bluuebunny/crossref_metadata_2025_split huggingface dataset:
The influence of diabetes upon adolescent and young adult development: A qualitative study
Authors: Dovey‐Pearce Gail , Doherty Yvonne , May Carl 
Published: February 2007

It is not clear how developmentally appropriate healthcare services for adolescents (11–15) and young adults (16–25) should be provided.Aims.First, to describe and understand the influence of diabetes upon psychosocial development and second, to highlight the implications for healthcare teams.Design.Given the heterogeneity of findings, lack of conceptual clarity and lack of quantitative measures, qualitative semi‐structured interviews were used, to define more clearly the constructs significant to young people.Methods.People aged 16–25 registered with one secondary care diabetes service, across two districts in north‐east England were contacted. Nineteen interviews were conducted and analysed using a Framework Approach.Results.Diabetes can impact upon personal identity and self‐concept. Peer support can buffer from negative effects, especially if young people control the disclosure of their diabetes. In coming to rely more on peers, participants continue to value the safe base of their family, especially at times of change and challenge. A key challenge appears to be coming to terms with risk and mortality.Conclusion.Health care services need to support young people with self‐care but must also understand and respond to the social and personal complexities of growing‐up with a long‐term health condition. Psychologists may have a role in promoting and supporting such an approach.
Endogenous PKIγ Limits the Duration of the Anti-Apoptotic Effects of PTH and β-Adrenergic Agonists in Osteoblasts
Authors: Chen Xin , Song In-Hwan , Dennis James E , Greenfield Edward M 
Published: February 2007

Abstract
PKIγ knockdown substantially extended the anti-apoptotic effects of PTH and β-adrenergic agonists, whereas PKIγ overexpression decreased these effects. Therefore, inhibition of PKIγ activity may provide a useful co-therapy in combination with intermittent PTH or β-adrenergic agonists for bone loss in conditions such as osteoporosis.
Introduction: PTH has both catabolic and anabolic effects on bone, which are primarily caused by cAMP/protein kinase A (PKA) signaling and regulation of gene expression. We previously showed that protein kinase inhibitor-γ (PKIγ) is required for efficient termination of cAMP/PKA signaling and gene expression after stimulation with PTH or β-adrenergic agonists. Inhibition of osteoblast apoptosis is thought to be an important, but transient, mechanism partly responsible for the anabolic effects of intermittent PTH. Therefore, we hypothesized that endogenous PKIγ also terminates the anti-apoptotic effect of PTH.
Materials and Methods: PKIγ knockdown by antisense transfection or siRNA was used to examine the ability of endogenous PKIγ to modulate the anti-apoptotic effects of PTH and β-adrenergic agonists in ROS 17/2.8 cells.
Results: Knockdown of PKIγ substantially extended the anti-apoptotic effects of PTH, whether apoptosis was induced by etoposide or dexamethasone. In contrast, overexpression of PKIγ decreased the anti-apoptotic effect of PTH pretreatment. This study is also the first demonstration that β-adrenergic agonists mimic the anti-apoptotic effects of PTH in osteoblasts. Moreover, PKIγ knockdown also substantially extended this anti-apoptotic effect of β-adrenergic agonists. Taken together, these results show that endogenous PKIγ limits the duration of the anti-apoptotic effects of cAMP/PKA signaling in osteoblasts.
Conclusions: Because significant individual variability exists in the anabolic responses to PTH therapy in current clinical treatment of osteoporosis, inhibition of PKIγ activity may provide a useful co-therapy in combination with intermittent PTH or β-adrenergic agonists for bone loss in conditions such as osteoporosis. However, the potential use of such a co-therapy would depend on it not adversely affecting bone formation or other organ systems.
Comparison of Serum Folate Species Analyzed by LC-MS/MS with Total Folate Measured by Microbiologic Assay and Bio-Rad Radioassay
Authors: Fazili Zia , Pfeiffer Christine M , Zhang Mindy 
Published: February 2007

