bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vascular Calcification in Middle Age and Long-Term Risk of Hip Fracture: The Framingham Study
Authors: Samelson Elizabeth J , Cupples L Adrienne , Broe Kerry E , Hannan Marian T , O'Donnell Christopher J , Kiel Douglas P 
Published: June 2007

Abstract
Osteoporosis and atherosclerosis frequently occur in the same individuals and may share similar pathogenic mechanisms. This study examined the relation between severity of aortic calcification in middle-age years and subsequent risk of hip fracture in women and men in the population-based Framingham Study.
Introduction: We assessed vascular calcification in women and men in middle age and risk of hip fracture at advanced age.
Materials and Methods: Participants included 2499 Framingham cohort members (mean age, 61 yr; range, 47–80 yr). Semiquantitative methods were used to determine severity of abdominal aortic calcification on baseline radiographs. Information on potential confounding factors was obtained from study examinations conducted at, or before, baseline radiography. Hip fractures were ascertained by active surveillance and confirmed by medical records.
Results: Thirty-five-year cumulative incidence of hip fracture was 16% in women and 5% in men with prevalent aortic calcification at baseline (score 1+) and 14% in women and 4% in men without aortic calcification (score 0). Hazard ratios (HRs) and 95% CIs for hip fracture did not increase from the lowest to the highest category of aortic calcification. HRs were 1.0, 1.2 (95% CI, 0.9–1.8), 1.2 (95% CI, 0.7–1.9), 1.1 (95% CI, 0.7–1.7), and 1.4 (95% CI, 0.8–2.3) in women (p for trend = 0.44) and 1.0, 1.8 (95% CI, 0.8–3.8), 1.8 (95% CI, 0.7–4.6), 1.5 (95% CI, 0.6–3.9), and 1.2 (95% CI, 0.2–5.7) in men (p for trend = 0.29) for aortic calcification scores 0 (reference), 1–4, 4–5, 6–10, and 11+, respectively. However, aortic calcification score was strongly associated with increased risk of death (p for trend &lt; 0.0001 in women and men). HRs (95% CIs) for mortality from the lowest to highest aortic calcification score were 1.0, 1.6 (1.4–1.9), 1.7 (1.4–2.1), 1.8 (1.5–2.2), and 2.1 (1.7–2.6) for women, and for men were 1.0, 1.4 (1.1–1.6), 1.4 (1.2–1.8), 1.6 (1.3–2.0), and 1.9 (1.5–2.5).
Conclusions: Vascular calcification in middle-aged adults does not increase long-term hip fracture risk.
Abortion Among Young Women and Subsequent Life Outcomes
Authors: Fergusson David M. , Boden Joseph M. , Horwood L. John 
Published: June 2007

CONTEXT:  Young women frequently cite concerns about the effects of unplanned pregnancies on future life course outcomes, including education, employment and relationships, as reasons for seeking abortion. There is relatively little evidence as to whether abortion leads to improved life course outcomes for young women who choose this option. METHODS:  Data from 492 women participating in a 25‐year longitudinal study of a New Zealand birth cohort were used in regression models that examined the relationship between pregnancy and abortion history prior to age 21 and selected social and economic outcomes at ages 21–25. RESULTS:  Compared with young women who became pregnant before age 21 but did not seek an abortion, young women who had an abortion had significantly better outcomes on six out of 10 measures spanning education, income, welfare dependence and domestic violence. Adjustment for confounding factors indicated that most of these differences were explained by family, social and educational characteristics that were present prior to pregnancy. Nonetheless, even after adjustment for confounding factors, young women who had abortions had higher levels of subsequent educational achievement than those who became pregnant but did not have abortions. CONCLUSIONS:  Abortion may mitigate some effects of early unplanned pregnancy. However, further study of its potential risks and benefits is needed so that women can make fully informed decisions as to whether to terminate unintended pregnancies.
Identifying Barriers to Emergency Contraception Use Among Young Women from Various Sociocultural Groups in British Columbia, Canada
Authors: Shoveller Jean , Chabot Cathy , Soon Judith A. , Levine Marc 
Published: June 2007

