bluuebunny/crossref_metadata_2025_split huggingface dataset:
Elevation of CSF Tumor Necrosis Factor α Levels in New Daily Persistent Headache and Treatment Refractory Chronic Migraine
Authors: Rozen Todd , Swidan Sahar Z. 
Published: February 2007

Objective.—To determine if patients with new daily persistent headache (NDPH) have elevated levels of tumor necrosis factor α (TNF α) in the CSF.Background.—NDPH is considered one of the most treatment resistant of all headache syndromes. This reflects a lack of understanding of its pathogenesis. As a certain percentage of NDPH patients have their headaches start after an infection, the possibility of a persistent state of systemic or CNS inflammation comes into question. TNF α is a proinflammatory cytokine involved in brain immune and inflammatory activities, as well as in pain initiation. The goal of this study was to look at TNF α levels in the CSF of NDPH patients, to determine if CNS inflammation may play some role in the pathogenesis of this condition.Methods.—CSF TNF α levels were studied in 38 patients: 20 with NDPH and a control population of 16 patients with chronic migraine (CM), and 2 with post‐traumatic headache (PT).Results.—CSF TNF α levels were elevated in 19 of 20 NDPH patients, 16 of 16 CM patients, and both PT patients. Serum TNF α levels were normal in most of the study subjects.Conclusion.—An elevation of CSF TNF α levels was found in almost all NDPH patients and suggest a role for TNF α in the pathogenesis of this condition. Surprisingly, all CM and PT patients tested had elevated CSF TNF α levels. In most patients with elevated CSF levels, serum TNF α levels were normal. All of these syndromes may be manifestations of CNS inflammation. As most of the positive‐tested patients showed minimal to no improvement during aggressive inpatient treatment, persistent elevation of CSF TNF α levels may be one of the causes of treatment refractory CDH.
Resistance to Phenobarbital Extends to Phenytoin in a Rat Model of Temporal Lobe Epilepsy
Authors: Bethmann Kerstin , Brandt Claudia , Löscher Wolfgang 
Published: February 2007

Summary:  Purpose: Most patients who are resistant to the first antiepileptic drug (AED) treatment are also resistant to a treatment with a second or third AED, indicating that patients who have an inadequate response to initial treatment with AEDs are likely to have refractory epilepsy. Animal models of refractory epilepsy are important tools to study mechanisms of AED resistance and develop new treatment strategies for counteracting resistance. We have recently described a rat model of temporal lobe epilepsy (TLE), in which spontaneous recurrent seizures (SRS) develop after a status epilepticus induced by sustained electrical stimulation of the basolateral amygdala. Prolonged treatment of epileptic rats with phenobarbital (PB) resulted in two subgroups, PB responders and PB nonresponders. Methods: In the present study we examined if rats with PB‐resistant seizures are also resistant to phenytoin (PHT), using continuous EEG/video recording of spontaneous seizures. Results: First, a new group of 15 epileptic rats was produced and selected by treatment with PB into responders (8 rats) and nonresponders (6 rats), respectively. During subsequent treatment with PHT, the doses of PHT had to be individually adjusted for each rat to avoid toxicity. Treatment with PHT led to complete seizure control in two animals and a >50% reduction of seizure frequency in three other rats, which were considered PHT responders. In nine of the remaining rats, PHT did not exert any clear anticonvulsant effect, so that these rats were considered nonresponders. Plasma levels of PHT did not differ significantly between responders and nonresponders. When comparing the PB and PHT nonresponder groups, five of the six PB‐resistant rats (83%) were also resistant to PHT, demonstrating that rats that have an inadequate response to initial treatment with PB are likely to be also resistant to treatment with a second AED. Conclusions: The AED‐resistant rats of our model meet the definition of pharmacoresistance in animal models, that is, persistent seizure activity not responding to at least two AEDs at maximum tolerated doses. This new model of pharmacoresistant TLE may be useful in the targeted development of new therapies for refractory epilepsy.
Seizure‐Promoting Effect of Blood–Brain Barrier Disruption
Authors: Marchi Nicola , Angelov Lilyana , Masaryk Thomas , Fazio Vincent , Granata Tiziana , Hernandez Nadia , Hallene Kerri , Diglaw Tammy , Franic Linda , Najm Imad , Janigro Damir 
Published: February 2007

