bluuebunny/crossref_metadata_2025_split huggingface dataset:
Experiences of Parents Who Have Children With Chronic Kidney Disease: A Systematic Review of Qualitative Studies
Authors: Tong Allison , Lowe Alison , Sainsbury Peter , Craig Jonathan C. 
Published: February 2008

OBJECTIVE. The objective of this study was to describe the experiences of parents who have children with chronic kidney disease.
METHODS. We conducted a systematic review and meta-ethnography of studies that had used in-depth interviews or focus groups to explore experiences of parents with children who have chronic kidney disease (predialysis, hemodialysis, peritoneal dialysis, or after kidney transplantation). We searched 5 electronic databases (through to August 2005), Medline, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, and Sociofile/Sociological Abstract, and reference lists of relevant articles.
RESULTS. Sixteen articles that reported the experiences of parents of 358 children with chronic kidney disease were included. Ten themes emerged, which we grouped into 3 interrelated clusters: intrapersonal (living with constant uncertainty, stress, and maintaining vigilance despite experiencing fatigue), interpersonal (medicalization of the parental role, dependence on and conflict with staff, and disrupted peer relationships), and external issues (management of the medical regimen, pursuit of information, organizing transportation, accommodation and finances, adhering to the child's liquid and diet restrictions, and balancing medical care with domestic responsibilities).
CONCLUSIONS. In addition to “normal” parental roles, being a parent of a child with chronic kidney disease demands a high-level health care provider, problem solving, information seeking, and financial and practical skills at a time when the capacity to cope is threatened by physical tiredness, uncertainty, and disruption to peer support within and outside the family structure. Parents of children with chronic kidney disease need multidisciplinary care, which may lead to improved outcomes for their children.
Population-Based Assessments of Ophthalmologic and Audiologic Follow-up in Children With Very Low Birth Weight Enrolled in Medicaid: A Quality-of-Care Study
Authors: Wang C. Jason , Elliott Marc N. , McGlynn Elizabeth A. , Brook Robert H. , Schuster Mark A. 
Published: February 2008

OBJECTIVE. The purpose of our work was to determine whether children with very low birth weight (&lt;1500 g) who are at high risk for vision and hearing problems and enrolled in Medicaid receive recommended follow-up vision and hearing services and to examine predictors of services.PATIENTS AND METHODS. We conducted a retrospective analysis of 2182 children born in South Carolina from 1996 to 1998 with birth weights of 401 to 1499 g, gestations of ≥24 weeks, and survival of ≥90 days of life. Receipt of services for Medicaid-enrolled children was assessed by using a linked data set that included files from vital records, death certificates, Medicaid, Chronic Rehabilitative Services, and the Early Intervention Program. We assessed the receipt of hearing rehabilitation by 6 months of age for children with nonconductive hearing loss and routine ophthalmologic examination between ages of 1 and 2 years for all children with very low birth weight. Multivariate logistic regression was restricted to ophthalmologic examinations because of sample size.RESULTS. Among children with very low birth weight with nonconductive hearing loss, 20% received hearing rehabilitation by 6 months of age. Twenty-three percent of children with very low birth weight received an ophthalmologic examination between the ages of 1 and 2 years. Limiting our analysis to children &lt;1000 g or extending the measurement period to 7 months (hearing) and age 3 years (vision) did not substantially increase the percentage of children receiving the services. The receipt of an ophthalmologic examination was associated positively with Medicaid enrollment by the time of hospital discharge and birth in a level-3 hospital and negatively associated with higher birth weight, an Apgar score of ≥7, and black maternal race. Among children born at &lt;1000 g, all of whom were eligible for the Early Intervention Program, the receipt of an ophthalmologic examination was positively associated with program enrollment.CONCLUSIONS. There is a shortfall in the provision of critical services for children with very low birth weight. These findings reinforce the Institute of Medicine's concerns regarding inadequate outcome data and health care services for preterm infants and support the importance of enrollment in the Early Intervention Program for children with very low birth weight.
Quality of Life of Formerly Preterm and Very Low Birth Weight Infants From Preschool Age to Adulthood: A Systematic Review
Authors: Zwicker Jill Glennis , Harris Susan Richardson 
Published: February 2008