Abstract
Background: The Bio-Rad QuantaPhase II radioassay (BR), used for 25 years to measure total folate (TFOL) concentrations for the National Health and Nutrition Examination Survey (NHANES), will be discontinued in 2007. Liquid chromatography–tandem mass spectrometry (LC-MS/MS) or a microbiologic assay (MA) will be used in the future.
Methods: We measured folate species by LC-MS/MS and TFOL by MA and BR in 327 serum samples.
Results: LC-MS/MS measured 5-methyltetrahydrofolic acid (5CH3THF; 82%), folic acid (FA; 8%), 5-formyltetrahydrofolic acid (5CHOTHF; 6%), tetrahydrofolic acid (THF; 4%), and 5,10-methenyltetrahydrofolic acid (5,10CH=THF; 0%). The sum of the folate species correlated well with TFOL measured by MA (R2 = 0.97) and BR (R2 = 0.91). Compared with LC-MS/MS results, MA and BR values were significantly lower (−6% and −29%, respectively); however, these differences were concentration dependent. The MA almost completely recovered folates added to serum samples except for FA [69% (3%)] and THF [36% (10%)]. The BR underrecovered 5CH3THF [61% (9%)] and 5CHOTHF [38% (14%)] and overrecovered 5,10CH=THF [234% (32%)]. Multiple linear regression models with log-transformed data yielded a good fit for converting BR data to MA or LC-MS/MS data and MA data to LC-MS/MS data.
Conclusions: The good correspondence between the sum of folate species determined by LC-MS/MS and TFOL determined by MA makes these 2 assays interchangeable. The BR produces much lower results, on average, probably because of 5CH3THF underrecovery. The conversion equations provided could be used for future NHANES time trend analyses.
Mass Spectrometry–Based Hepcidin Measurements in Serum and Urine: Analytical Aspects and Clinical Implications
Authors: Kemna Erwin HJM , Tjalsma Harold , Podust Vladimir N , Swinkels Dorine W 
Published: February 2007

Abstract
Background: Discovery of the central role of hepcidin in body iron regulation has shed new light on the pathophysiology of iron disorders. Information is lacking on newer analytical approaches to measure hepcidin in serum and urine. Recent reports on the measurement of urine and serum hepcidin by surface-enhanced laser-desorption/ionization time-of-flight mass spectrometry (SELDI-TOF MS) necessitate analytical and clinical evaluation of MS-based methodologies.
Methods: We used SELDI-TOF MS, immunocapture, and tandem MS to identify and characterize hepcidin in serum and urine. In addition to diagnostic application, we investigated analytical reproducibility and biological and preanalytical variation for both serum and urine on Normal Phase 20 and Immobilized Metal Affinity Capture 30 ProteinChip arrays. We obtained samples from healthy controls and patients with documented iron-deficiency anemia, inflammation-induced anemia, thalassemia major, and hereditary hemochromatosis.
Results: Proteomic techniques showed that hepcidin-20, -22, and -25 isoforms are present in urine. Hepcidin-25 in serum had the same amino acid sequence as hepcidin-25 in urine, whereas hepcidin-22 was not detected in serum. The interarray CV was 15% to 27%, and interspot CV was 11% to 13%. Preliminary studies showed that hepcidin-25 differentiated disorders of iron metabolism. Urine hepcidin is more affected by multiple freeze-thaw cycles and storage conditions, but less influenced by diurnal variation, than is serum hepcidin.
Conclusion: SELDI-TOF MS can be used to measure hepcidin in both serum and urine, but serum requires a standardized sampling protocol.
Neonatal Intensive Care Unit Census Influences Discharge of Moderately Preterm Infants
Authors: Profit Jochen , McCormick Marie C. , Escobar Gabriel J. , Richardson Douglas K. , Zheng Zheng , Coleman-Phox Kim , Roberts Rebecca , Zupancic John A.F. 
Published: February 2007