Summary: Purpose:It is generally accepted that blood–brain barrier (BBB) failure occurs as a result of CNS diseases, including epilepsy. However, evidences also suggest that BBB failure may be an etiological factor contributing to the development of seizures.Methods:We monitored the onset of seizures in patients undergoing osmotic disruption of BBB (BBBD) followed by intraarterial chemotherapy (IAC) to treat primary brain lymphomas. Procedures were performed under barbiturate anesthesia. The effect of osmotic BBBD was also evaluated in naive pigs.Results:Focal motor seizures occurred immediately after BBBD in 25% of procedures and originated contralateral to the hemisphere of BBBD. No seizures were observed when BBB was not breached and only IAC was administered. The only predictors of seizures were positive indices of BBBD, namely elevation of serum S100β levels and computed tomography (CT) scans. In a porcine model of BBBD, identical procedures generated an identical result, and sudden behavioral and electrographic (EEG) seizures correlated with successful BBB disruption. The contribution of tumor or chemotherapy to acute seizures was therefore excluded.Conclusion:This is the first study to correlate extent of acute BBB openings and development of seizures in humans and in a large animal model of BBB opening. Acute vascular failure is sufficient to cause seizures in the absence of CNS pathologies or chemotherapy.
Safety of Rapid Intravenous Loading of Valproate
Authors: Limdi Nita A. , Knowlton Robert K. , Cofield Stacey S. , Ver Hoef Lawrence W. , Paige Alfred L. , Dutta Sandeep , Faught Edward 
Published: February 2007

Summary:  Background: The introduction of IV valproic acid (VPA) has facilitated its use in situations where oral administration is not feasible. The present study was designed to evaluate the safety of administration of undiluted VPA (20 or 30 mg/kg/min) administered intravenously at rates of 6 or 10 mg/kg/min. Methods: Forty patients received a VPA loading dose (20 or 30 mg/kg) at 6 or 10 mg/kg/min. Heart rate (HR), mean arterial pressure (MAP), oxygen saturation, respiratory rate, and three lead ECG measurements were taken at baseline. Following dose administration the measurements were repeated at 2.5‐min intervals for the first 20 min, then at 30, 45, 60 min, and 4 h. Local tolerance was defined as absence of irritation or phlebitis at the site of injection. Systemic tolerability was defined as absence of significant changes in vital signs and level of consciousness (LOC). Changes in vital signs and local intolerance scores were compared across time using repeated measures analysis of variance. Results: Rapid administration was well tolerated with no significant changes in HR (p = 0.9) or MAP (p = 0.7). Complaints of local irritation were transient, lasting less than 3 min in all patients with no indication of redness, irritation, or phlebitis. No patient exhibited a decline in the LOC. Conclusions: Rapid administration of undiluted valproate is safe and well tolerated at infusion rate up to 10 mg/kg/min and doses of up to 30 mg/kg. The lack of serious cardiovascular, neurological, hepatic, or local adverse effects supports the use of VPA in emergent situations.
Children, Coping, and the Stress of Illness: A Synthesis of the Research
Authors: Ryan‐Wenger Nancy A. 
Published: February 2007

purpose. To synthesize and critique the current research on coping strategies used by children who are ill, to identify gaps in the research base, and to provide direction for practice, future research, and theory development population. 32 research articles on coping strategies used by children with chronic or acute illness conclusions. Children's repertoire of coping strategies is the same during health and illness, although the frequency or effectiveness of some of the strategies is often different. practice implications. Much more in‐depth descriptive and longitudinal research is needed, particularly how, when, and why coping strategies are learned, retained, and later discarded. Research is needed to examine the relationship between coping and health outcomes, and on the effectiveness of nursing interventions designed to influence children's coping behavior.
Use of a Projective Technique to Assess Young Children's Appraisal and Coping Responses to a Venipuncture
Authors: Caty Suzanne , Ellerton Mary Lou , Ritchie Judith Anne 
Published: February 2007