OBJECTIVE. The goal of this systematic review was to synthesize studies that examined the health-related quality of life of preschool- and school-aged children, adolescents, and young adults who were born preterm and/or at very low birth weight.
METHODS. We searched 7 databases up to September 2006 (Medline, PubMed, Embase, EBM Reviews, Cumulative Index of Nursing and Allied Health Literature, PsycINFO, and the Educational Resource Information Center) as well as gray literature sources. We independently screened studies and included them only if a quality-of-life outcome measure was used and findings compared preterm, very low birth weight, or extremely low birth weight infants with term or normal birth weight peers. We independently assessed the methodologic quality of each study by using criteria adapted from the Centre for Reviews and Dissemination.
RESULTS. Fifteen cohort or cross-sectional studies met the review criteria. In 6 studies of preschool-aged children, differences were found between study and control groups, suggesting that many preschool children born preterm or at very low birth weight perform more poorly than their peers in physical, emotional, and/or social functioning. Extremely low birth weight school-aged children had lower health utility scores compared with their peers, and similar results were found for adolescents. Parents of preterm and very low birth weight teens noted significantly poorer performance in their child's global health, behavior, and physical functioning, whereas the teenagers themselves did not. In young adulthood, differences in physical functioning remained, but subjective quality of life was similar to normal birth weight peers.
CONCLUSIONS. The effects of preterm birth/very low birth weight on health-related quality of life seem to diminish over time, which possibly reflects issues related to a child's report versus a parent-proxy report, differing definitions of health-related quality of life, and adaptation of individuals over time, versus true change in health-related quality of life.
Many Pediatric Residents Seek and Obtain Part-time Positions
Authors: Cull William L. , Caspary Gretchen L. , Olson Lynn M. 
Published: February 2008

OBJECTIVE. The goal was to monitor the number of pediatric residents seeking part-time employment after graduation and to examine the difficulty of their job searches, compared with residents seeking full-time employment.
METHODS. As part of the American Academy of Pediatrics Graduating Resident Survey, national random samples of 500 graduating, categorical pediatrics residents were surveyed from 2003 through 2005, between May and August of each year. Responses were pooled to examine resident interest in and experience with part-time employment. Totals of 308 (62%), 307 (61%), and 281 (56%) residents completed the survey in 2003, 2004, and 2005, respectively. Analyses focused on residents who applied for nonfellowship jobs.
RESULTS. A total of 51% of residents applied for nonfellowship jobs. Of those who applied for such jobs, 38% reported that they applied for part-time positions and 21% actually accepted part-time positions. Residents who applied for part-time positions were more likely to report moderate or considerable job search difficulty (part-time: 36%; full-time: 25%). The average starting salary for residents who accepted part-time jobs was almost $34000 less than that for residents working full-time (part-time: $71615; full-time: $105598). Residents who accepted part-time positions expected to work 15 hours less per week in practice (38 vs 23 hours) and were more likely to accept a position in the same city/area as their residency (part-time: 60%; full-time: 47%).
CONCLUSIONS. Approximately 4 of 10 pediatric residents seek part-time employment after graduation, and 2 of 10 accept part-time positions. Strong interest in part-time positions is likely to continue, and this important trend has implications for the pediatric workforce.
Prematurely Born Children Demonstrate White Matter Microstructural Differences at 12 Years of Age, Relative to Term Control Subjects: An Investigation of Group and Gender Effects
Authors: Constable R. Todd , Ment Laura R. , Vohr Betty R. , Kesler Shelli R. , Fulbright Robert K. , Lacadie Cheryl , Delancy Susan , Katz Karol H. , Schneider Karen C. , Schafer Robin J. , Makuch Robert W. , Reiss Allan R. 
Published: February 2008

