bluuebunny/crossref_metadata_2025_split huggingface dataset:
Experience Rating versus Employment Protection Laws in a Model where Firms Monitor Workers*
Authors: Fath Julia , Fuest Clemens 
Published: August 2005

AbstractWhile layoff costs in the U.S. are mostly due to experience‐rated unemployment insurance, layoff costs in European labour markets are primarily a consequence of employment protection laws. In this paper we compare the effects of experience rating and employment protection laws on employment and welfare in a model where unemployment arises due to efficiency wage setting and where labour turnover is inefficiently high. We show that a revenue‐neutral introduction of experience rating reduces labour turnover and increases employment and welfare. The introduction of employment protection laws may also reduce labour turnover but employment declines.
Home versus School Learning: A New Approach to Estimating the Effect of Class Size on Achievement
Authors: Lindahl Mikael 
Published: August 2005

AbstractThe effects of class size on scholastic achievement are estimated using a seasonal feature of the school system. The fact that schools are in session during the school year and out of session during the summer makes it possible to control for non‐school influences on both the level of and changes in achievement. Using Swedish data, smaller classes are found to generate higher test scores and this effect is larger for immigrants. The results are also compared with those from applying the same data to the widely used value‐added model.
Sexuality and sexual activity in pregnancy
Authors: Bartellas Elias , Crane Joan M. G. , Daley Melita , Bennett Kelly A. , Hutchens Donna 
Published: August 2005

Objectives
To evaluate women's sexual experience in pregnancy, and to describe their sources of information regarding sexuality during this period.Design
Cross‐sectional study.Setting
The offices of obstetricians providing obstetric care in a tertiary care university hospital in St. John's, Newfoundland, Canada.Population
One hundred and forty‐one pregnant women.Methods
Pregnant women anonymously completed self‐administered questionnaires regarding sexuality and sexual activity during pregnancy. Responses were summarised using descriptive statistics, and comparisons were made between the trimesters of pregnancy. Multiple logistic regression was performed to assess the influences of a variety of factors on sexual activity.Results
Vaginal intercourse and sexual activity overall decreased throughout pregnancy (P= 0.004 and 0.05, respectively) with the trimester of pregnancy being the only independent predictor. Most women reported a decrease in sexual desire (58%). Overall, 49% of women worried that sexual intercourse may harm the pregnancy. Concerns regarding sexual activity leading to preterm labour or premature rupture of membranes increased as the pregnancy progressed (P < 0.001 and P= 0.001, respectively). Only 29% of women discussed sexual activity in pregnancy with their doctor and 49% of these women raised the issue first, with 34% feeling uncomfortable in bringing up the topic themselves. Most women (76%) who had not discussed these issues with their doctor felt they should be discussed.Conclusions
A reduction in sexual activity, vaginal intercourse and sexual desire occurs in many women as pregnancy progresses. Both the woman and her partner have concerns regarding complications in the pregnancy as a result of sexual intercourse. The majority of women wish to discuss these issues with their doctor, but are not always comfortable raising the topic themselves.
Pregnancy outcome in carriers of fragile X
Authors: Kallinen Juuso , Korhonen Kati , Kortelainen Saara , Heinonen Seppo , Ryynänen Markku 
Published: August 2005

Objective
To evaluate pregnancy outcome in women who are carriers of fragile X.Design
Cross‐sectional case‐control study.Setting
Department of Obstetrics and Gynaecology, Kuopio University Hospital, Finland.Sample
Sixty‐three singleton pregnancies in carriers of fragile X who were referred for genetic counselling and prenatal diagnosis to Kuopio University Hospital.Methods
Logistic regression analysis was used to compare pregnancy outcome in women who are fragile X carrier with outcome of the general obstetric population.Results
Carriers of fragile X often experienced more bleeding in late pregnancy than did the reference group. Otherwise, the course and outcome of pregnancy were comparable in both groups.Conclusion
Pregnancy outcome in women who are carriers of fragile X is favourable. There is no need to initiate special fetal monitoring because of the fragile X status of the woman.
Cord blood oxygen saturation in vigorous infants at birth: what is normal?
Authors: Arikan G. M. , Scholz H. S. , Petru E. , Haeusler M. C. H. , Haas J. , Weiss P. A. M. 
Published: August 2005

