bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transition to adult care: experiences and expectations of adolescents with a chronic illness
Authors: Tuchman L. K. , Slap G. B. , Britto M. T. 
Published: August 2008

AbstractBackground  Effective means of transitioning adolescent patients with chronic illness from paediatric to adult medical care are poorly documented and supported by limited evidence. The purpose of this study is to describe expectations and concerns of adolescents with chronic illness regarding transition from subspecialty paediatric to adult‐centred care during the transition process in order guide effective programme design and implementation.Methods  Qualitative content and thematic analysis of semi‐structured individual interviews with 22 adolescents with chronic illness, including cystic fibrosis, sickle cell disease, juvenile rheumatoid arthritis, and inflammatory bowel disease. Interviews took place at 1–3 time points over an 18‐month study period.Results  Transition topics included: timing of transfer to adult care, the transition process, attitudes about transition, and factors that might aid transition. During the study period, one‐third of participants made the transition to adult‐oriented health care. All participants who had transitioned to adult‐oriented care reported participating in a structured transition programme. Concerns of those who had not initiated the transition process centred on re‐establishing relationships and bringing a new team ‘up to speed’. Most adolescents anticipating transfer to adult care identified only downsides and felt unprepared to transition at the time of the interview. Subjects who had transitioned noted benefits of the adult‐oriented system, even if they had been ambivalent prior to transfer of care. Participants suggested that earlier discussions about transition, opportunities to meet new healthcare teams and visits to adult‐oriented venues prior to transition might aid in the transition process.Conclusions  Subspecialty paediatric providers should anticipate common fears and concerns of adolescents and discuss the benefits of transfer to adult‐oriented care. Further evaluation of existing transition programmes is an area for future study and is necessary for improvement of the continuum of care for adolescents with chronic medical conditions.
Is there a relationship between preferred posture and positioning in early life and the direction of subsequent asymmetrical postural deformity in non ambulant people with cerebral palsy?
Authors: Porter David , Michael Shona , Kirkwood Craig 
Published: August 2008

AbstractBackground  It has been suggested that asymmetrical positioning of an infant with reduced mobility may lead to postural deformity becoming established over time. However, evidence to support or question this line of thinking is lacking. Therefore, the aim of this retrospective cohort study was to test the association between asymmetrical positioning in the first 12 months of life and the subsequent direction of postural deformity in non‐ambulant people with cerebral palsy.Methods  The direction of scoliosis, pelvic obliquity and windswept hip pattern and also the side of unilateral hip subluxation/dislocation were determined for 246 young people ranging in age from 1 year and 2 months to 19 years (median age 10 years and 3 months). Parents/carers of the participants were interviewed to establish holding and feeding positions and preferred lying posture adopted in early life. Univariate analyses and multivariate logistic regression analyses were carried out.Results  The study provided evidence of an association between asymmetrical lying posture adopted in the first year of life and the direction of the subsequent pattern of postural deformity. If the child's head had been rotated to the right during supine lying, it was more likely that the scoliosis would be convex to the left, pelvic obliquity would be lower on the left, windswept hip pattern would be to the right and hip subluxation/dislocation would occur on the left. The likelihood of the deformities occurring in the same direction was also increased if consistent side lying on the right had been preferred.Conclusions  Clinicians should be aware of positioning for children with severe disabilities particularly those who prefer supine lying with their head rotated to the side and those who prefer consistent side lying.
Outcome of Newborn Hearing Screening Programme delivered by health visitors
Authors: Basu S. , Evans K. L. , Owen M. , Harbottle T. 
Published: August 2008