OBJECTIVE. The goal was to use diffusion tensor imaging to test the hypothesis that prematurely born children demonstrate long-term, white matter, microstructural differences, relative to term control subjects.METHODS. Twenty-nine preterm subjects (birth weight: 600–1250 g) without neonatal brain injury and 22 matched, term, control subjects were evaluated at 12 years of age with MRI studies, including diffusion tensor imaging and volumetric imaging; voxel-based morphometric strategies were used to corroborate regional diffusion tensor imaging results. Subjects also underwent neurodevelopmental assessments.RESULTS. Neurodevelopmental assessments showed significant differences in full-scale, verbal, and performance IQ and Developmental Test of Visual Motor Integration scores between the preterm and term control subjects. Diffusion tensor imaging studies demonstrated widespread decreases in fractional anisotropy (a measure of fiber tract organization) in the preterm children, compared with the control subjects. Regions included both intrahemispheric association fibers subserving language skills, namely, the right inferior frontooccipital fasciculus and anterior portions of the uncinate fasciculi bilaterally, and the deep white matter regions to which they project, as well as the splenium of the corpus callosum. These changes in fractional anisotropy occurred in subjects with significant differences in frontal, temporal, parietal, and deep white matter volumes. Fractional anisotropy values in the left anterior uncinate correlated with verbal IQ, full-scale IQ, and Peabody Picture Vocabulary Test-Revised scores for preterm male subjects. In addition, preterm male subjects were found to have the lowest values for fractional anisotropy in the right anterior uncinate fasciculus, and fractional anisotropy values in that region correlated with both verbal IQ and Peabody Picture Vocabulary Test-Revised scores for the preterm groups; these findings were supported by changes identified with voxel-based morphometric analyses.CONCLUSIONS. Compared with term control subjects, prematurely born children with no neonatal ultrasound evidence of white matter injury manifest changes in neural connectivity at 12 years of age.
Influence of Multiple Social Risks on Children's Health
Authors: Larson Kandyce , Russ Shirley A. , Crall James J. , Halfon Neal 
Published: February 2008

OBJECTIVE. Social risk factors such as growing up in poverty, racial/ethnic minority status, and maternal depression have been associated with poorer health outcomes for children. This study examined the strength of association of 8 social risk factors, both individually and as part of a cumulative social risk index, on parent-reported child health status.METHODS. We performed an analysis of cross-sectional data from the 2003 National Survey of Children's Health, a telephone survey of 102353 parents of children aged 0 to 17 years. In bivariate and multivariate logistic regression models, 8 social risk factors were tested as independent predictors of 4 parent-reported child health outcomes: global health status, dental health, socioemotional health, and overweight. These risk factors were combined into a categorical “social risk index” ranging from low risk (0 risk factors) to very high risk (≥6 risk factors), and risk gradients were examined using linear polynomial testing and multivariate logistic regression.RESULTS. The percentage of children in poorer health increased with the number of social risk factors across all health outcomes. More than half of children had ≥2 risk factors, and 24% had ≥4. Low maternal mental health, black or Hispanic race/ethnicity, &lt;200% of the federal poverty level, low household education, unsafe neighborhoods, and lack of health insurance increased the odds for less than very good child health in adjusted models.CONCLUSIONS. Multiple social risk factors have a cumulative effect on parent-reported child health status across physical and socioemotional domains, demonstrating a very strong risk gradient effect. These findings emphasize the importance of addressing multiple levels of social risk to achieve improvements in child health.
Risk Factors for Severe Respiratory Syncytial Virus Disease in Children With Cancer: The Importance of Lymphopenia and Young Age
Authors: El Saleeby Chadi M. , Somes Grant W. , DeVincenzo John P. , Gaur Aditya H. 
Published: February 2008

