bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of clinical placements as a means of recruiting health care professionals to underserviced areas in Southeastern Ontario: Part 2 – Community perspectives
Authors: Van Diepen Kelly , MacRae Michelle , Paterson Margo 
Published: January 2007

AbstractObjective:  Part 2 of this two‐part study identifies current recruitment strategies and existing incentives used by underserviced communities to recruit health science students during the clinical placement stage. Discussion surrounding current gaps in recruitment strategies and potential funding sources are explored. Design:  Mixed‐method two‐part study using a self‐administered questionnaire. Settings:  Six community hospitals and one private practice. Participants:  Community resource contact from seven underserviced communities in Southeastern Ontario. Main outcome measures:  Level of community agreement that current recruitment strategies include travel stipends, rent‐free accommodation and interprofessional education opportunities. Results:  A 100% response rate established that one sample community provides travel stipends, three provide rent‐free accommodation, and four offer interprofessional education opportunities. These incentives were frequently offered exclusively to medical students. Conclusions:  When considering the results from part 1 of the study, there is a substantial gap between financial incentives students deem important in the creation of an appealing clinical placement opportunity and the provisions offered to them by the sample communities. The findings of this study support the need for a recruitment enhancement program in Southeastern Ontario.
Medical clinic facilities and doctor characteristics: What older rural men value
Authors: Newton Fiona J. , Ewing Michael T. , Burney Sue , Vella‐Brodrick Dianne 
Published: January 2007

AbstractObjective:  To identify the medical clinic facilities and doctor characteristics deemed important to older men living in a rural area of Australia. Design:  Cross‐sectional study using a self‐report questionnaire. Setting:  Mildura Rural City Council, located in north‐west Victoria. Participants:  Eighty‐two men aged 55
+ years living in the precincts of the Mildura Rural City Council with the capability to read and write in English.Main outcome measures:  Factors perceived as important characteristics of medical facilities and GPs. Results:  Between high‐ and lower‐income‐status participants, the provision of bulk‐billing services was a significant predictor of clinic features deemed essential. Approximately 70% of participants wanted a GP who conveys information in an understandable manner and allows them time to ask questions and to discuss their problems. Participants perceived GP qualifications as more important than gender or nationality. Conclusions:  The findings highlight the need for medical training institutions to ensure that medical graduates have well‐developed communication skills. Older men on low incomes are particularly concerned about the provision of bulk‐billing services. Any further reduction to the number of these services has the potential to further limit patient choice of GP and might have significant implications for general well‐being.
Health professional partnerships and their impact on Aboriginal health: An occupational therapist's and Aboriginal health worker's perspective
Authors: Hooper Kerry , Thomas Yvonne , Clarke Michelle 
Published: January 2007

AbstractObjective:  To describe the extent and nature of demonstrated professional partnerships between occupational therapists and Aboriginal health workers in rural and remote communities of North Queensland. The study identifies ways in which professional partnerships improve client services and enhance occupational therapy outcomes through exploring the aspects of communication, collaboration and bridging cultural boundaries. Design:  Data collected via in‐depth, semistructured telephone interviews. Setting:  Aboriginal and mainstream health and human service organisations in rural and remote North Queensland. Rural and remote areas were identified using the Accessibility and Remoteness Index of Australia codes. Participants:  Seven participants working in rural and remote areas of North Queensland, comprising four occupational therapists and three Aboriginal health workers. All participants were female. Results:  Participants identified five core themes when describing the extent and nature of professional partnerships between occupational therapists and Aboriginal health workers. Themes include: professional interaction; perception of professional roles; benefits to the client; professional interdependence; and significance of Aboriginal culture. According to participants, when partnerships between occupational therapists and Aboriginal health workers were formed, clients received a more culturally appropriate service, were more comfortable in the presence of the occupational therapist, obtained a greater understanding of occupational therapy assessment and intervention, and felt valued in the health care process. Conclusions:  This study substantiates the necessity for the formation of professional partnerships between occupational therapists and Aboriginal health workers. The findings suggest that participation in professional partnerships has positive implications for occupational therapists working with Aboriginal clients and Aboriginal health workers in rural and remote regions of North Queensland.
Informing rural and remote students about careers in health: The effect of Health Careers Workshops on course selection
Authors: Eley Robert M. , Hindmarsh Natalie , Buikstra Elizabeth 
Published: January 2007