AbstractBackground  The Newborn Hearing Screening Programme (NHSP) was introduced in England in 2001 to detect congenital hearing loss in the newborn. The screen is either hospital‐ or community‐based.Objectives  This is the first large‐scale study of community‐based NHSP published in the United Kingdom which aims to evaluate the performance of the community‐based screen and compare it against national targets for NHSP and the outcome of national pilot projects.Method  Hearing screening data recorded for 10 074 well babies between March 2004 and December 2005 were analysed. Babies who were admitted to the Special Care Baby Unit were excluded. The case notes of all children who failed the initial hearing screen, either unilateral or bilateral, were reviewed retrospectively. Specific performance measures include coverage rate, referral rate and yield. Reasons for failure to complete the screen were identified.Results  The community programme met all the standards set by the NHSP and the results are comparable with the average of the pilot sites reported in 2004.Conclusion  The data demonstrate that a community‐based hearing screening programme conducted by Health Visitors meets all the current national standards and could be implemented across wider areas in this country. Its advantages include a low false positive rate and convenience for parents living in rural areas. The babies identified can be diagnosed and rehabilitated in a time which meets national standards.
Transitions in the lives of young people with complex healthcare needs
Authors: Kirk S. 
Published: August 2008

AbstractBackground  The disabled child population now incorporates a group of children and young people with complex healthcare needs, many of whom are supported by medical devices and technologies. Little is known about their experiences and perspectives, particularly in relation to transitions.Methods  Twenty‐eight young people aged between 8 and 19 years old were recruited via Community Children's Nursing Teams. Data were collected by in‐depth qualitative interviews and analysed using Grounded Theory principles and procedures.Results  Young people with complex healthcare needs experience multiple and often concurrent transitions in their lives. As well as moving from childhood to adulthood, they experience different organizational and illness transitions. This paper focuses on their experiences of moving from children to adult services and moving from parental care to self‐care. Moving to adult services was characterized as a time of uncertainty because of lack of information and involvement in transition planning. Concerns were expressed about the continuity of support packages into adult services and whether specialist expertise would be available. Young people in adult services described how they had needed to adjust to a different culture and way of working and the loss of relationships with familiar, trusted professionals. In addition to becoming socially independent, young people were in the process of acquiring control over their healthcare and support needs. The acquisition of responsibility for managing therapies and devices was described as an evolving, individually negotiated process. However, responsibility for decision‐making and liasing with services could be acquired suddenly on transfer to adult services and not as part of an integrated self‐care transition process.Conclusions  Transition is often too focused on service transition and transfer rather than conceptualizing it holistically as part of the process of moving to adulthood and independence. Young people with complex healthcare needs may have support needs that are unfamiliar for adult services at present. Multi‐agency personalized planning that involves parents and young people is essential to ensure continuity of support and integration with other life transitions.
Stress in mothers of preterm infants in Bangladesh: associations with family, child and maternal factors and children's neuro‐development
Authors: Khan N. Z. , Muslima H. , Bhattacharya M. , Parvin R. , Begum N. , Jahan M. , Begum D. , Akhtar S. , Ahmed A. S. M. N. U. , Darmstadt G. L. 
Published: August 2008

AbstractBackground  The aim of this paper was to ascertain stress experienced by mothers of prospectively followed up preterm infants, and associations with family, child and maternal factors and children's neuro‐development.Methods  Within a follow‐up study of preterm infants <33 weeks gestational age at a Child Development Center in Dhaka Shishu Hospital, mothers were interviewed with the Self‐Report Questionnaire (SRQ) at each visit. Association between SRQ scores and child, family and maternal variables at first and final visit and children's neuro‐developmental outcomes was determined.Results  Low income mothers were more compliant (54%) compared with the defaulters (31%) (P = 0.0001) among the 159 mothers enrolled. Of the 88 mothers who were followed up until a mean age of 22 months of their child, 29.3% were at high risk for psychiatric morbidity at first visit compared with 23.9% on their last visit. Use of abortifacients (P = 0.026) and higher maternal age (P = 0.040) were significantly associated with maternal stress at first visit; while at last follow‐up, total number of visits had the most significant association (P = 0.041). Twenty‐five per cent and 19% of mothers were at risk for psychiatric morbidity in children developing normally and those with neuro‐developmental impairments respectively.Conclusions  Mothers at risk for psychiatric morbidity can be helped through follow‐up support within public hospitals close to their homes, which is most availed by low income families. Neuro‐developmental monitoring of high‐risk infants closer to homes may be more feasible in resource poor countries than reliance on hospital visits, which increase stress. Biological markers of stress and coping strategies need further research.
Serious injuries in children: variation by area deprivation and settlement type
Authors: Reading Richard 
Published: August 2008

.

