bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hearing in children after meningococcal meningitis
Authors: Drake R , Dravitski J , Voss L 
Published: March 2003

Objective: To review the outcome of sensorineural hearing loss in children who have had confirmed meningococcal meningitis. Methods: A retrospective audit of children admitted to the Starship Children’s Hospital with a confirmed diagnosis of meningococcal meningitis during a 4‐year period. Results: Sixty‐five children had confirmed meningococcal meningitis. Dexamethasone was administered according to recommended guidelines in 46 children (72%) while 12 children (19%) did not receive steroids at any stage. All children were appropriately referred for hearing assessment. Forty‐nine children (75%) had their hearing tested and reliable sensorineural evaluation was obtained in all but one case. Thirty‐four children (70%) were seen up to 6 weeks from discharge, 86% by 12 weeks. Sixteen cases (25%) did not attend for audiological assessment. Sensorineural hearing impairment was found in two children (4.2%). Conclusions: Children with meningococcal meningitis were reliably referred for audiological assessment but 39% either failed to attend for an outpatient hearing evaluation (25%) or had an unacceptable delay between discharge and testing (14%). Of those reliably tested, two children (4.2%) had significant sensorineural hearing loss.
Ureaplasma urealyticum and its association with chronic lung disease in Asian neonates
Authors: Agarwal P , Rajadurai Vs , Pradeepkumar Vk , Tan Kw 
Published: March 2003

Objective: The aim of the present prospective cohort study was to evaluate the relationship between lower respiratory tract colonization with Ureaplasma urealyticum and development of chronic lung disease (CLD) in a high‐risk neonatal population. Methods: Prospective cohort study of preterm infants with a birthweight < 1500 g needing mechanical ventilation within 24 h of birth in a tertiary care neonatal unit. Endotracheal aspirates from these infants were cultured within 24 h for U. urealyticum and the rate of colonization was determined. The primary outcome measure was the incidence of CLD at 28 days of life. Results: Of the 41 infants studied, 10 (24%) infants were colonized with U. urealyticum. The colonization rate was higher in babies < 1000 g compared with babies weighing 1000–1500 g (P = 0.04). There was no significant difference between the colonized and non‐colonized groups with regard to the antenatal use of steroids, maternal prolonged rupture of membranes, gestational age, birthweight, sex, respiratory distress syndrome, use of surfactant, patent ductus arteriosus and gastrooesophageal reflux. Of the 37 survivors, 20 (54%) developed CLD; eight infants (88.5%) in the colonized group developed CLD compared with 12 infants (42.8%) in the non‐colonized group (P = 0.01). Conclusions: Neonates colonized with U. urealyticum were twice as likely to have CLD than non‐colonized babies (relative risk 2.01; 95% confidence interval 1.27–3.37). These data suggest a significant association between colonization with U. urealyticum and CLD in infants weighing < 1500 g.
Transient hyperphosphatasaemia: An important condition to recognize
Authors: Carroll AJ , Coakley JC 
Published: March 2003

Objective: To investigate the prevalence and aetiology of transient hyperphosphatasaemia (TH) of infancy and childhood in a tertiary referral paediatric hospital. Methodology: Retrospective review of the medical records of patients with measured plasma alkaline phosphatase (ALP) activity of over 1000 U/L. Results: Over a period of 1 year, 68 children with plasma ALP activity of over 1000 U/L were identified. The main aetiologies were liver disease (34 cases), TH (21 cases) and bone disease (11 cases). The mean age of children with TH was 1 year and 5 months and there was a male predominance (3:1). The children with liver and bone disease were older (mean ages of 6 years, 6 months and 5 years, 1 month, respectively) and there was no gender difference. The mean plasma ALP activity for the children with TH was 3395 U/L, and in those patients in whom ALP activity was measured sequentially, mean ALP returned to within normal limits after an average of 70 days. There was a seasonal predominance of TH cases, with a significant number presenting during the winter, suggesting a viral aetiology. The most common clinical presentation of children with TH was gastroenteritis (8/21). Conclusion: Cases of TH can be clearly identified by considering the age of the patient and by excluding other known causes of markedly elevated ALP, in particular liver or bone disease. Using these exclusion criteria, the prevalence of TH was found to be high. Early recognition of this benign condition may prevent misdiagnosis and further unnecessary investigations.
Childhood speech disorders: Reported prevalence, comorbidity and socioeconomic profile
Authors: Keating D , Turrell G , Ozanne A 
Published: March 2003

