bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using Video Recording to Identify Management Errors in Pediatric Trauma Resuscitation
Authors: Oakley Ed , Stocker Sergio , Staubli Georg , Young Simon 
Published: March 2006

OBJECTIVE. To determine the ability of video recording to identify management errors in trauma resuscitation and to compare this method with medical record review.
METHOD. The resuscitation of children who presented to the emergency department of the Royal Children's Hospital between February 19, 2001, and August 18, 2002, for whom the trauma team was activated was video recorded. The tapes were analyzed, and management was compared with Advanced Trauma Life Support guidelines. Deviations from these guidelines were recorded as errors. Fifty video recordings were analyzed independently by 2 reviewers. Medical record review was undertaken for a cohort of the most seriously injured patients, and errors were identified. The errors detected with the 2 methods were compared.
RESULTS. Ninety resuscitations were video recorded and analyzed. An average of 5.9 errors per resuscitation was identified with this method (range: 1–12 errors). Twenty-five children (28%) had an injury severity score of &gt;11; there was an average of 2.16 errors per patient in this group. Only 10 (20%) of these errors were detected in the medical record review. Medical record review detected an additional 8 errors that were not evident on the video recordings. Concordance between independent reviewers was high, with 93% agreement.
CONCLUSIONS. Video recording is more effective than medical record review in detecting management errors in pediatric trauma resuscitation. Management errors in pediatric trauma resuscitation are common and often involve basic resuscitation principles. Resuscitation of the most seriously injured children was associated with fewer errors. Video recording is a useful adjunct to trauma resuscitation auditing.
A Typical Feeding Enhances Memory for Spoken Words in Healthy 2- to 3-Day-Old Newborns
Authors: Valiante A. Grace , Barr Ronald G. , Zelazo Philip R. , Papageorgiou Apostolos N. , Young Simon N. 
Published: March 2006

OBJECTIVE. The objective of this study was to determine whether healthy 2- to 3-day-old newborns have better memory of a spoken word after a typical feeding (breast milk or formula) than before a feeding and, if so, whether memory is related to blood glucose.METHODS. A naturalistic study was conducted in which delayed recognition memory of a spoken word was examined in 60 healthy 2- to 3-day-old newborns either 120 minutes after their previous feeding (preprandial) or 30 minutes after their last feeding (postprandial). In this procedure, infants initially turn their head toward a novel word (orientation) and with repeated presentations cease turning toward it (habituation). Mean number of trials to reach orientation and habituation criteria provides measures of attention and rate of learning, respectively. After a 100-second delay, the word is presented again. Infants either turn toward it, indicating that they have forgotten it, or remain habituated, indicating that they remembered the word. Percentage of trials with head turns toward the word after the delay is the principal dependent measure.RESULTS. The postprandial group was split at the median for blood glucose to define high- and low-glucose groups. All 3 groups showed similar rates of orientation and habituation. On reexposure to the word during postdelay trials, the preprandial group displayed less retention than the postprandial high and low groups. No correlation was found between memory and blood glucose levels. The postprandial high blood glucose level differed statistically from the preprandial level, whereas the postprandial low level did not.CONCLUSIONS. Memory for spoken words in newborns is better after a typical milk feeding than before a feeding. This feeding effect is specific to memory and does not include attention or rate of learning. Also, it is not necessarily associated with increased blood glucose. It remains to be seen whether feeding enhances memory for other types of stimuli and what implications this may have for development.
Reasons for Testing and Clinical and Demographic Profile of Adolescents With Non–Perinatally Acquired HIV Infection
Authors: Grant Althea M. , Jamieson Denise J. , Elam-Evans Laurie D. , Beck-Sague Consuelo , Duerr Ann , Henderson Sheryl L. 
Published: March 2006