Edwards P.,
Green J.,
Lachowycz K.,
Grundy C. &
Roberts I.
(
2008
)

,
93
,
485
–
489
.

DOI: 10.1136/adc.2007.116541
.
Objective  To examine the variation in serious injuries in children by the level of deprivation in an area and by types of settlement.Methods  Hospital admission rates for serious injury to children aged 0–15 years in census lower super output areas in England during the 5‐year period 1 April 1999 to 31 March 2004 were analysed.Results  Rates of serious injury in children were higher in the most deprived areas than in the least deprived for pedestrians [rate ratio (RR) 4.1; 95% CI 2.8–6.0] and cyclists (RR 3.0; 95% CI 1.9–4.7). Rates of serious pedestrian injury were lower in towns and fringe areas (RR 0.67; 95% CI 0.53–0.86) and in village (RR 0.64; 95% CI 0.50–0.83) areas than in urban areas. The rate of serious injury to cyclists was lower in London than in other urban areas (RR 0.78; 95% CI 0.62–0.98). The rate of serious injury to car occupants was higher in village than in urban areas (RR 1.51; 95% CI 1.05–2.17). Rates of serious injury caused by falls were higher in London (RR 1.60; 95% CI 1.47–1.75) and lower in villages (RR 0.76; 95% CI 0.66–0.88) than in urban areas. Steeper socio‐economic gradients in serious injury rates were identified in rural areas for cyclists and for children suffering falls.Conclusions  Socio‐economic inequalities in serious injury exist across the whole of England, particularly for child pedestrians. Rates of serious injury vary by settlement type, and inequalities vary by cause of injury between rural and urban settings.
Effects of prenatal cocaine exposure on special education in school‐aged children
Authors: Reading Richard 
Published: August 2008

.

Levine T. P.,
Liu J.,
Das A.,
Lester B.,
Lagasse L.,
Shankaran S.,
Bada H. S.,
Bauer C. R. &
Higgins R.
(
2008
)

.
Published online
.

DOI: 10.1542/peds.2007‐2826
.
Objective  The objective of this study was to evaluate the effects of prenatal cocaine exposure on special education at age 7 with adjustment for covariates.Methods  As part of the prospective, longitudinal, multi‐site study of children with prenatal cocaine exposure (Maternal Lifestyle Study), school records were reviewed for 943 children at 7 years to determine involvement in special education outcomes: (1) individualized education plan; (2) special education conditions; (3) support services; (4) special education classes; and (5) speech and language services. Logistic regression was used to examine the effect of prenatal cocaine exposure on these outcomes with environmental, maternal and infant medical variables as covariates, as well as with and without low child IQ.Results  Complete data for each analysis model were available for 737–916 children. When controlling for covariates including low child IQ, prenatal cocaine exposure had a significant effect on individualized education plan. When low child IQ was not included in the model, prenatal cocaine exposure had a significant effect on support services. Male gender, low birthweight, white race and low child IQ also predicted individualized education plan. Low birthweight and low child IQ were significant in all models. White race was also significant in speech and language services. Other covariate effects were model specific. When included in the models, low child IQ accounted for more of the variance and changed the significance of other covariates.Conclusions  Prenatal cocaine exposure increased the likelihood of receiving an individualized education plan and support services, with adjustment for covariates. Low birthweight and low child IQ increased the likelihood of all outcomes. The finding that white children were more likely to get an individualized education plan and speech and language services could indicate a greater advantage in getting educational resources for this population.
Explaining educational inequalities in preterm birth. The Generation R Study
Authors: Reading Richard 
Published: August 2008

.

Jansen P.,
Tiemeier H.,
Jaddoe V.,
Hofman A.,
Steegers E.,
Verhulst F.,
Mackenbach J. &
Raat H.
(
2008
)

.
Published online
.