OBJECTIVE. The timely discharge of moderately premature infants has important economic implications. The decision to discharge should occur independent of unit census. We evaluated the impact of unit census on the decision to discharge moderately preterm infants.
DESIGN/METHODS. In a prospective multicenter cohort study, we enrolled 850 infants born between 30 and 34 weeks' gestation at 10 NICUs in Massachusetts and California. We divided the daily census from each hospital into quintiles and tested whether discharges were evenly distributed among them. Using logistic regression, we analyzed predictors of discharge within census quintiles associated with a greater- or less-than-expected likelihood of discharge. We then explored parental satisfaction and postdischarge resource consumption in relation to discharge during census periods that were associated with high proportions of discharge.
RESULTS. There was a significant correlation between unit census and likelihood of discharge. When unit census was in the lowest quintile, patients were 20% less likely to be discharged when compared with all of the other quintiles of unit census. In the lowest quintile of unit census, patient/nurse ratio was the only variable associated with discharge. When census was in the highest quintile, patients were 32% more likely to be discharged when compared with all of the other quintiles of unit census. For patients in this quintile, a higher patient/nurse ratio increased the likelihood of discharge. Conversely, infants with prolonged lengths of stay, an increasing Score for Neonatal Acute Physiology II, and minor congenital anomalies were less likely to be discharged. Infants discharged at high unit census did not differ from their peers in terms of parental satisfaction, emergency department visits, home nurse visits, or rehospitalization rates.
CONCLUSIONS. Discharges are closely correlated with unit census. Providers incorporate demand and case mix into their discharge decisions.
Impact of Full Mental Health and Substance Abuse Parity for Children in the Federal Employees Health Benefits Program
Authors: Azrin Susan T. , Huskamp Haiden A. , Azzone Vanessa , Goldman Howard H. , Frank Richard G. , Burnam M. Audrey , Normand Sharon-Lise T. , Ridgely M. Susan , Young Alexander S. , Barry Colleen L. , Busch Alisa B. , Moran Garrett 
Published: February 2007

OBJECTIVE. The Federal Employees Health Benefits Program implemented full mental health and substance abuse parity in January 2001. Evaluation of this policy revealed that parity increased adult beneficiaries’ financial protection by lowering mental health and substance abuse out-of-pocket costs for service users in most plans studied but did not increase rates of service use or spending among adult service users. This study examined the effects of full mental health and substance abuse parity for children.
METHODS. Employing a quasiexperimental design, we compared children in 7 Federal Employees Health Benefits plans from 1999 to 2002 with children in a matched set of plans that did not have a comparable change in mental health and substance abuse coverage. Using a difference-in-differences analysis, we examined the likelihood of child mental health and substance abuse service use, total spending among child service users, and out-of-pocket spending.
RESULTS. The apparent increase in the rate of children’s mental health and substance abuse service use after implementation of parity was almost entirely due to secular trends of increased service utilization. Estimates for children’s mental health and substance abuse spending conditional on this service use showed significant decreases in spending per user attributable to parity for 2 plans; spending estimates for the other plans were not statistically significant. Children using these services in 3 of 7 plans experienced statistically significant reductions in out-of-pocket spending attributable to the parity policy, and the average dollar savings was sizeable for users in those 3 plans. In the remaining 4 plans, out-of-pocket spending also decreased, but these decreases were not statistically significant.
CONCLUSIONS. Full mental health and substance abuse parity for children, within the context of managed care, can achieve equivalence of benefits in health insurance coverage and improve financial protection without adversely affecting health care costs but may not expand access for children who need these services.
New York State Cystic Fibrosis Consortium: The First 2.5 Years of Experience With Cystic Fibrosis Newborn Screening in an Ethnically Diverse Population
Authors: Giusti Robert , Badgwell Ashley , Iglesias Alejandro D. ,   and the New York State Cystic Fibrosis Newborn Screening Consortium
Published: February 2007