AbstractObjective:  Since 1994, as part of the Health Careers in the Bush program, Queensland Health has run residential workshops to provide secondary school students from rural and remote areas with information about health careers. This study reports on the influence of the program on tertiary course selection. Design:  Self‐administered mail survey and telephone interviews. Setting:  Secondary schools. Participants:  Past students who had in year 10 attended residential career workshops run by Queensland Health. Main outcome measures:  Tertiary courses; self‐reported influence of the workshop program on raising awareness and course selection. Results:  Over 90% of participants reported that the workshops had a major impact on their course and career selection. The workshops provided exposure to a wide variety of health‐related disciplines, enabling students to be better informed about their course and career plans within the industry. Half of the students changed their course as a result of attending a workshop, and 83% enrolled in a health‐related course. The 17% who did not enrol in a health‐related course also recognised the value of the workshop program. Conclusion:  The workshop program raised awareness of health professions and offered valuable information to rural students about a wide range of health careers. Results suggest that provision of such information in a residential‐workshop format contributed significantly to tertiary course selection of rural and remote students. The benefit to the health industry from these workshops has been substantial in relation to the small amount of funds invested.
Medico‐legal child deaths in Istanbul: data from the Morgue Department
Authors: CANTURK NERGIS , ES¸IYOK BURCU , OZKARA ERDEM , CANTURK GUROL , BULENT OZATA A. , FATIH YAVUZ M. 
Published: January 2007

AbstractBackground: Before determining health policies, finding solutions to problems and taking precautions, one should define the problems and their regional and national dimensions. Data about causes of death vary from country to country and, therefore, it is clear that precautions should be based on regional data and needs, which will be more effective.Method: The authors reviewed deaths among children aged 1 month to 18 years, whose autopsies were performed in the Morgue Department, State Institute of Forensic Medicine, Istanbul, Turkey, between 2000 and 2002.Results: The authors evaluated autopsy reports about 736 child deaths. The mean age of the children was 8.77 ± 6.25 years and 62.8% of the children were male. As to causes of death, the most frequent was asphyxia. Almost half of them were caused by mechanical asphyxia due to drowning. A total of 48.5% of the deaths were accidental. There was a significant difference in causes of death between children aged 11 years or younger and those aged over 11 years. Death due to nontraumatic conditions and poisoning was predominant among children aged 11 years and younger, while death due to gunshot wounds and stab wounds was predominant among children aged more than 11 years. There was a significant difference in causes of death between females and males.Conclusion: Asphyxia, poisoning and blunt traumatic injuries were found to be the leading causes of death, which can be prevented or decreased by certain precautions. As a result, new regulations should be enacted to protect children against accidents, injuries and hazards and a child protection program is needed in Turkey.
Cerebral hemiatrophy (Dyke–Davidoff–Masson syndrome) in childhood: Clinicoradiological analysis of 19 cases
Authors: ATALAR MEHMET H. , ICAGASIOGLU DILARA , TAS FIKRET 
Published: January 2007