DOI: 10.1136/adc.2007.136945
.
Background  Although a low socio‐economic status has consistently been associated with an increased risk of preterm birth, little is known about the pathways through which socio‐economic disadvantage influences preterm birth.Aim  To examine mechanisms that might underlie the association between the educational level of pregnant women as an indicator of socio‐economic status, and preterm birth.Methods  The study was nested in a population‐based cohort study in the Netherlands. Information was available for 3830 pregnant women of Dutch origin.Findings  The lowest educated pregnant women had a statistically significant higher risk of preterm birth [OR = 1.89 (95% CI: 1.28, 2.80)] than the highest educated women. This increased OR was reduced by up to 22% after separate adjustment for age, height, pre‐eclampsia, intrauterine growth restriction, financial concerns, long‐lasting difficulties, psychopathology, smoking habits, alcohol consumption and BMI of the pregnant women. Joint adjustment for these variables resulted in a reduction of 89% of the increased risk of preterm birth among low educated pregnant women [fully adjusted OR = 1.10 (95% CI: 0.66, 1.84)].Conclusions  Pregnant women with a low educational level have a nearly twofold higher risk of preterm birth than women with a high educational level. This elevated risk could largely be explained by pregnancy characteristics, indicators of psychosocial well‐being and lifestyle habits. Apparently, educational inequalities in preterm birth go together with an accumulation of multiple adverse circumstances among women with a low education. A number of explanatory mechanisms unravelled in the present study seem to be modifiable by intervention programmes.
LRP5 in premature adrenarche and in metabolic characteristics of prepubertal children
Authors: Lappalainen Saila , Saarinen Anne , Utriainen Pauliina , Voutilainen Raimo , Jääskeläinen Jarmo , Mäkitie Outi 
Published: August 2008

SummaryObjective  Premature adrenarche (PA) is associated with unfavourable metabolic characteristics. We hypothesized that genetic variation in low density lipoprotein (LDL) receptor‐related protein 5 (LRP5), which is involved in Wnt signalling in the adrenal cortex and in cholesterol metabolism, plays a role in the pathogenesis of PA.Design and patients  We performed a cross‐sectional association study in 73 Finnish children with PA and 97 age‐ and gender‐matched healthy controls.Measurements  LRP5 genotypes were determined by direct sequencing. Single‐marker associations with clinical‐metabolic characteristics, including adrenocortical function, glucose tolerance and lipid profile, were examined with age and gender as covariates.Results  Nineteen single nucleotide polymorphisms (SNPs) in LRP5 were found in the 170 children. No significant differences in the genotype distributions were observed between the PA and control groups. SNPs A1330V and N740N were associated with higher serum dehydroepiandrosterone sulphate (DHEAS) levels in the control subjects (A/A vs. A/a; mean 0·8 vs. 1·4 µmol/l, P = 0·01). They were also associated with higher plasma levels of total (4·2 vs. 4·7 mmol/l, P = 0·02) and LDL cholesterol (2·4 vs. 2·9 mmol/l, P = 0·02) in the control group, as was SNP V1119V (P = 0·04 and P = 0·03, respectively). SNPs F549F and V1119V were associated with higher systolic blood pressure (P = 0·04 and P = 0·02, respectively). There were no differences in the parameters of glucose metabolism between the genotype groups.Conclusions  Genetic variation in LRP5 did not predispose to PA but was associated with metabolic characteristics, especially lipid profile, in healthy prepubertal children.
Emotional outcome after intensive care: literature review
Authors: Rattray Janice E. , Hull Alastair M. 
Published: August 2008