purpose. To examine the appraisal, emotional and coping responses of young hospitalized children to three phases of a venipuncture procedure. design. Exploratory, descriptive setting. Pediatric unit of a community hospital participants. Four‐ to 9‐year‐old hospitalized children (N = 45) main outcome measures. Data were obtained by means of a projective technique and interview format. Content analysis of the children's responses was guided by the use of four published measures (appraisal, behavioral coping strategies, cognitive coping strategies, and helpful interventions). results. The children appraised each phase of the venipuncture as a threat, a benefit, or a threat/benefit. The most frequently identified behavioral coping strategies were self‐protective behaviors and returning to normal activities. The most frequently identified cognitive coping behaviors were reality‐oriented working through, emotion‐regulating cognitions, and diversionary thinking. The children reported the most helpful intervention as providing information about the event. conclusion. The children were able, through a projective technique, to appraise a venipuncture and spontaneously identify many cognitive and behavioral coping strategies and interventions to help them manage a venipuncture.
Outcomes of a Nursing Intervention for Siblings of Chronically Ill Children: A Pilot Study
Authors: Williams Phoebe Dauz , Hanson Sandra , Karlin Robyn , Ridder Lavonne , Liebergen Adrienne , Olson Joyce , Barnard Martha U. , Tobin‐Rommelhart Susan 
Published: February 2007

purpose. To evaluate the outcomes of a structured, educational, and support group intervention (ISEE, Intervention for Siblings: Experience Enhancement) for siblings of children with chronic illness (cancer, cystic fibrosis, diabetes, and spina bifida), including a session with parents about sibling needs; and to describe sibling and parent perceptions of sibling experiences at home. design. One‐group, pretest‐posttest pilot study participants. A convenience sample of 22 siblings and parents setting. A Midwestern university medical center main outcome measures. Knowledge of Illness Test, parent ratings on a global, single item, 10‐point scale results. Sibling test scores increased significantly after the intervention, compared to baseline. Parents' average evaluation rating was 9 on a 10‐point scale. Parents supported their positive ratings with verbatim descriptors. Sibling and parent perceptions of sibling experiences were congruent, suggesting the sources of potential adjustment problems in siblings, and were consistent with the literature. conclusions. A randomized, clinical trial with a larger sample size is needed to evaluate the intervention further.
Learning the Baby: A Maternal Thinking and Problem‐Solving Process
Authors: Sullivan Joan M. 
Published: February 2007

purpose. To describe a maternal problem‐solving process from new mothers' day‐to‐day experience of caring for and developing a relationship with their babies design. Qualitative study using grounded theory approach setting. Mothers' homes (n = 23) and workplaces (n = 2) participants. 25 mothers of babies from 2 weeks to 7 months main outcome measures. Semi‐structured interviews results. “Learning the Baby” was a major thinking process that emerged. Systematic thinking dominated mothers' problem‐solving. Even after the babies were comforted, mothers were not certain their efforts alleviated the babies' problems, because they usually were not certain of the problem. conclusions. Mothers' thinking directs their caregiving actions. The findings were related to previous problem‐solving and women's thinking perspectives. Nurses must use planned and unplanned encounters effectively to collaborate with and teach mothers about baby behavior and health care.
Conflicting Responses: The Experiences of Fathers of Infants Diagnosed With Severe Congenital Heart Disease
Authors: Clark Suzanne M. , Miles Margaret Shandor 
Published: February 2007