OBJECTIVE. We sought to determine the epidemiologic features of respiratory syncytial virus infection in immunocompromised pediatric patients and to identify the risk factors for severe disease.
METHODS. We designed a retrospective study examining the experience with respiratory syncytial virus infection in pediatric patients with underlying malignancies and hematopoietic stem cell transplant recipients seen between 1997 and 2005. Clinical and laboratory data were extracted from patient records, and independent predictors of disease severity were investigated.
RESULTS. Fifty-eight patients met the study criteria. Twenty-three patients (40%) had underlying diagnoses of acute lymphoblastic leukemia, 11 (19%) had solid tumors, and 24 (41%) were hematopoietic stem cell transplant recipients, had acute myeloid leukemia, or had severe combined immunodeficiency syndrome. Seventeen patients (29%) were &lt;2 years of age. Overall, 16 patients (28%) developed lower respiratory tract infections. The frequency of lower respiratory tract infections was highest in patients with hematopoietic stem cell transplants, acute myeloid leukemia, or severe combined immunodeficiency syndrome (42%). Independent predictors of lower respiratory tract infections were profound lymphopenia, with absolute lymphocyte counts of &lt;100 cells per mm3, and age of ≤2 years. Of all patients with lower respiratory tract infections, 31% died as a result of respiratory syncytial virus infection. The overall mortality rate was low (5 of 58 patients; 8.6%). All deaths occurred in patients with lower respiratory tract infections who were before or after hematopoietic stem cell transplants or were &lt;2 years of age and receiving treatment for acute myeloid leukemia. Neutropenia was not a predictor of respiratory syncytial virus lower respiratory tract infection or death.
CONCLUSIONS. This study identified profound lymphopenia and young age as independent predictors of respiratory syncytial virus-related lower respiratory tract infections in immunocompromised children. No association between neutropenia and respiratory syncytial virus-related morbidity or death was found. These findings can guide interventions for respiratory syncytial virus infection in high risk hosts.
Neurodevelopmental Outcomes of Extremely Low Birth Weight Infants Exposed Prenatally to Dexamethasone Versus Betamethasone
Authors: Lee Ben H. , Stoll Barbara J. , McDonald Scott A. , Higgins Rosemary D. ,   for the National Institute of Child Health and Human Development Neonatal Research Network
Published: February 2008

OBJECTIVE. We compared the development of adverse neurodevelopmental outcomes at corrected ages of 18 to 22 months for extremely low birth weight infants exposed prenatally to dexamethasone, betamethasone, or no steroid.METHODS. Study infants were extremely low birth weight (401–1000 g) infants who were in the care of National Institute of Child Health and Human Development Neonatal Research Network centers between January 1, 2002, and April 30, 2003; they were assessed neurodevelopmentally at corrected ages of 18 to 22 months. Outcomes were defined as Bayley Scales of Infant Development-II Mental Development Index of &lt;70, Bayley Scales of Infant Development-II Psychomotor Development Index of &lt;70, bilateral blindness, bilateral hearing aid use, cerebral palsy, and neurodevelopmental impairment. Neurodevelopmental impairment was defined as ≥1 of the aforementioned outcomes.RESULTS. A total of 1124 infants met entry criteria. There were no statistically significant associations between prenatal dexamethasone exposure and any follow-up outcome, compared with no prenatal steroid exposure. Prenatal betamethasone exposure was associated with reduced risks of hearing impairment and neurodevelopmental impairment and with increased likelihood of unimpaired status, compared with no prenatal steroid exposure. Compared with betamethasone, dexamethasone was associated with a trend for increased risk of Psychomotor Development Index of &lt;70, increased risk of hearing impairment, and decreased likelihood of unimpaired status.CONCLUSIONS. Prenatal betamethasone exposure was associated with increased likelihood of unimpaired neurodevelopmental status and reduced risk of hearing impairment at corrected ages of 18 to 22 months among extremely low birth weight infants, compared with prenatal dexamethasone exposure or no prenatal steroid exposure. Pending a randomized, clinical trial, it may be in the best interests of infants to receive betamethasone, rather than dexamethasone, when possible.
Infectious Disease Hospitalizations Among Infants in the United States
Authors: Yorita Krista L. , Holman Robert C. , Sejvar James J. , Steiner Claudia A. , Schonberger Lawrence B. 
Published: February 2008