CONTEXT:  Despite advances related to the provision of emergency contraception in Canada, particularly the granting of independent prescriptive authority to pharmacists in 2000, little is known about the ways in which women perceive potential barriers to using it. METHODS:  In 2004, an ethnically diverse sample of 52 women living in Greater Vancouver participated in interviews that were analyzed for an assessment of women’s knowledge, attitudes and experiences related to emergency contraception, with particular attention to the ways in which ethnicity affected their stories. RESULTS:  Participants generally misperceived emergency contraception as an abortifacient, and often mistakenly thought that it has long‐term effects on health and fertility. Knowledge gaps regarding reproductive physiology impeded clear understanding of when it is most effective. Participants also reported receiving subtle and sometimes overtly stigmatizing messages from providers when they sought emergency contraception. Asian and South Asian women were particularly concerned about negative interactions with providers; for example, they feared that female providers from their sociocultural community might recognize, chastise or gossip about them. Institutional policies (e.g., a Catholic hospital’s refusal to provide the method), coupled with low awareness of pharmacists’ prescriptive authority, also created barriers to use. CONCLUSIONS:  Women’s ability to benefit from emergency contraception is hampered by lack of knowledge and conservative cultural or social mores. Serious contextual and structural shifts are required before woman‐centered approaches to provision of the method become the norm.
Multipartnered Fertility Among Young Women with a Nonmarital First Birth: Prevalence and Risk Factors
Authors: Benjamin Guzzo Karen , Furstenberg Frank F. 
Published: June 2007

CONTEXT:  Although early nonmarital fertility has been well studied, less attention has been paid to the subsequent fertility of young unwed mothers. In particular, the frequency with which these young women have subsequent births with a new partner (multipartnered fertility) and the risk factors associated with doing so are unknown. METHODS:  The proportion of young women who had a first birth and the proportion who subsequently had a child with a new partner were determined among a sample of participants in Waves 1 (1995) and 3 (2001–2002) of the National Longitudinal Study of Adolescent Health. Multivariate analyses identified characteristics associated with multipartnered fertility. RESULTS:  By Wave 3, when these young women were 19–25 years old, 29% had had a first birth, and 3% had had births with multiple partners. Among women with a nonmarital first birth, 14% subsequently had a birth with another partner, and 41% with two or more children had had multiple partners. The prevalence of multipartnered fertility differed sharply by race and ethnicity. Most new‐partner births occurred outside of marriage, especially among black women. Respondents who had no contact with their partner after informing him of their first pregnancy or who had not wanted to have a child with him had an increased likelihood of multipartnered fertility. CONCLUSIONS:  The context in which first births occur sets the stage for subsequent childbearing. Programs that help women avoid having births in unfavorable circumstances, such as in early and unstable relationships, may reduce the prevalence of multipartnered fertility.
U.S. Women’s One‐Year Contraceptive Use Patterns, 2004
Authors: Frost Jennifer J. , Singh Susheela , Finer Lawrence B. 
Published: June 2007

CONTEXT:  Unintended pregnancies occur far too often in the United States, and half occur when couples fail to practice contraception. Improved measures of the continuity of women’s contraceptive use, nonuse and switching patterns can help identify ways to reduce unintended pregnancy. METHODS:  A nationally representative sample of 1,978 adult women at risk of unintended pregnancy was surveyed by telephone in 2004. Respondents provided detailed information about contraceptive use and periods of stopping or switching methods during the past year. A typology of patterns of contraceptive use was created, classifying women into mutually exclusive categories according to their exposure to pregnancy risk. RESULTS:  Twenty‐three percent of women at risk of unintended pregnancy were exposed to a high risk of pregnancy because of gaps in contraceptive method use in the year prior to the survey—8% were consistent nonusers, and 15% experienced 1–11 months of nonuse while at risk. More than half of women used a method during each of the previous 12 months—38% used the same method or methods all year, and 24% switched methods. Fifteen percent of women had gaps in contraceptive use when they were not at risk. Women reported a variety of reasons for their gaps in contraceptive use, including method‐related difficulties and side effects, infrequent sex and being ambivalent about avoiding pregnancy. CONCLUSIONS:  Strategies for reducing gaps in contraceptive use include improved counseling to help women both choose the right method and continue method use, especially when they have periods of infrequent sexual activity or are experiencing method‐related side effects or problems.
Visual Function at 11 Years of Age in Preterm-Born Children With and Without Fetal Brain Sparing
Authors: Kok Joke H. , Prick Liesbeth , Merckel Elly , Everhard Yolande , Verkerk Gijs J.Q. , Scherjon Sicco A. 
Published: June 2007