purpose. To explore the experiences of fathers of infants newly diagnosed with severe congenital heart disease. design. An analysis of qualitative data collected as part of a larger longitudinal study of parenting the medically fragile infant. participants. Eight fathers whose infants were hospitalized for severe congenital heart disease, were technology dependent at time of enrollment, and were expected to have serious chronic health problems at discharge. data collection measures. Semistructured interviews in the hospital and the home until the child reached 15 months adjusted age. results. Findings indicate that fathers experience four interrelated conflicting reactions: the joy of seeing the child born and becoming a father, plus the sadness and loss associated with the baby's illness; the challenge of becoming attached while dealing with fears about the infant's vulnerability and potential death; the need to try to maintain control while feeling a loss of control; and the struggle to remain strong for others while hiding their intense emotions. These findings extend the previous limited research about fathers by identifying the unique conflicts fathers of seriously ill infants experience in coping with the child's diagnosis and treatment. Findings have implications for intervening with fathers during the early diagnostic phase of a serious illness, particularly serious congenital heart disease.
Broken Past, Fragile Future: Personal Stories of High‐Risk Adolescent Mothers
Authors: Williams Christine , Vines Susan W. 
Published: February 2007

purpose. To uncover what adolescent mothers view as their childhood struggles, their transition to the role of motherhood following a childhood of abuse/neglect, and their important relationships after they became parents. design. Qualitative, phenomenological. setting. Community‐based parenting program for first‐time mothers at risk for abusing or neglecting their children. participants. Seven first‐time mothers, ages 13 to 20, who reported they had been abused and/or neglected as children. All had healthy newborns. results. Five themes emerged from the data: impoverished past, disintegration of relationships, emotional distance, problem fixing, and reconnecting. Participants described a process of using the experience of pregnancy and parenting as a mechanism for growth. Becoming a parent provided an opportunity to receive support from family members and to build more positive relationships. They viewed the experience as a second chance for a successful and fulfilling life.
Using Parents' Concerns to Detect and Address Developmental and Behavioral Problems
Authors: Glascoe Frances Page 
Published: February 2007

purpose. Half of all children with disabilities are not identified before school entrance, precluding their participation in early intervention programs with known value in reducing high school dropout rates, increasing employment, delaying child‐bearing, and reducing criminal behavior. Screening tests that can greatly improve detection rates have not been popular in primary care. This article describes an alternative approach in an evidence‐based technique relying on professional elicitation and interpretation of parents' concerns. population. 971 children from pediatric practices, day‐care centers, public schools, and their siblings. conclusions. Research shows that parents' concerns are as accurate as quality screening tests and that parents are equally able to raise important concerns regardless of differences in education and child‐rearing experience. Parents' concerns can be elicited quickly, and 92% of parents can answer questions in writing while in exam or waiting rooms. Parents' concerns can help make a range of other important decisions about children's developmental and behavioral needs.
Improving Access to Health Care for Children
Authors: Sochalski Julie , Villarruel Antonia M. 
Published: February 2007

issues and purpose. The number of uninsured children has been growing at an alarming rate. The most vulnerable children are those in lower‐income families who are falling through the cracks between evolving government‐sponsored health insurance programs. Recent policy initiatives may not be adequate to extend coverage to more children.conclusions. Many low‐income children actually are eligible for Medicaid but are not enrolled for a variety of reasons. The numbers of these children have risen due to welfare reform. Better outreach efforts are needed to ensure that new child health insurance programs and Medicaid expansions achieve their goals.implications for practice. A comprehensive assessment of insurance status and referral to community agencies should be an integral part of patient care for all healthcare providers.
Agenda for Children and Youth: Linking Research, Policy, and Practice
Authors: Montoya Patricia 
Published: February 2007

issues and purpose. In this past century, we have made significant strides in our understanding of children's needs, but there is still much to learn as we enter the coming century. We must seek this new knowledge not only for the sake of knowing, but also for the sake of making change, ensuring that what we learn helps improve the future for our children and youth. These efforts require a strong link between policy, practice, and research.conclusions. Research partnerships can build our base of knowledge and help answer emerging policy and practice questions. Through research that focuses on the diversity and developmental phases of children, we can bring policy and practice into line with an increasingly refined understanding of children and their needs.practice implications. Because nurses look at the holistic needs of individuals, it is critical that they are involved in setting the social service research agenda and seeking ways that policy and practice can both inform and be informed by this research.
“Love Is All You Need”? Student Nurses' Interest in Working With Children
Authors: Happell Brenda M. 
Published: February 2007