OBJECTIVE. The purpose of this work was to report on the first 2.5 years of newborn screening for cystic fibrosis in New York.METHODS. Directors of the 11 New York cystic fibrosis centers were asked to provide mutation data, demographic data, and selected laboratory results for each patient diagnosed by newborn screening and followed at their center. Summary data were also submitted from the New York newborn screening laboratory on the total number of patients screened, the number of positive screens, and the number of patients that were lost to follow-up. A second survey was submitted by each center regarding the availability of genetic counseling services at the center.RESULTS. A total of 106 patients with cystic fibrosis were diagnosed through newborn screening in the first 2.5 years and followed at the 11 Cystic Fibrosis Foundation–sponsored cystic fibrosis care centers in New York. Two screen-negative infants were subsequently diagnosed with cystic fibrosis when symptoms developed. The allele frequency of ΔF508 was 57.4%, which is somewhat lower than the allele frequency of ΔF508 in the US cystic fibrosis population of 70%. There were 90 non-Hispanic white (84%), 12 Hispanic, 2 Asian, and 1 black infants diagnosed with cystic fibrosis during this period. Five patients were diagnosed secondary to a positive screen based on a high immunoreactive trypsinogen and no mutations.CONCLUSIONS. Newborn screening for cystic fibrosis has been effectively conducted in New York using a unique screening algorithm that was designed to be inclusive of the diverse racial makeup of the state. However, this algorithm results in a high false-positive rate, and a large number of healthy newborns are referred for confirmatory sweat tests and genetic counseling. This experience indicates that it would be helpful to convene a working group of cystic fibrosis newborn screening specialists to evaluate which mutations should be included in a newborn screening panel.
Randomized Trial of a Single Repeat Dose of Prenatal Betamethasone Treatment in Imminent Preterm Birth
Authors: Peltoniemi Outi M. , Kari M. Anneli , Tammela Outi , Lehtonen Liisa , Marttila Riitta , Halmesmäki Erja , Jouppila Pentti , Hallman Mikko ,   for the Repeat Antenatal Betamethasone Study Group
Published: February 2007

BACKGROUND. A single dose of prenatal betamethasone treatment decreases neonatal morbidity rates when administered within 7 days before preterm delivery. A single repeat dose or booster dose of betamethasone before delivery has been proposed to be effective, but its efficacy has not been subjected to a randomized, blinded trial.METHODS. Women with imminent delivery before 34.0 gestational weeks were eligible if they remained without delivery for &gt;7 days after a single course of betamethasone. After stratification, a single repeat dose of betamethasone (12 mg) or placebo was administered. The primary outcome was survival without respiratory distress syndrome or severe intraventricular hemorrhage (grade 3 or 4).RESULTS. A total of 249 mothers had been enrolled by the time the study was discontinued. All of the 159 infants in the betamethasone group and 167 in the placebo group were born before 36 weeks of gestation. The intact survival rate was unaffected and was lower than anticipated, because the gestational age-adjusted incidence of respiratory distress syndrome was higher than the population incidence. The requirement for surfactant therapy in respiratory distress syndrome was increased in the betamethasone group. According to posthoc analysis of the data for 206 infants who were delivered within 1 to 24 hours, the betamethasone booster tended to increase the risk of respiratory distress syndrome and to decrease intact survival rates.CONCLUSIONS. According to this study, a single booster dose of betamethasone just before preterm birth may perturb respiratory adaptation. These results caution against uncontrolled use of a repeat dose of glucocorticoid in high-risk pregnancies.
Adolescents’ Reported Consequences of Having Oral Sex Versus Vaginal Sex
Authors: Brady Sonya S. , Halpern-Felsher Bonnie L. 
Published: February 2007

OBJECTIVE. The present study examined whether adolescents’ initial consequences of sexual activity differ according to type of sexual activity and gender.
METHODS. Surveys were administered to 618 adolescents recruited from 2 public high schools in the autumn of ninth grade (2002) and at 6-month intervals until the spring of tenth grade (2004). Analyses were limited to the 275 adolescents (44%) who reported engaging in oral sex and/or vaginal sex at any assessment. Participants were 14 years of age at study entry, 56% female, and of diverse socioeconomic and ethnic backgrounds.
RESULTS. In comparison with adolescents who engaged in oral sex and/or vaginal sex, adolescents who engaged only in oral sex were less likely to report experiencing a pregnancy or sexually transmitted infection, feeling guilty or used, having their relationship become worse, and getting into trouble with their parents as a result of sex. Adolescents who engaged only in oral sex were also less likely to report experiencing pleasure, feeling good about themselves, and having their relationship become better as a result of sex. Boys were more likely than girls to report feeling good about themselves, experiencing popularity, and experiencing a pregnancy or sexually transmitted infection as a result of sex, whereas girls were more likely than boys to report feeling bad about themselves and feeling used.
CONCLUSIONS. Adolescents experience a range of social and emotional consequences after having sex. Our findings have implications for clinical practice and public health campaigns targeted toward youth.
Risk Factors for Deformational Plagiocephaly at Birth and at 7 Weeks of Age: A Prospective Cohort Study
Authors: van Vlimmeren Leo A. , van der Graaf Yolanda , Boere-Boonekamp Magda M. , L'Hoir Monique P. , Helders Paul J.M. , Engelbert Raoul H.H. 
Published: February 2007