OBJECTIVE. We have demonstrated earlier an accelerated maturation of the visual evoked potential in the first year of life in preterm infants with antenatal brain sparing. We have now assessed visual functioning at 11 years of age in the same cohort and compared the groups with and without brain sparing.
DESIGN/METHODS. One hundred sixteen survivors included in a study on the outcome of preterm infants born at &lt;33 weeks' gestation with and without fetal brain sparing and admitted to the NICU were followed extensively. Ninety-eight infants (85%) were again assessed at 11 years of age. Data were available for fetal Doppler measurements indicating brain sparing, neonatal cerebral ultrasound scanning, and developmental outcome in the first 5 years. Mean birth weight was 1303 g; mean gestational age was 29.8 weeks. The infants were divided into 2 groups with and without brain sparing. Visual functioning was estimated by measuring visual acuity, visual fields, eye position, and binocular function and by visual motor tests.
RESULTS. Six percent of the children were found to have a visual acuity of &lt;0.8, 12% had strabismus, and 14% to 46% showed abnormal results on the visual motor tests. No statistical differences were found between the 2 groups. However, children with severe cerebral ultrasound diagnoses in the neonatal period were found to have significantly more abnormalities on visual functioning and lower scores on visual motor tests than children without these morbidities.
CONCLUSIONS. Children with fetal brain sparing do not demonstrate a different development of their visual functioning at late school age. However, an abnormal cerebral ultrasound in the neonatal period is associated with impaired visual function in later life.
Violent Entertainment Pitched to Adolescents: An Analysis of PG-13 Films
Authors: Webb Theresa , Jenkins Lucille , Browne Nickolas , Afifi Abdelmonen A. , Kraus Jess 
Published: June 2007

OBJECTIVE. The purpose of this study was to evaluate the violence content of the top-grossing PG-13 films of 1999 and 2000 to determine what percentage of it had potential for negative effects on young viewers and what percentage of it had potential for prosocial or beneficial effects.METHODS. A large, multidimensional analytic instrument was designed for systematic coding of each act of violence and its contextualization by features that have been shown either to enhance or to protect against harmful effects that are associated with violent media exposure: perpetrators and victims of violence, motivation for violence, presence of weapons, degree of realism, and consequences of violence. Descriptive statistics by genre were performed for each film. An ordinal logistic regression model was used to examine the association between the seriousness of violence and weapons, motive, and genre.RESULTS. In the sample of 77 PG-13 films, a total of 2251 violent actions were observed with roughly half (47%) of lethal magnitude. A total of 118 acts contained justified violence that were initiated by major characters and were extremely serious, and approximately two thirds of the films (49 [64%]) were rated PG-13 for reasons other than violence.CONCLUSIONS. Violence permeated nearly 90% of the films in our study. Although only a small subset of this content contained violence that was associated with negative effects, only 1 film contained violence that was associated with protective or beneficial effects.
Continuity of Health Insurance Coverage Among Young Adults With Disabilities
Authors: Callahan S. Todd , Cooper William O. 
Published: June 2007