OBJECTIVES. We sought to examine the demographic, clinical, and behavioral characteristics; reasons for HIV testing; and factors that contribute to delays in entry into specialized HIV care after diagnosis of HIV infection among adolescents in an urban clinic in Georgia.
METHODS. All of the data for this study were obtained solely by medical chart review. Demographic, clinical, behavioral, and HIV testing data were abstracted from medical charts of 59 non–perinatally HIV-infected adolescents who were aged 13 to 18 years and entered care at the pediatric and adolescent HIV clinic of a Georgia hospital during 1999–2002. HIV-infected adolescents were compared by demographic, clinical, and behavioral characteristics as well as by circumstances surrounding HIV testing. Recent seroconversion was defined as having a documented negative or indeterminate HIV antibody test (confirmed) or a self-reported negative HIV test (probable) ≤6 months before HIV diagnosis.
RESULTS. Of 59 HIV-infected adolescents, 35 (59%) were female and 56 (95%) were black/African American. Fifteen (25%) had ≥1 sexually transmitted infection when they entered care. All female (vs 38% male) adolescents were infected through heterosexual sexual intercourse; 9 (26%) were pregnant at the time of HIV diagnosis. Adolescents whose HIV was diagnosed at non–health care facilities entered HIV care much later than adolescents whose HIV was diagnosed at health care facilities (median: 108 vs 25 days). Approximately one half of adolescents had CD4+ T-cell counts &lt;350 cells per μL and/or HIV-1 viral loads &gt;55000 copies per mL at entry into care. Twenty-seven (46%) adolescents had a previous negative HIV test; 7 had confirmed recent seroconversion, and 3 had probable recent seroconversion. Among adolescents with a documented reason for testing, routine medical screening was the most frequent reason for HIV testing; few adolescents were documented as having self-initiated HIV testing.
CONCLUSIONS. Strategies are needed to implement timely linkage to medical services of adolescents who receive a diagnosis of HIV infection at non–health care facilities and to increase HIV testing, prevention efforts, and recognition of recent HIV infection among sexually active adolescents.
A Behavioral and Cognitive Profile of Clinically Stable HIV-Infected Children
Authors: Nozyce Molly L. , Lee Sophia S. , Wiznia Andrew , Nachman Sharon , Mofenson Lynne M. , Smith Mary E. , Yogev Ram , McIntosh Kenneth , Stanley Kenneth , Pelton Stephen 
Published: March 2006

OBJECTIVE. The purpose of this research was to characterize behavioral and cognitive profiles of clinically and immunologically stable antiretroviral-experienced HIV-infected children.METHODS. Two hundred seventy-four previously treated HIV-infected children aged 2 to 17 years were assessed for behavioral, developmental, and cognitive functioning. Correlations between neuropsychological measures, age, and CD4 lymphocyte count were investigated.RESULTS. The most common behavioral problems, as measured by the Conners' Parent Rating Scale, were psychosomatic (28%), learning (25%), hyperactivity (20%), impulsive-hyperactive (19%), conduct (16%), and anxiety (8%) problems. Mean Wechsler Intelligence Scale for Children-III scores were less than established population norms; the mean verbal IQ was 85, the mean performance IQ was 90, and the mean full-scale score was 86. Hyperactivity was more frequent in children with a Wechsler Intelligence Scale for Children-III performance IQ of &lt;90. Anxiety problems were more likely in children ≥9 years of age. Children with CD4 counts of &lt;660 cells per mm3 were more likely to be identified as having a conduct disorder. No association was noted between behavioral problems and neuroimaging.CONCLUSIONS. Clinically and immunologically stable HIV-infected children had more frequent behavioral problems and lower developmental and cognitive scores than established childhood norms.
Birth Characteristics and Risk of Low Intellectual Performance in Early Adulthood: Are the Associations Confounded by Socioeconomic Factors in Adolescence or Familial Effects?
Authors: Bergvall Niklas , Iliadou Anastasia , Tuvemo Torsten , Cnattingius Sven 
Published: March 2006