OBJECTIVE. The purpose of this work was to identify risk factors for deformational plagiocephaly within 48 hours of birth and at 7 weeks of age.PATIENTS AND METHODS. This was a prospective cohort study in which 380 healthy neonates born at term in Bernhoven Hospital in Veghel were followed at birth and at 7 weeks of age. Data regarding obstetrics, sociodemographics, asymmetry of the skull, anthropometrics, motor development, positioning, and care factors related to potentially provoking deformational plagiocephaly were gathered, with special interest for putative risk factors. The main outcome measure at birth and at 7 weeks of age was deformational plagiocephaly, assessed using the plagiocephalometry parameter oblique diameter difference index, a ratio variable, calculated as the longest divided by the shortest oblique diameter of the skull × 100%. A cutoff point of ≥104% was used to indicate severe deformational plagiocephaly.RESULTS. Only in 9 of 23 children who presented deformational plagiocephaly at birth was deformational plagiocephaly present at follow-up, whereas in 75 other children, deformational plagiocephaly developed between birth and follow-up. At birth, 3 of 14 putative risk factors were associated with severe flattening of the skull: gender, birth rank, and brachycephaly. At 7 weeks of age, 8 of 28 putative risk factors were associated with severe flattening: gender, birth rank, head position when sleeping, position on chest of drawers, method of feeding, positioning during bottle-feeding, and tummy time when awake. Early achievement of motor milestones was a protective factor for developing deformational plagiocephaly. Deformational plagiocephaly at birth was not a predictor for deformational plagiocephaly at 7 weeks of age. There was no significant relation between supine sleeping and deformational plagiocephaly.CONCLUSIONS. Three determinants were associated with an increased risk of deformational plagiocephaly at birth: male gender, first-born birth rank, and brachycephaly. Eight factors were associated with an increased risk of deformational plagiocephaly at 7 weeks of age: male gender, first-born birth rank, positional preference when sleeping, head to the same side on chest of drawers, only bottle feeding, positioning to the same side during bottle feeding, tummy time when awake &lt;3 times per day, and slow achievement of motor milestones. This study supports the hypothesis that specific nursing habits, as well as motor development and positional preference, are primarily associated with the development of deformational plagiocephaly. Earlier achievement of motor milestones probably protects the child from developing deformational plagiocephaly. Implementation of practices based on this new evidence of preventing and diminishing deformational plagiocephaly in child health care centers is very important.
Disparities in Dental Insurance Coverage and Dental Care Among US Children: The National Survey of Children's Health
Authors: Liu Jihong , Probst Janice C. , Martin Amy B. , Wang Jong-Yi , Salinas Carlos F. 
Published: February 2007

OBJECTIVES
We sought to understand disparities in dental insurance coverage and dental care among US children by race/ethnicity, urban/rural residence, and socioeconomic status.

METHODS
Linked data from the National Survey of Children's Health and Area Resource File were analyzed (N = 89 071). Multiple logistic regression analysis was used to adjust for confounders.

RESULTS
A total of 22.1% of US children lacked parentally reported dental insurance coverage in the preceding year, 26.9% did not have a routine preventive dental visit, and 5.1% had parentally perceived unmet need for preventive dental care. US born minority children were less likely to lack dental insurance than US-born white children; however, foreign-born Hispanic children were more likely to be uninsured. Rural children were more likely to be uninsured than urban children. Children with health insurance were more likely to have dental coverage. Children who lacked dental insurance were less likely to have received preventive care and more likely to have unmet need for care. Compared with US-born white children, all minority children were less likely to receive preventive care. These disparities were exacerbated among foreign-born children. Fewer race-based disparities were found for unmet need for dental care. Only black children, both US and foreign-born, had higher odds of unmet need for preventive services than US-born white children. Poor dental health was strongly associated with unmet need. Disparities in dental insurance coverage and dental care are also evident by family socioeconomic status.

CONCLUSIONS
Poor and minority children were less likely to receive preventive dental care, even when insurance status was considered. Rural children were less likely to have dental insurance than urban children. Foreign birth affected insurance status for Hispanic children and use of preventive services for all minority children.