OBJECTIVES. Although considered critical to facilitate the successful transition from pediatric to adult health care, the continuity of insurance coverage for young adults with disabilities as they make the transition to adulthood has not been well characterized. The purpose of this work was to compare the continuity of insurance coverage reported by a nationally representative sample of young adults 16 to 25 years old with and without disabilities during a consecutive 36-month period.METHODS. We performed secondary analysis of data from the 2001 Survey of Income Program and Participation. Data for the survey were collected at 4-month intervals from February 2001 through January 2004 for 5170 young adults. Subjects with disabilities were those who reported limitations in activities of daily living or work, used assistive devices, and/or had learning disabilities, mental retardation, or other mental disorders. The primary outcome was uninsurance defined for each study month in which there was no coverage by private, public, or military programs. We present bivariate analyses of the months of uninsurance according to disability status using longitudinal weights and design-effect adjustments to account for the complex sample design.RESULTS. The sample consisted of 599 subjects with and 4571 without reported disabilities, representing 3970000 and 30800000 young adults in the United States, respectively. At study entry, 22% of the young adults with disabilities were uninsured. During the 36-month follow-up period, 56% of the young adults with disability reported gaps in insurance coverage with a mean of 15 months of uninsurance. The proportion of uninsured subjects did not significantly differ by disability status.CONCLUSIONS. The majority of young adults with disabilities reported gaps in insurance coverage, and many were uninsured for a substantial portion of the study period. As an increasing number of children with special health care needs make the transition to adulthood, improving the continuity of health insurance coverage for this population warrants specific attention.
Statistical Literacy for Readers ofPediatrics: A Moving Target
Authors: Hellems Martha A. , Gurka Matthew J. , Hayden Gregory F. 
Published: June 2007

OBJECTIVE. Pediatric residents are expected to study research design and statistical methods to enable them to critically appraise the pediatric literature and apply the findings to patient care. However, it is not clear how best to teach these skills or even which statistical concepts are most important. An earlier study demonstrated that the statistical complexity of articles published in Pediatrics increased from 1952 to 1982. The goals of our study were to assess whether this trend has continued and to determine the statistical measures and procedures most commonly encountered in Pediatrics.METHODS. We reviewed the print research articles published in Pediatrics, volume 115, 2005, and recorded the statistical measures and procedures reported in each article to determine how many articles used statistics or statistical procedures and what statistical procedures were encountered most commonly.RESULTS. The proportion of articles that used any inferential statistics increased from 48% in 1982 to 89% in 2005. The mean number of inferential procedures per article increased from 2.5 in 1982 to 3.9 in 2005. The most commonly encountered statistical procedures or measures were descriptive statistics, tests of proportions, measures of risk, logistic regression, t tests, nonparametric tests, analysis of variance, multiple linear regression, sample size and power calculation, and tests of correlation. However, a reader who is familiar with only these concepts can understand the analyses used in only 47% of articles.CONCLUSIONS. Our results confirm a trend toward the use of new and increasingly complex statistical techniques in Pediatrics. Educational efforts might most profitably focus on the principles underlying statistical analysis rather than on specific statistical tests. Authors, reviewers, and journal editors have a greater responsibility for ensuring that statistical procedures are used appropriately, as it may be increasingly unrealistic to expect readers to fully understand the statistical analyses used in journal articles.
Heelys and Street Gliders Injuries: A New Type of Pediatric Injury
Authors: Vioreanu Mihai , Sheehan Eoin , Glynn Aaron , Casidy Noelle , Stephens Michael , McCormack Damian 
Published: June 2007

OBJECTIVES. Our goals were to highlight an increasing trend in orthopedic injuries in children as a result of “heeling” or “street gliding,” to describe injuries sustained by children using Heelys (HSL, Carrollton, TX) and Street Gliders (Glowgadgets Ltd, Bristol, United Kingdom), and to increase public awareness and prevent such injuries.
PATIENTS AND METHODS. We prospectively recorded the data of all roller shoes injuries referred to our department during the summer school holiday. Using a data-collection sheet, we recorded demographic data, type of injury, mechanism and place of injury, heeling or street-gliding experience, use of safety equipment, methods of treatment, and intention to continue heeling or street gliding after recovery from injury.
RESULTS. Over a 10-week period, 67 children suffered orthopedic injuries while using Heelys or Street Gliders. There were 56 girls and 11 boys with a mean age of 9.6 years. Upper limbs were the most common location of injury. Distal radius fractures were the most prevalent, followed by supracondylar fractures, elbow dislocations, and hand fractures. The majority of children suffered the injury while heeling or street gliding outdoors. Interestingly, 20% of the injuries happened while trying Heelys or Street Gliders for the first time, and 36% of the injuries occurred while learning (using 1–5 times) how to use them. None of the children used any sort of protective gear at the time of the injury. The majority of the injured children expressed their intention to continue heeling or street gliding after complete recovery from their injury.
CONCLUSIONS. Our study shows that the majority of children with injuries from heeling or street gliding are girls. We recommend close supervision of children using Heelys or Street Gliders during the steep learning curve and usage of protective gear at all times. These new types of injuries have a serious impact on child health and constitute a burden for the pediatric orthopedic service.
Compliance With Alarm Limits for Pulse Oximetry in Very Preterm Infants
Authors: Clucas Luisa , Doyle Lex W. , Dawson Jennifer , Donath Susan , Davis Peter G. 
Published: June 2007