AbstractBackground: The purpose of this study was to emphasize the clinical and imaging findings of 19 child cases of cerebral hemiatrophy.Methods: A total of 11 male and eight female patients underwent assessment with computed tomography and magnetic resonance imaging. The patients ranged from 1 to 17 years in age. The evaluated parameters were: location of the lesions, midline structural shift effect, ipsilateral calvarial and parenchymal changes.Results: Left cerebral hemiatrophy was seen in 14 of the cases while right cerebral hemiatrophy was observed in five cases. Unilateral calvarial thickening was seen in 11 cases, hyperpneumatization of paranasal sinuses in five, and hypoplasia of the middle frontal cranial fossa in three patients. Cerebral peduncle atrophy was noted in seven cases. In total, 11 patients had thalamic atrophy and lentiform nucleus hypoplasia. In one case, cerebral hemiatrophy was associated with ipsilateral large schizencephalic cleft and absence of the septum pellucidum, whereas in another case, there was diffuse cerebellar atrophy associated with cerebral hemiatrophy.Conclusion: Computed tomography and, in particular, magnetic resonance imaging are the procedures of choice with respect to assessment of the etiology and extent of cerebral parenchymal involvement in cerebral hemiatrophy.
Efficacy of pollen immunotherapy in seasonal allergic rhinitis
Authors: CAN DEMET , TANAÇ REMZIYE , DEMİR ESEN , GÜLEN FIGEN , VERAL ALI 
Published: January 2007

AbstractBackground: The efficacy of subcutaneous pollen immunotherapy has been documented in published double‐blind, placebo‐controlled studies related to treatment of seasonal allergic rhinitis. In the present study, subjective (symptom scores) and objective (nasal peak inspiratory flow, nasal smear, nasal biopsy) parameters were used to study the efficacy of pollen immunotherapy.Methods: Forty‐eight patients (32 male), mean ± SE age 13.6 ± 2.8 years allergic to grass‐pollen participated in the present study. Patients were divided into three groups: group I, 24 patients who did not receive pollen immunotherapy; group II, 12 patients who received the build‐up phase of pollen immunotherapy; and group III, 12 patients who had just finished pollen immunotherapy. With regard to objective and subjective parameters these three groups were compared.Results: When group I was compared to groups II and III, the patients who had not received any immunotherapy were found to have a high daytime nasal symptoms score (P < 0.01), high daytime eye symptoms score(P < 0.01) and high night‐time symptoms score (P < 0.01). In objective parameters, it was found that group I had low nasal peak inspiratory flow (P < 0.05), and a high eosinophil count in nasal smears (P < 0.05) and peripheral blood (P < 0.05). It was also demonstrated that there was an increased eosinophil infiltration (P < 0.01) and mast cell infiltration (P < 0.05) in nasal biopsy in group I. There was no significant difference between group II and group III according to these results (P > 0.05).Conclusions: Immunotherapy leads to a better clinical and histopathological prognosis in children with seasonal allergic rhinitis.
Intussusception in children of school age
Authors: IKEDA TARO , KOSHINAGA TSUGUMICHI , INOUE MIKIYA , GOTO HIROSHI , SUGITOU KIMINOBU , HAGIWARA NORITSUGU 
Published: January 2007

AbstractBackground: There are only a few reports discussing the characteristics of intussusception developing in school‐age children. The characteristics of these cases are discussed, with reference to previous literature.Methods: The present study included eight cases of intussusception in school‐age children among 143 intussusception patients treated on an inpatient basis at Nihon University Itabashi Hospital, during the 11 year period from 1993 to 2003. The remaining 135 patients were assigned to the infant group as controls. The clinical characteristics of intussusception in school‐age children were compared with those of the condition developing in infants.Results: The eight children of school age with intussusception ranged in age from 8 to 15 years (mean, 11.6 years), and consisted of five boys and three girls. The major symptom was abdominal pain, occurring in 100% (8/8). Bloody stools and vomiting were reported in two patients each (25%) from this group. The triad of abdominal pain, bloody stools and vomiting was recognized in only one child (12.5%) of this group. Two children (25.0%) had a palpable abdominal mass, and one child (12.5%) complained of diarrhea. None of the school‐age children with intussusception had any antecedent infection; five, two and one patients had the ileo‐colic type, ileo‐ileo‐colic type and ileo‐ileal type of intussusception, respectively. Four underwent enema reduction and four underwent surgical reduction. One of the eight children (12.5%) had underlying organic abnormality; in the remaining children the condition was labeled idiopathic. One child developed recurrences.Conclusions: In school‐age children intussusception is generally believed to be commonly secondary to underlying organic abnormality, but in the present study only one of eight school‐age children had underlying organic abnormality; in the remaining children, the condition was labeled idiopathic. The major symptom in school‐age intussusception was abdominal pain. Therefore this may need to be differentiated from appendicitis in children of school age. It is considered that abdominal ultrasonography (USG) is a simple and useful method for making the diagnosis of intussusception, and that diagnostic USG should be conducted in all school‐age children presenting with acute abdominal pain.
Presence of herpesviruses in middle ear fluid of children with otitis media with effusion
Authors: BULUT YASEMIN , KARLIDAG TURGUT , SEYREK ADNAN , KELES EROL , TORAMAN ZULAL ASCI 
Published: January 2007

