTING, AND PARTICIPANTS. A randomized, double-blind, controlled school-based feeding trial was done in 5- to 13-year-old iron-deficient children (n = 186). At baseline, a high prevalence of lead poisoning was found in the younger children. Subsequently, all 5- to 9-year-old children participating in the trial (n = 134) were followed to determine if iron fortification would affect their blood lead levels.INTERVENTION. Children were dewormed and fed 6 days/week for 16 weeks either an iron-fortified rice meal (∼15 mg of iron per day as ferric pyrophosphate) or an identical control meal without added iron. Feeding was directly supervised and compliance monitored.OUTCOME MEASURES. Hemoglobin, serum ferritin, C-reactive protein, transferrin receptor, zinc protoporphyrin, and blood lead concentrations were measured.RESULTS. The prevalence of iron deficiency was significantly reduced in the iron group (from 70% to 28%) compared with the control group (76% to 55%). There was a significant decrease in median blood lead concentration in the iron group compared with the control group. The prevalence of blood lead levels ≥10 μg/dL was significantly reduced in the iron group (from 65% to 29%) compared with the control group (68% to 55%).CONCLUSIONS. Our findings suggest providing iron in a fortified food to lead-exposed children may reduce chronic lead intoxication. Iron fortification may be an effective and sustainable strategy to accompany environmental lead abatement.
Antibiotic Treatment of Wheezing in Children With Asthma: What Is the Practice?
Authors: Kozyrskyj Anita L. , Dahl Matthew E. , Ungar Wendy J. , Becker Allan B. , Law Barbara J. 
Published: June 2006

OBJECTIVE. Antibiotics are not recommended for the treatment of wheezing in children with asthma, but little is known about their use. This study was undertaken to evaluate trends and determinants of antibiotic use in children with wheezing during the fiscal years 1995 through 2001.
METHODS. Using the population-based health care and prescription databases in Manitoba, Canada, this descriptive study examined time trends in antibiotic prescription use for wheezing episodes in a population of children with asthma. The likelihood of receiving an antibiotic prescription according to child and physician characteristics also was determined. Annual population-based rates of antibiotic prescriptions for wheezing episodes were modeled by age and antibiotic class, using general estimating equations. The odds ratio for receiving an antibiotic prescription according to child demographics and physician factors was determined from hierarchical linear modeling.
Results. The antibiotic prescription rate for wheezing decreased by 28% from 708 prescriptions per 1000 children with asthma in 1995 to 511 prescriptions in 2001. Fifteen-fold increases in use were observed for broader spectrum macrolides in preschool children. Twenty-three percent of physician visits for wheezing resulted in an immediate antibiotic prescription, but this percentage increased to 64% for antibiotics that were received within 7 days of the episode. General practitioners prescribed antibiotics more often than did pediatricians. Physicians who were not trained in Canada or the United States were 40% more likely to prescribe antibiotics than their counterparts.
CONCLUSIONS. Antibiotic use for wheezing in children declined in the 1990s, but the increased use of broader spectrum macrolides has implications for antibiotic resistance. A link between antibiotic prescribing and physician specialty and location of training identifies opportunities for intervention.