AbstractTitle.  Emotional outcome after intensive care: literature review. Aim.  This paper is a report of a literature review to identify (a) the prevalence of emotional and psychological problems after intensive care, (b) associated factors and (c) interventions that might improve this aspect of recovery.Background.  Being a patient in intensive care has been linked to both short‐ and long‐term emotional and psychological consequences.Data sources.  The literature search was conducted during 2006. Relevant journals and databases were searched, i.e. Medline and CINAHL, between the years 1995 and 2006.Review methods.  The search terms were ‘anxiety’, ‘depression’, posttraumatic stress’, ‘posttraumatic stress disorder’ and ‘intensive care’.Results.  Fifteen papers were reviewed representing research studies of anxiety, depression and posttraumatic stress, and seven that represented intensive care follow‐up clinics and patient diaries. Being in intensive care can result in significant emotional and psychological problems for a number of patients. For the majority of patients, symptoms of distress will decrease over time but for a number these will endure for some years. Current evidence indicates that emotional problems after intensive care are related to both subjective and objective indicators of a patient’s intensive care experience. Evidence suggests some benefit in an early rehabilitation programme, daily sedation withdrawal and the use of patient diaries. However, additional research is required to support such findings.Conclusion.  Our understanding of the consequences of intensive care is improving. Psychological care for intensive care patients has lagged behind care for physical problems. We now need to focus on developing and evaluating appropriate interventions to improve psychological outcome in this patient group.
Haemangiomas and associated congenital malformations in a large population‐based sample of infants
Authors: Bukowinski Anna T. , Ryan Margaret A. K. , Slymen Donald J. , Sevick Carter J. , Alcaraz John E. , Smith Tyler C. 
Published: August 2008

SummaryHaemangiomas are common, benign, vascular tumours, observed in 4–12% of infants during the first year of life. Most cases progress without complication, yet a small proportion experience life‐threatening complications. Concomitant congenital malformations have been reported in a small but significant proportion of haemangioma patients. This study aimed to describe haemangioma cases and to identify patterns of congenital malformations associated with these diagnoses in a large population. Diagnoses of haemangiomas and 21 congenital malformations were extracted from electronic medical records of 467 295 singleton infants born to US military families from 1998 to 2003. Cluster analysis was used to group cases according to these diagnoses. Multivariable logistic regression was used to further explore the associations of the 21 congenital malformations with the diagnosis of haemangioma and to assess the adjusted relationships between a number of characteristics of interest and diagnosis of haemangioma.Clusters found to be associated with haemangioma were characterised by anomalies of the cervix, vagina, and external female genitalia, anophthalmia or microphthalmia, hydrocephalus without spina bifida, and reduction deformities of the brain. Logistic regression identified three congenital malformations significantly associated with haemangioma diagnosis: spina bifida without anencephalus, hydrocephalus without spina bifida, and anomalies of the cervix, vagina and external female genitalia. Characteristics significantly associated with haemangioma included female gender, preterm birth, white non‐Hispanic race/ethnicity and increasing maternal age. This exploratory study identified a number of important associations between haemangiomas and congenital malformations that may provide insight into the pathogenesis of these disorders and have possible implications for clinical care.
Role of volatiles and metasomatized subcontinental lithospheric mantle in the genesis of magmatic Ni–Cu–PGE mineralization: insights from in situ H, Li, B analyses of hydromagmatic phases from the Valmaggia ultramafic pipe, Ivrea‐Verbano Zone (NW Italy)
Authors: Fiorentini M. L. , Beresford S. W. 
Published: August 2008

Abstract In situ trace element and isotopic data of hydromagmatic phases from the Valmaggia peridotite pipe provide insights into the origin of the metasomatic fluids that affected the Ivrea‐Verbano Zone (NW Italy) during the late Carboniferous and shed new light on genetic models for the formation of Ni–Cu–PGE deposits. Volatiles implicated in the formation of hydromagmatic phases are not hydrothermal and did not derive from crustal assimilation. Low boron concentrations exclude the implication of fluids derived from dehydration of a subducted slab and indicate an origin from mantle‐derived juvenile water. Metasomatism introduced elevated contents of alkalis, Cu, PGEs and S into the depleted mantle of the Ivrea‐Verbano Zone. Increased water activity caused the harzburgite to undergo partial melting, thus producing pockets of volatile‐rich sulphide‐bearing ultramafic magma that evolved to form independent intrusions that host Ni–Cu–PGE mineralization.