OBJECTIVE. In this study we investigated whether the association between measures of fetal growth restriction and intellectual performance was mediated by socioeconomic or familial factors.METHODS. This was a population-based cohort study of 357768 Swedish males born as singletons without congenital malformations between 1973 and 1981. The main outcome measure was intellectual performance at military conscription.RESULTS. Compared with men born with appropriate birth weight for gestational age, men born light for gestational age suffered an increased risk of low intellectual performance after adjustment for maternal and socioeconomic factors. The increase in risk of low intellectual performance related to a decrease in birth weight for gestational age was similar between families and within families. Men born short or with a small head circumference for gestational age were also at increased risk of low intellectual performance, both when adjusting for maternal and socioeconomic factors and within families.CONCLUSIONS. We found that all of the studied dimensions of restricted fetal growth are independently associated with increased risks of low intellectual performance and that these associations are only partly mediated by socioeconomic or familial factors.
Prevalence, Stability, and Outcomes of Cry-Fuss and Sleep Problems in the First 2 Years of Life: Prospective Community-Based Study
Authors: Wake Melissa , Morton-Allen Elise , Poulakis Zeffie , Hiscock Harriet , Gallagher Susan , Oberklaid Frank 
Published: March 2006

OBJECTIVE. To report the prevalence and stability of cry-fuss problems during the first 4 months of life and sleep problems from 2 to 24 months and relationships between the persistence of cry-fuss and sleep problems and outcomes at 24 months.METHODS. The study was a prospective cohort study in maternal and child health centers in 3 local government areas in Melbourne, Australia. A total of 483 first-born infants were monitored prospectively from 2 weeks through 2, 4, 8, 12, 18, and 24 months. Child behavior, maternal depression, parenting stress, and marital quality were assessed. Predictor variables were parent reports of moderate or greater cry-fuss problems (2 and 4 months) and sleep problems (8, 12, 18, and 24 months) and parent-reported, 24-hour, sleep/cry-fuss diaries (2, 4, and 12 months).RESULTS. The response rate was 68% (483 of 710 infants); the attrition rate was &lt;6%. The prevalence of cry-fuss problems decreased from 19.1% at 2 months to 12.8% at 4 months, with 5.6% of mothers reporting cry-fuss problems at both ages. Prevalence rates of sleep problems were 21.2%, 16.2%, 10.0%, and 12.1% at 8, 12, 18, and 24 months, respectively; 6.4% had a problem at ≥3 of these ages. In multivariate analyses, cry-fuss/sleep problems at ≥3 previous time points (but not 1 or 2 time points) contributed significantly to depression (2.8% of variance), total behavior (1.4% of variance), and total stress (4.6% of variance) scores. Repeated problems had a greater impact than a concurrent sleep problem on depression and stress scores, whereas the reverse was true for behavior scores.CONCLUSIONS. Most cry-fuss and sleep problems in the first 2 years of life are transient. Persistent, rather than transient, problems contribute to maternal depression, parenting stress, and subsequent child behavior problems.
Parents' Perceptions of Their Child's Weight and Health
Authors: Eckstein Kathryn C. , Mikhail Laura M. , Ariza Adolfo J. , Thomson J. Scott , Millard Scott C. , Binns Helen J. ,   for the Pediatric Practice Research Group
Published: March 2006

OBJECTIVE. This study explored parents' perceptions about their child's appearance and health and evaluated a tool to determine parents' visual perception of their child's weight.METHODS. Parents of children aged 2 to 17 years were surveyed concerning their child's appearance and health and opinions about childhood overweight. They also selected the sketch (from 7 choices) that most closely matched the body image of their child using 1 of 8 gender–and age-range–specific panels of sketches. Children's height and weight were measured. Respondents were grouped by child body mass index (BMI) percentile (&lt;5th, 5–84th, 85–94th [at risk for overweight (AROW)], and ≥95th [overweight]). Those with BMI ≥5th percentile were analyzed. Logistic regression was used to examine factors influencing parental perceptions and levels of worry about their overweight or AROW child.RESULTS. Of the 223 children, 60% were &lt;6 years old, 42% were male, 17% were black, 35% were Hispanic, 42% were white, and 7% were other; 19% were AROW, and 20% were overweight. Few parents (36%) identified their overweight or AROW child as “overweight” or “a little overweight” using words, but more (70%) selected a middle or heavier sketch. Among parents of overweight and AROW children, 18% recalled a doctor’s concern and 26% were worried about their child’s weight. If the overweight or AROW child was age ≥6 years, parents were more likely to identify their child as “overweight” or “a little overweight” using words, select a middle or heavier sketch, and to be worried. Parents of older children were more likely to be worried if they perceived their child as less active/slower than other children or recalled a doctor’s concern.CONCLUSIONS.Few parents of overweight and AROW children recognized their child as overweight or were worried. Recognition of physical activity limitations and physicians’ concerns may heighten the parent's level of concern. Sketches may be a useful tool to identify overweight children when measurements are not available.
Emergency Physicians' Prescribing of Asthma Controller Medications
Authors: Scarfone Richard J. , Zorc Joseph J. , Angsuco Cherrie J. 
Published: March 2006