OBJECTIVE. The objective of this study was to determine the rate of compliance with hospital guidelines for alarm limits for pulse oximetry in preterm infants on oxygen therapy.
METHODS. All infants admitted to the nurseries at the Royal Women's Hospital, Melbourne, Australia, with gestational age &lt;32 weeks or birth weight &lt;1500 g between August 2005 and February 2006 were eligible for inclusion. Data on the alarm limits set for infants on oxygen therapy were collected prospectively. The target saturation range recommended in written hospital guidelines was 88% to 92%, with alarm limits set at 85% and 94%.
RESULTS. Data were prospectively collected for 144 subjects with mean (SD) gestational age 29.3 (2.4) weeks and birth weight 1226 (354) g; 1073 alarm limits were collected when infants were on oxygen. The lower alarm limit was set correctly 91.1% of the time. In contrast, the upper alarm limit was set correctly only 23.3% of the time: 76.5% of the time it was too high, and 23.8% of the time it was set at 100%. Infants with an upper alarm limit set correctly on a particular day had a significantly lower birth weight, gestational age, postmenstrual age, and postnatal age than infants who had the upper alarm limit set too high. Use of assisted ventilation, higher inspired oxygen concentrations, and more frequent changes in inspired oxygen concentration were all associated with improved odds of having an appropriately set upper alarm limit.
CONCLUSIONS. This study suggests that current guidelines regarding the upper pulse oximeter alarm limit for infants receiving oxygen might be commonly exceeded, although compliance might be better for infants at higher risk of adverse outcomes. However, there might be less variation from guidelines for the lower alarm limit.
Quality of Primary Care and Subsequent Pediatric Emergency Department Utilization
Authors: Brousseau David C. , Hoffmann Raymond G. , Nattinger Ann B. , Flores Glenn , Zhang Yinghua , Gorelick Marc 
Published: June 2007

OBJECTIVE. Our objective was to determine whether parent-reported, high-quality primary care was associated with decreased nonurgent pediatric emergency department utilization.METHODS. A retrospective analysis of prospectively collected data for a cohort of children from the 2000–2001 and 2001–2002 Medical Expenditure Panel Survey panels was performed. Baseline parent-reported quality of primary care with respect to family-centeredness, timeliness, and realized access (a measure of the child's ability to receive necessary care and referrals) was assessed by using composite scores from the Consumer Assessment of Healthcare Providers and Systems survey. The primary outcomes were the numbers of subsequent nonurgent and urgent emergency department visits per child.RESULTS. Of 8823 children included, 70.0% rated family-centeredness, 88.2% rated realized access, and 55.6% rated timeliness as high quality. After adjustment for demographic factors and health status, high-quality family-centeredness was associated with a 42% reduction in nonurgent emergency department visits for publicly insured children and a 49% reduction for children ≤2 years of age. Greater realized access was associated with a 44% reduction in nonurgent emergency department visits for children 3 to 11 years of age and a 56% reduction for children ≥12 years of age. Greater realized access was also associated with decreased nonurgent emergency department visits for publicly and privately insured children (37% and 35%, respectively). There was no significant association between timeliness and nonurgent emergency department utilization, nor was any quality-of-care domain associated with urgent emergency department utilization.CONCLUSIONS. Parent-reported, high-quality family-centeredness and a high level of realized access to primary care were associated with decreased subsequent nonurgent emergency department visits for children. Parent reports of health care quality in these domains provide important complementary information on health care quality.