Objective: To describe the reported prevalence, comorbidity and socioeconomic status (SES) of children with speech disorders. Methodology: Data from the 1995 Australian Health Survey were used. Information relating to the health of 12 388 children aged 0–14 years was collected via face‐to‐face interviews with a responsible adult. Speech disorders were recorded if children had reported difficulty talking, producing speech sounds, or who stuttered. Results: The prevalence of childhood speech disorders (CSD) was 1.7% (n = 209). Of this group, 25.8% (n = 54) had a developmental delay or intellectual impairment; when these were excluded, the prevalence of CSD was reduced to 1.3% (n = 155). Among males, the peak prevalence occurred at age 5 (6.5%), for females the highest rates were for 3–4‐year‐olds (1.8%). Children with a speech disorder had a greater number of additional health problems. No relationship was found between SES and CSD. Conclusions: Children with speech disorders often have complex health and developmental needs. Developing effective prevention programs with a view to improving the long‐term health and social outcomes of these children will require a mix of individual (clinical) and population‐based (public‐health) strategies.
Scooter injuries in children
Authors: Chapman S , Webber C , O'Meara M 
Published: March 2003

Objectives: To study the causes, patterns of injury and use of safety equipment in children presenting with ‘push/kick’ scooter‐related injuries. To draw comparisons with in‐line skate, skateboard and bicycle injuries and to suggest strategies for injury prevention. Methods: A retrospective review of medical data was undertaken for 12 consecutive months to September 2000. All children aged < 15 years who had attended the Sydney Children’s Hospital with scooter, in‐line skate (rollerblade), skateboard or bicycle injuries were identified. Children with scooter injuries for the latter 6 month period were contacted by telephone and interviewed, together with their parents, using a structured questionnaire. Results: There was a marked rise in the number of scooter injuries from October 1999 to September 2000. Sixty‐one per cent of these injuries occurred during the final 3 months of the study period, making scooters the most common cause of injury in the studied groups for this period. Forty‐two per cent of scooter injuries were fractures. Only 3% of children used safety equipment at the time of injury, despite 86% owning some form of safety equipment. Children were less likely to use safety equipment with a scooter than with any other form of activity studied. (Chi‐squared P = 0.000). Conclusions: Scooters are a common cause of childhood injury, resulting in injury patterns similar to those caused by in‐line skates, skateboards and bicycles. Safety equipment is rarely worn when scooters are ridden. Injury patterns and riding styles suggest that if existing guidelines for in‐line skating, skateboarding and bicycling are modified and applied to scooters, a reduction in injury numbers may be achieved.
Incidence of alveolar capillary dysplasia in severe idiopathic persistent pulmonary hypertension of the newborn
Authors: Tibballs J , Chow CW 
Published: March 2003

Objective:  To determine the incidence and outcome and to review the management of alveolar capillary dysplasia (ACD) among newborns with severe idiopathic persistent pulmonary hypertension (PPHN).Methods:  A retrospective review of medical records of infants admitted to a paediatric intensive care unit from 1982 to 2000 with a diagnosis of severe PPHN, and re‐examination of lung histological sections was carried out. Results: Thirteen new‐born infants with pulmonary hypertension not associated with any known cause were identified. All were treated with conventional mechanical ventilation or high‐frequency oscillatory ventilation with high inspired‐oxygen and non‐specific pulmonary vasodilators. Nine infants were also treated with inhaled nitric oxide therapy and eight with extracorporeal membrane oxygenation (ECMO). Seven infants died and six survived. At autopsies, the histological features of ACD were seen in the six who had died in the newborn period. All these had been treated with ECMO. In two of these six infants, lung biopsies had been performed showing similar features, suggesting the possibility of diagnosis during life. In the remaining infant, who died at 3 months of age, there was only marked hypertrophy of the muscle coat in the small pulmonary arteries.Conclusions:  Alveolar capillary dysplasia is probably not as rare a condition as previously suggested in sporadic case reports from literature on the subject. It should be entertained as a cause of otherwise severe idiopathic PPHN of the newborn, particularly if ECMO is required. Diagnosis during life is possible by lung biopsy. It is uncertain if survival occurs with milder forms of the condition.
Child and parent satisfaction with the use of spacer devices in acute asthma
Authors: Cotterell EM , Gazarian M , Henry RL , O'Meara MW , Wales SR 
Published: March 2003