OBJECTIVES. To determine the frequency with which emergency department (ED) physicians prescribe long-term controller medications (LTCMs) for children with asthma, to assess ED physicians' awareness of and level of agreement with national guidelines for LTCM use, and to identify criteria ED physicians use to prescribe LTCMs and barriers to the use of LTCMs.METHODS. A survey of all physician members of the American Academy of Pediatrics Section on Emergency Medicine who provide care for children in an ED was performed.RESULTS. Surveys were returned by 391 (50%) of 782 physicians. The majority (80%) indicated that fewer than one half of children with persistent asthma were using LTCMs on ED arrival. Although 99% believe that children with persistent asthma should be treated with LTCMs, &lt;20% provide LTCMs for the majority of such children at ED discharge. For 49%, the main reason for not prescribing these medications was the belief that this was the role of the primary care provider or asthma specialist. Practice setting, prior training, and annual patient volume were not associated significantly with prescribing LTCM. Patient's age and likelihood of compliance and physician's belief in efficacy and concerns about adverse effects were not important criteria in the decision to begin LTCM.CONCLUSIONS. ED physicians often encounter children with persistent asthma who are not receiving LTCMs, they believe in the efficacy and safety of LTCMs, and they think that children with persistent disease should be treated with LTCMs, but they prescribe LTCMs infrequently.
Effects of Decreasing Sugar-Sweetened Beverage Consumption on Body Weight in Adolescents: A Randomized, Controlled Pilot Study
Authors: Ebbeling Cara B. , Feldman Henry A. , Osganian Stavroula K. , Chomitz Virginia R. , Ellenbogen Sheila J. , Ludwig David S. 
Published: March 2006

OBJECTIVE. The role of sugar-sweetened beverages (SSBs) in promoting obesity is controversial. Observational data link SSB consumption with excessive weight gain; however, randomized, controlled trials are lacking and necessary to resolve the debate. We conducted a pilot study to examine the effect of decreasing SSB consumption on body weight.METHODS. We randomly assigned 103 adolescents aged 13 to 18 years who regularly consumed SSBs to intervention and control groups. The intervention, 25 weeks in duration, relied largely on home deliveries of noncaloric beverages to displace SSBs and thereby decrease consumption. Change in SSB consumption was the main process measure, and change in body mass index (BMI) was the primary end point.RESULTS. All of the randomly assigned subjects completed the study. Consumption of SSBs decreased by 82% in the intervention group and did not change in the control group. Change in BMI, adjusted for gender and age, was 0.07 ± 0.14 kg/m2 (mean ± SE) for the intervention group and 0.21 ± 0.15 kg/m2 for the control group. The net difference, −0.14 ± 0.21 kg/m2, was not significant overall. However, baseline BMI was a significant effect modifier. Among the subjects in the upper baseline-BMI tertile, BMI change differed significantly between the intervention (−0.63 ± 0.23 kg/m2) and control (+0.12 ± 0.26 kg/m2) groups, a net effect of −0.75 ± 0.34 kg/m2. The interaction between weight change and baseline BMI was not attributable to baseline consumption of SSBs.CONCLUSIONS. A simple environmental intervention almost completely eliminated SSB consumption in a diverse group of adolescents. The beneficial effect on body weight of reducing SSB consumption increased with increasing baseline body weight, offering additional support for American Academy of Pediatrics guidelines to limit SSB consumption.
Polysomnographic Characteristics in Normal Preschool and Early School-Aged Children
Authors: Montgomery-Downs Hawley E. , O’Brien Louise M. , Gulliver Tanya E. , Gozal David 
Published: March 2006