OBJECTIVE. This study describes the burden and epidemiologic features of infectious disease hospitalizations among infants in the United States.
METHODS. Hospitalizations with an infectious disease listed as a primary diagnosis for infants (&lt;1 year of age) in the United States during 2003 were examined by using the Kids' Inpatient Database. National estimates of infectious disease hospitalizations, hospitalization rates, and various hospital parameters were examined.
RESULTS. During 2003, an estimated 286739 infectious disease hospitalizations occurred among infants in the United States and accounted for 42.8% of all infant hospitalizations. The national infectious disease hospitalization rate was 7010.8 hospitalizations per 100000 live births, or ∼1 infectious disease hospitalization for every 14 infants. The median length of stay was 3 days, and stays totaled &gt;1 million hospital days for infants. Infectious disease hospitalization rates were highest among boys and nonwhite infants. The most commonly listed diagnoses among the infant infectious disease hospitalizations included lower respiratory tract infections (59.0%), kidney, urinary tract, and bladder infections (7.6%), upper respiratory tract infections (6.5%), and septicemia (6.5%). The median cost of an infectious disease hospitalization was $2235, with total annual hospital costs of approximately $690 million, among infants in the United States.
CONCLUSIONS. Infectious disease hospitalizations among infants account for substantial health care expenditures and hospital time in the United States, with respiratory disease hospitalizations constituting more than one half of all hospitalizations. Younger infants, boys, and nonwhite infants were at increased risk for infectious disease hospitalization. Measures to reduce racial disparities and the occurrence of respiratory tract infections should substantially decrease the infectious disease burden among infants.
Guided Differentiation of Embryonic Stem Cells into Pdx1-Expressing Regional-Specific Definitive Endoderm
Authors: Shiraki Nobuaki , Yoshida Tetsu , Araki Kimi , Umezawa Akihiro , Higuchi Yuichiro , Goto Hideo , Kume Kazuhiko , Kume Shoen 
Published: February 2008

Abstract
The generation of specific lineages of the definitive endoderm from embryonic stem (ES) cells is an important issue in developmental biology, as well as in regenerative medicine. This study demonstrates that ES cells are induced sequentially into regional-specific gut endoderm lineages, such as pancreatic, hepatic, and other cell lineages, when they are cultured directly on a monolayer of mesoderm-derived supporting cells. A detailed chronological analysis revealed that Activin, fibroblast growth factor, or bone morphogenetic protein signals are critical at various steps and that additional short-range signals are required for differentiation into Pdx1-expressing cells. Under selective culture conditions, definitive endoderm (47%) or Pdx1-positive pancreatic progenitors (30%) are yielded at a high efficiency. When transplanted under the kidney capsule, the Pdx1-positive cells further differentiated into all three pancreatic lineages, namely endocrine, exocrine, and duct cells.
Disclosure of potential conflicts of interest is found at the end of this article.
Directed Differentiation of Ventral Spinal Progenitors and Motor Neurons from Human Embryonic Stem Cells by Small Molecules
Authors: Li Xue-Jun , Hu Bao-Yang , Jones Stefanie A. , Zhang Ying-Sha , LaVaute Timothy , Du Zhong-Wei , Zhang Su-Chun 
Published: February 2008

Abstract
Specification of distinct cell types from human embryonic stem cells (hESCs) is key to the potential application of these naïve pluripotent cells in regenerative medicine. Determination of the nontarget differentiated populations, which is lacking in the field, is also crucial. Here, we show an efficient differentiation of motor neurons (∼50%) by a simple sequential application of retinoid acid and sonic hedgehog (SHH) in a chemically defined suspension culture. We also discovered that purmorphamine, a small molecule that activates the SHH pathway, could replace SHH for the generation of motor neurons. Immunocytochemical characterization indicated that cells differentiated from hESCs were nearly completely restricted to the ventral spinal progenitor fate (NKX2.2+, Irx3+, and Pax7−), with the exception of motor neurons (HB9+) and their progenitors (Olig2+). Thus, the directed neural differentiation system with small molecules, even without further purification, will facilitate basic and translational studies using human motoneurons at a minimal cost.
Disclosure of potential conflicts of interest is found at the end of this article.