Objective:  To evaluate child and parent satisfaction with the use of spacers in acute asthma.Methods:  All parents of children presenting to the emergency department of Sydney Children's Hospital over a 3‐month period with mild to moderately severe acute asthma who were treated with bronchodilators by spacer device were asked to complete an anonymous questionnaire. Children aged 8 years and older completed a separate questionnaire independently.Results:  One hundred and eleven of 158 parents (70%) responded. The majority (84%) found it ‘easy’ or ‘very easy’ to use the spacer and 85% reported that they intended to use the spacer at home. Of those parents who had previously used a nebulizer (n = 73), 84% said that the spacer was easier to use, 77% said that the spacer was better tolerated by their child and 84% said that overall they preferred the spacer. Seventeen of 31 children aged 8−14 years treated with a spacer (55%) responded to the satisfaction survey. All respondents found it ‘easy’ or ‘OK’ to use the spacer and the majority (82%) ‘liked it’ or thought ‘it was OK’. The majority of children (82%) said that they preferred using spacers because it was quicker (29%) or easier to use (53%).Conclusion:  The use of spacer devices in mild to moderately severe acute asthma is highly acceptable for children and parents; the majority prefer this mode of drug delivery to nebulization.
Nature, severity and correlates of psychological distress in women admitted to a private mother–baby unit
Authors: Fisher JRW , Feekery CJ , Rowe‐Murray HJ 
Published: March 2003

Objective: To characterize psychological distress of women admitted with their infants to a private hospital mother–baby unit. Methods: A cross‐sectional self‐report survey including standardized psychometric questionnaires of consecutive admissions to Masada Private Hospital Mother–Baby Unit, Melbourne between 1 June and 30 November 1997. Scores on the Profile of Mood States, Edinburgh Postnatal Depression Scale, Intimate Bonds Measure, Parental Bonding Instrument, Social Support Questionnaire, Vulnerable Personality Scale self‐report instruments and responses to a structured self‐report questionnaire. Of the women admitted, 109 out of 146 participated in the survey. Results: Clinically significant fatigue was almost universal in this cohort. Psychological distress clustered into three distinct groups: (i) probable depression; (ii) fatigue and distress; and (iii) fatigue only. It may be more accurate to conceptualise postpartum psychological distress either as a continuum, or as a wide range of distinct states, rather than as a dichotomous condition in which individuals are categorized as being or not being cases. In this cohort, the severity of distress was associated most consistently with the quality of a woman’s relationship with her partner and with infants who were difficult to settle. Conclusions: It appears that some cases of psychological distress in women following childbirth may be inaccurately conceptualised as depression. Clinically significant fatigue and moderate distress are distinguishable from depression, and warrant specifically tailored assessment strategies and treatments. Following the birth of a baby, the partner of a mother has a strong influence on her emotional health and should be included in any assessment and intervention.
Asthma in children: Gaps between current management and best practice
Authors: Haby MM , Powell CVE , Oberklaid F , Waters EB , Robertson CF 
Published: March 2003