OBJECTIVE. The objective of this study was to describe overnight polysomnographic measures in normal children aged 3 to 7 years. We conducted a retrospective analysis of normal polysomnographic evaluations from participants in 2 large community-based studies of sleep-disordered breathing among preschoolers and early school-aged children at Kosair Children’s Hospital Sleep Medicine Research Center at the University of Louisville. Participants included 542 healthy children with ages ranging from 3.2 to 8.6 years.
RESULTS. Subjects were excluded from analysis if they had documented snoring during polysomnography, an obstructive apnea-hypopnea index of ≥1.0, or a periodic leg-movement index of ≥5.0. Because the greatest differences in polysomnography occurred between ages 5 and 6 years, analyses were performed for children 3 to 5 years and for ages ≥6. Sleep cyclicity was distinct between age groups, with both showing an initial brief rapid-eye-movement period, which lengthened across the night, but only the older group showing a decrease in cycle length across the night. Average obstructive apnea indices were 0.03 per hour of total sleep time (TST) for 3- to 5-year-old children and 0.05 per hour of TST for ≥6-year-old children, whereas central apnea indices were 0.82 and 0.45 per hour of TST, respectively. Older children spent a greater percentage of sleep time supine, and the apnea-hypopnea index differed according to body position. Twenty percent of all subjects had end tidal carbon dioxide values of &gt;45 mm Hg, and 2.2% had recorded values &gt;50 mm Hg during ≥50% TST. High variance was present on all measures.
CONCLUSIONS. Developmental changes occur in several polysomnographic measures among normal children from 3 to 7 years of age, particularly during transition from preschool to early school age. Our findings in a large number of healthy community children comprise the most extensive compilation of normative reference values for laboratory-based pediatric polysomnography to date.
Patterns of Infantile Hemangiomas: New Clues to Hemangioma Pathogenesis and Embryonic Facial Development
Authors: Haggstrom Anita N. , Lammer Edward J. , Schneider Richard A. , Marcucio Ralph , Frieden Ilona J. 
Published: March 2006

OBJECTIVES. Large facial infantile hemangiomas have higher rates of complications than small localized hemangiomas, more often require treatment, and can be associated with neurological, ophthalmologic, and cardiac anomalies (PHACE syndrome). The anatomic patterns of these hemangiomas are often referred to as “segmental” despite a lack of precise anatomic definitions. Our study aims to define “segmental” hemangiomas based on clinically observed patterns. Our secondary goal is to relate the observed patterns to currently accepted developmental patterns to gain insight into hemangioma pathogenesis and craniofacial development.
METHODS. Photographic data were extracted from a large cohort of patients with infantile hemangiomas. We mapped 294 hemangiomas and recorded common morphologic patterns. Anatomic descriptions of the most common patterns were described and compared with accepted concepts of craniofacial development.
RESULTS. Four primary segments were identified (Seg1–Seg4). Seg2 and Seg3 correspond with the previously recognized maxillary and mandibular prominences. Seg1 and Seg4 differ from standard human embryology texts. The frontotemporal segment, Seg1, encompasses the lateral forehead, anterior temporal scalp, and lateral frontal scalp. The segment Seg4, encompassing the medial frontal scalp, nasal bridge, nasal tip, ala, and philtrum, is substantially narrower on the forehead than the previously described frontonasal prominence.
CONCLUSIONS. The patterns provide new clues regarding facial development. The observed patterns resemble previously described facial developmental units on the lower face but are distinctly different on the upper face. The patterns suggest that neural crest derivatives may play a role in the development of facial hemangiomas. Finally, these patterns (Seg1–Seg4) help standardize the nomenclature of facial segmental hemangiomas to analyze more effectively hemangioma risks and behavior.