ISSUES AND PURPOSE. To investigate the impact of comprehensive nursing education on the future career interests of undergraduate nursing students, with particular emphasis on attitudes toward working with children.DESIGN AND METHODS. Descriptive design with surveys of 793 undergraduates in university schools of nursing throughout Victoria, Australia.RESULTS. Working with children is the most popular of nine possible career choices. Student explanations reflected a love of, and desire to work with, children, suggesting a relatively naive and uninformed view.PRACTICE IMPLICATIONS. In view of the problems experienced in the recruitment and retention of adequate numbers of pediatric nurses, there is an urgent need to promote a more realistic view of this area of practice.
Bone Loss in Adolescents Using Depo‐Provera
Authors: Kass‐Wolff Jane H. 
Published: February 2007

ISSUES AND PURPOSE. Contraceptive methods that decrease bone density in a population already deficient in calcium are a rising concern in women's health.CONCLUSIONS. Use of Depo‐Provera (DMPA) significantly decreases bone mass density (BMD) in normal adolescents up to the age of 21. DMPA is often used in adolescents with disabilities who may already be at high risk for osteoporosis. The effects are likely to be similar to that in ablebodied adolescents, but research is limited.PRACTICE IMPLICATIONS. Through early identification of risk factors in able‐bodied and disabled adolescents, primary care providers considering the use of DMPA in adolescents can optimize BMD by providing adequate nutritional assessment, counseling on nutritional sources of calcium, calcium supplementation, guidance on exercise, and alcohol and smoking prevention or cessation.
Rearing the Child Who Is Technology Dependent: Perceptions of Parents and Home Care Nurses
Authors: O'Brien Maureen E. , Wegner Carole B. 
Published: February 2007

ISSUES AND PURPOSE. Most children who are dependent on technology for survival live with their families at home. This study explores the perceptions of parents and home care nurses regarding rearing the technology‐dependent child.DESIGN AND METHODS. In this qualitative study, interviews were conducted with 16 parents whose child is technology dependent and 15 registered nurses who provided home care.RESULTS. Rearing the child who is technology dependent is similar to but different from raising other children. Parental communication and negotiation of child‐rearing expectations with home care nurses is essential.PRACTICE IMPLICATIONS. Improved collaboration and communication between parents and nurses may reduce parental stress and enhance development for children who are dependent on technology.
The Effects of Infant Feeding Decisions on Infant Growth
Authors: Barton Sharon Jackson , Howard Patricia Kunz , Rayens Mary Kay 
Published: February 2007

ISSUES AND PURPOSE. To determine the effects of feeding decisions on infant growth in the first 6 months of life.DESIGN AND METHODS. Growth measurements were collected twice during the first 6 months of infancy as part of a larger investigation of infant feeding practices (N = 52).RESULTS. Infants who received solid foods before the age of 4 to 6 months weighed less than those who received solid foods after 4 to 6 months. There were no differences in growth measurements between formula‐fed and breastfed infants, although breast‐fed infants weighed more at birth.PRACTICE IMPLICATIONS. Emphasize the importance of feeding breast milk (preferably) or formula only for the first 6 months. Advise parents to withhold fruit juices until the infant is at least 6 months old.
Selecting an Accurate Point‐of‐Care Testing System: Clinical and Technical Issues and Implications in Neonatal Blood Glucose Monitoring
Authors: Sirkin Amy , Jalloh Tina , Lee Luisa 
Published: February 2007

issues and purpose.
Rapid identification and treatment of glucose abnormalities is crucial in the prevention of potentially devastating neurological injury in neonates. Choice of a point‐of‐care glucose testing system must consider accuracy, clinical advantages, and data management capabilities. conclusions.
The benefits and limitations of point‐of‐care testing must be weighed against the time delay of central laboratory testing. practice implications.
Considerations in selecting a point‐of‐care blood glucose monitoring system include accuracy, precision, versatility, and the potential for cross infection and blood loss. When a system is selected, studies must be done to identify potential sources of error and confirm the utility and accuracy of the system in the identified population.