Objectives:  To determine the extent to which steps three to six of the Australian six‐step asthma management plan are being implemented in the community and to identify barriers to the adoption of best practice asthma management.Methods:  A cross‐sectional descriptive study was conducted at the Royal Children’s Hospital and Sunshine Hospital, Melbourne. Two hundred and thirty‐one 2−5‐year old children who visited the emergency department for asthma were enrolled in the study. Main outcome measures were frequency of asthma management practices and barriers, as measured by parent‐completed questionnaire.Results:  Gaps: 51% of parents do not feel they have enough information about asthma triggers, more than 60% of children with persistent or frequent episodic asthma are not using regular preventive medication, 48% do not have a written action plan, 39% have not had their asthma reviewed in the last 6 months, and 38% of parents do not feel that they have enough information about their child’s asthma. Areas where current practice was close to best practice: 83% of doctors had talked to parents about what causes or ‘triggers’ their child’s asthma, less than 1% of children are using puffers without a spacer, 83% of parents who had an action plan used it for the current visit to the emergency department.Conclusions:  Large gaps still exist between current management and best practice in this group of emergency department attenders. Improvements in asthma management could be achieved if the child’s asthma doctor requested review visits for asthma, provided an action plan and followed best practice in relation to asthma medications.
Partition of metals in the Vistula River and in effluents from sewage treatment plants in the region of Cracow (Poland)
Authors: Guéguen C. , Dominik J. , Pardos M. , Benninghoff C. , Thomas R. L. 
Published: March 2003

AbstractThe Vistula River suffers from heavy pollution with multiple origins. In the upper reaches, metallic and chlorine pollution originates from the mining and industrial region of Upper Silesia. Downstream from Upper Silesia, urban and industrial sewage adds more metallic and organic contaminants from the large urban agglomeration of Cracow. Although the river status is monitored routinely, little is known about the partition of metals between particulate and dissolved forms. This study focuses on metal partitioning and on the impact of the two main wastewater treatment plants at Cracow on metal concentrations in the Vistula River. The Cd, Co, Cu, Mn, Pb and Zn content was measured in both dissolved and particulate fractions. High metal concentrations in the Vistula River persist, although current levels seem to be lower than those in the past. Metal concentrations in the Vistula River and effluents from the sewage treatment plants at Cracow are similar, indicating a relatively minor contribution from the treated sewage. However, untreated sewage may be a significant source of contaminants. Despite high anthropogenic metal concentrations, the metal partitioning coefficients (Kd) in the Vistula are similar to these found in unpolluted rivers. Within a narrow pH range, Kd values depend on the metal affinity to particles, but there is no evidence of dependence on particle or chloride concentrations. An important fraction of the toxic metals Pb and Cd is associated with particles, which may decrease their immediate availability to the biota of the river.
Watershed influences on the transport, fate and bioavailability of mercury in Lake Superior: Field measurements and modelling approaches
Authors: Back Richard C. , Hurley James P. , Rolfhus Kristopher R. 
Published: March 2003

AbstractThe issuance of fish consumption advisories in US states bordering Lake Superior has heightened the need for understanding the biogeochemical cycling and transformations of mercury in this great lake. Major routes of mercury (Hg) transport to lakes include atmospheric deposition (wet and dry), direct discharges and riverine (watershed) inputs. The specific objectives of this ongoing study are to: (i) determine the speciation and bioavailability of Hg transported to Lake Superior (ii) determine the importance of watershed‐specific characteristics that control physical and chemical forms of Hg; (iii) identify key mechanisms controlling Hg bioavailability and speciation in near‐shore zones relative to open lake regions; and (iv) provide process‐level information to compliment concurrent development of Hg fate and transport models of the Lake Superior ecosystem. Three tributaries of Lake Superior were chosen for detailed field study based on previous results and particular watershed characteristics. Mixing zones represent a potentially important zone of Hg entry into the food chain, and were sampled for biota, water and sediment in transects between the tributary mouth and the lake end member. Sampling of open‐water sites was conducted during Environmental Protection Agency‐sponsored cruises on the research vessel Lake Guardian. Results from our work on Lake Superior tributaries demonstrate that dissolved organic carbon and methylmercury (MeHg) export was greatest from watersheds containing wetlands. In Lake Superior, concentrations of Hg species were small at pelagic stations (total mercury (HgT) averaged 0.49 ng/L, MeHg averaged 6.4 pg/L). In contrast, MeHg concentrations in tributaries ranged from 100 to 250 pg/L. Watershed sites dominated by wetlands exhibited the greatest MeHg concentrations, occasionally in excess of 12 ng/L. Samples of bulk zooplankton ranged from 20 to 130 ng/g dry weight HgT and from 15 to 45 ng/g dry weight MeHg, and demonstrated typical bioacculmulation of mercury as well as distinct seasonality in concentrations.
Competitive mechanisms underlying synapse elimination in the lumbrical muscle of the rat
Authors: Betz W. J. , Ribchester R. R. , Ridge R. M. A. P. 
Published: March 2003