AbstractBackground: Otitis media with effusion (OME) is a disease that frequently occurs in children. Etiopathogenesis of the diseases has not been completely elucidated. There are limited numbers of studies on the presence of herpesviruses in otitis media cases with OME. The present study was undertaken to determine the rate of some herpesviruses in OME cases of children.Methods: A total of 92‐middle ear fluids were collected from 51 children. The samples were analyzed using polymerase chain reaction (PCR) for detection of herpesviruses including Herpes simplex virus (HSV), cytomegalovirus (CMV), Varicella zoster virus (VZV), and Epstein–Barr virus (EBV).Results: PCR analysis of the 92 samples showed that genomes of EBV in 12 (13.04%), HSV in seven (7.60%), CMV in five (5.43%), and VZV in three (3.26%) were present. Two of these samples were positive for both HSV and EBV genomes. Therefore, 25 (27.17%) of the samples were determined to be infected with any of the herpesviruses tested.Conclusions: In the present study, herpesviruses were determined at a high rate in middle ear fluids of children with OME. However, the present study is a preliminary study and more extensive studies, especially experimental studies, are required to elucidate the role of herpesviruses in pathogenesis of OME and whether there is a relation between rate of herpesviruses in OME cases, and the reactivation of latent infections.
Duration of fever and markers of serious bacterial infection inyoung febrile children
Authors: PRATT AMANDA , ATTIA MAGDY W. 
Published: January 2007

AbstractBackground: Despite the drastic change in the evaluation of the febrile young child due to the decreased incidence of serious bacterial infections (SBI) effected by Haemophilus influenza type B and pneumococcal vaccine, there remains a small role for blood work in the evaluation of these patients. Bacterial markers including white blood cell (WBC) count, absolute neutrophil count (ANC) and C‐reactive protein (CRP) have been studied and are widely used as predictors of SBI in febrile children. It has been suggested that CRP values should be interpreted cautiously when fever has been present <12 h based on the kinetics of this biological marker. This limitation has not been previously addressed with CRP, nor was it described with other markers, specifically WBC and ANC, therefore the purpose of the present paper was to assess WBC, ANC and CRP values as predictors of SBI in relation to duration of fever.Methods: Patients who presented to a pediatric emergency department between the ages of 1 and 36 months, with fever ≥39°C and no source of infection had a complete blood count (CBC) blood culture, and CRP level drawn. A urinalysis and/or urine culture was obtained when age and gender appropriate. A chest X‐ray was performed at the discretion of the treating physician. The study subjects were enrolled prospectively and then divided into two groups based on duration of fever of ≤ or >12 h, and compared.Results: One hundred and twenty‐eight patients were originally enrolled. Nine patients were excluded. Seventeen patients (14%) had SBI. One patient (<1%) had bacteremia, three (3%) had pneumonia, and 13 (10%) had urinary tract infections. Forty‐five patients presented with fever ≤12 h and 74 patients presented with fever >12 h. Area under the curve (AUC) for WBC, ANC and CRP was significantly larger in patients with SBI presenting with fever >12 h (0.85, 0.83, 0.92 respectively) compared to patients with SBI who presented with fever for <12 h (0.37, 0.42, 0.68 respectively).Conclusions: Bacterial markers studied were more predictive of SBI if the duration of fever was >12 h as shown by the AUC. CRP performed better than WBC and ANC in both scenarios.
Health‐care utilization and costs in Taiwanese pediatric patients with asthma
Authors: SUN HAI‐LUN , KAO YEA‐HUEI , LU TSUNG‐HSUEH , CHOU MING‐CHIEH , LUE KO‐HUANG 
Published: January 2007