AbstractThe process of neuromuscular synapse elimination has been studied in the fourth deep lumbrical (4DL) muscle of the rat, a preparation which offers technical advantages for some types of experimental work. Studies have been performed both during development and in adult denervated muscles undergiong reinnervation. Results indicate that synapse elimination is dependent upon competition between motoneurons. Cellular mechanisms underlying this competition have also been explored. Both neuromuscular activity and muscle fiber type recognition appear to play a role, but positional cues appear unimportant in this small muscle.
Ultrasound assessment of large joint amyloidosis in haemodialysis
Authors: Lanteri Marc , Ptasznik Ronnie , Hennesy Oliver , Constable Leonie , Dawborn John Kenneth 
Published: March 2003

SUMMARY:Dialysis‐related amyloidosis (DRA), associated with beta‐2 microglobulin deposition, is a common cause of morbidity in patients with renal failure undergoing chronic dialysis. The non‐invasive diagnosis of DRA in its early stages is difficult. High resolution ultrasound (US) was used to examine the shoulder, hip and knee joints of 25 chronic haemodialysis patients, and features distinctive of DRA were determined. Distinctive US features were associated with increased total duration of dialysis (15 ± 5 vs 4 ± 2 years), carpal tunnel syndrome (9/10 cases) and shoulder joint discomfort (19 vs three joints). These features include altered rotator cuff echogenicity (hyperechoic and hypoechoic areas; 20/48 joints), hypoechoic material in the biceps sheath (16/48), erosions of bone (15/48) and reduced biceps tendon fibril echogenicity (12/48). These changes are unique in the experience of the current authors, but histological proof that they are definitely the result of DRA has not yet been possible. Tears of the rotator cuff tendons (14/50) were not consistently associated with symptoms (7/14). Tendon thickness was also increased (as has been described previously). The hip capsule thickness was increased in patients with signs of DRA in the shoulder, but no specific changes in texture were seen. Asymptomatic knee joint effusions were present in 40/50 joints (80%). These features detectable on high resolution US allow the non‐invasive early detection of DRA and are useful in the diagnosis and management of this condition.
Defining relationships and limiting power: two leaders of Australian nursing, 1868–1904*
Authors: Godden Judith , Forsyth Sue 
Published: March 2003

Defining relationships and limiting power: two leaders of Australian nursing, 1868–1904 This paper analyses aspects of the relationship between nursing and medicine during 1868–1904, in terms of power, gender and authority. A biographical approach is used with a focus on two leading nurses in Australia and their relationship with two leading medical practitioners. The first nurse is Lucy Osburn, the figurehead of the first generation of Nightingale nursing in Australia. The second nurse represents the second generation when Nightingale nursing had largely won acceptance and was firmly established in Australian hospitals: she is Susan McGahey. Their main medical antagonists were Dr Alfred Roberts and Dr Anderson Stuart. A struggle over the control of nursing is evident in these relationships. The outcome transcended personalities, greatly influenced the structure of modern nursing, and marked the rising tide of medical domination in Australia.
The social production of an enterprise clinic: nurses, clinical pathway guidelines and contemporary healthcare practices
Authors: Barnes Lynne 
Published: March 2003

The social production of an enterprise clinic: nurses, clinical pathway guidelines and contemporary healthcare practicesIn this paper I critically engage with the forming of contemporary nursing practice with/in an ‘enterprise clinic’ in order to discuss the practical potential of developing a mode of reflective practice that is a critical ontology of self. Critical engagement in the paper is secured through a ‘troubling’ of the relationship between the contemporary practices of both the self and governance, without the reduction of one to the other. The paper draws on my doctoral study in which I combined the techniques of ethnography and discourse analysis in order to critically examine registered nurses’ employment of clinical pathway guidelines through an analysis of the political technologies through which that engagement was constituted. This critical purchase was applied because of the influence of the contemporary ‘problematisation’ of healthcare provision in western society on the formation and deployment of the professional identities of nurses.