AbstractBackground: In many countries, the burden of asthma is sufficient to warrant recognition as a high‐priority disorder in governmental health strategies. However, the components of the total health‐care costs for pediatric patients with asthma have not been well studied, and an overall understanding of health‐care utilization patterns in this population is lacking in Taiwan.Methods: A total of 33 461 patients aged 3–17 years who were enrolled in the National Health Insurance Research database from 1 January to 31 December 2002 were evaluated. Health‐care utilization and costs, including those related to office, outpatient hospital, emergency department, and inpatient hospital visits were compared between pediatric patients with and without asthma.Results: In 2002, the period prevalence of treated asthma was 6.0%. Pediatric patients with asthma used substantially more services than did those without asthma in all categories. Hospital outpatient visits and overall health‐care expenditure for patients with asthma were 2.2‐fold higher than those of patients without asthma. Asthma care represented 20% of all health‐care services that patients with asthma received, while the remaining 80% were for non‐asthma care. Almost three‐fourths of all asthma‐related costs were attributable to office and hospital outpatient visits; one‐fourth was attributable to urgent care and hospitalizations.Conclusions: These findings may serve as baseline data for future evaluation of changes in health‐care utilization and expenditure among pediatric patients with asthma.
Corticotropin and cortisol response to maximal exercise testing in central diabetes insipidus
Authors: BAS FIRDEVS , DARENDELILER FEYZA , TATLI BURAK , UNAL MEHMET , KAYSERILIOGLU ABIDIN 
Published: January 2007

AbstractBackground: It is known that arginine vasopressin (AVP) has a stimulatory effect on corticotropin (adrenocorticotropic hormone; ACTH) and cortisol secretion especially during stress. The present study was designed to investigate the effect of stress on ACTH and cortisol levels in patients with central diabetes insipidus (DI) with endogenous AVP deficiency receiving AVP therapy, and to determine whether these children need steroid replacement during stress.Methods: Seven patients with a median age of 12 years (range 7–13 years) with idiopathic central DI on appropriate Desmopressin (DDAVP) therapy (group 1) and seven healthy controls with a median age of 15 years (range 13–20 years; group 2) were included in the study. Acute stress was produced in all children by treadmill exercise, assessed by maximal oxygen consumption and heart rate. ACTH and cortisol levels were determined before and after exercise.Results: In group 1, median ACTH level after exercise (28.3 pg/mL) was not different from the median value (24.0 pg/mL) before exercise. However, median cortisol level (10.5 μg/dL) was significantly increased (14.9 μg/dL; P < 0.05) with exercise. In group 2, cortisol (median 9.3 μg/dL) and ACTH levels (median 6.3 pg/mL) were significantly increased after exercise (15 μg/dL and 13.6 pg/mL, respectively; P <  0.05). There was no significant difference between the groups with respect to cortisol levels before and after exercise, but the stimulated ACTH levels after exercise were higher in patients with DI than in the controls (P <  0.05). A positive correlation was observed between total daily DDAVP dose and cortisol level after exercise (rs=  0.786, P <  0.05).Conclusions: Cortisol response during acute stress is normal in children with DI and these patients do not need extra steroid treatment during stress. In contrast, the normal cortisol response obtained by increased ACTH levels in these patients indicates an increased sensitivity of corticotroph cells.