Objective
To define the normal ranges of umbilical cord blood oxygen saturation (SaO2) and acid‐base status at birth and to evaluate the effect of gestational age on cord blood values in vigorous newborn infants following spontaneous vaginal birth from a vertex position.Design
Prospective study.Setting
Department of Obstetrics and Gynaecology, University of Graz, Austria.Sample
Cord blood samples from 1281 vigorous newborn infants.Methods
Cord blood sampling was performed following on newborn infants following spontaneous vaginal birth in a vertex position. SaO2 was measured directly by a spectrophotometer and pH, base excess, pCO2 and pO2 by a pH/blood‐gas analyser. Infants with a 5‐minute Apgar score ≥ 7 were considered vigorous. Subgroups were classified according to the gestational age: preterm, term and postterm (< 37, 37–42 and > 42 weeks, respectively).Results
The median umbilical artery SaO2 was 24.3% and the 2.5th centile was as low as 2.7%. The median umbilical artery values were pH = 7.25, base excess =−4.3 mmol/L and pO2= 16 mmHg. The 2.5th centiles were 7.08, −11.1 mmol/L and 5 mmHg, respectively. The median umbilical artery pCO2 was 50 mmHg and the 97.5th centile was 75 mmHg. The mean umbilical artery and vein SaO2 values were not significantly influenced by gestational age. The umbilical artery SaO2 and base excess values were strongly skewed. The mean umbilical artery pH values in preterm infants were higher than in other subgroups. The mean umbilical artery and vein base excess values were lower in post‐term newborn infants than in other subgroups.Conclusions
The physiological range of oxygen saturation in umbilical cord of vigorous newborn infants at birth is wide and skewed. In contrast to pH and base excess, umbilical cord blood oxygen saturation is not influenced significantly by gestational age at birth.
The impact of adhesions on hospital readmissions over ten years after 8849 open gynaecological operations: an assessment from the Surgical and Clinical Adhesions Research Study
Authors: Lower Adrian M. , Hawthorn Robert J. S. , Emeritus Harold Ellis , O'Brien Fiona , Buchan Scot , Crowe Alison M. 
Published: August 2005

Objective
To investigate the epidemiology of, and the clinical burden related to, adhesions following gynaecological surgery.Population
The Scottish National Health Service Medical Record Linkage Database was used to define a cohort of 8849 women undergoing open gynaecological surgery in 1986.Methods
All readmissions for potential adhesion related disease in the subsequent 10 years were reviewed.Main outcome measures
Readmissions and the degree of adhesion involvement gave an indication of clinical burden and workload. The rate of readmission following the initial surgery determined the relative risk of disease related to adhesions.Results
Two hundred and forty‐five (4.5%) of 5433 readmissions following open gynaecological surgery were directly related to adhesions. 34.5% of patients were readmitted, on average 1.9 times, for a problem potentially related to adhesions or for further intra‐abdominal surgery that could be complicated by adhesions. Readmissions related to adhesions continued throughout the 10 year period of the study. The overall rate of readmission was 64.0/100 initial operations. For readmissions directly related to adhesions, the rate was 2.9/100 initial operations. Operations on the ovary had the highest rate directly related to adhesions (7.5/100 initial operations), with an overall rate of readmission of 106.4/100 initial operations.Conclusions
Despite the conservative approach taken in this study, the clinical burden, workload and relative risk of readmissions related to adhesions following open gynaecological surgery was considerable. Post‐operative adhesions have important consequences for patients, surgeons and the healthcare system. These results emphasise the need for more effective strategies to prevent adhesions.
A pilot study of Hypericum perforatum for the treatment of premenstrual syndrome
Authors: Stevinson Clare , Ernst Edzard 
Published: August 2005

Objective
To investigate whether Hypericum perforatum could relieve symptoms of premenstrual syndrome in a small group of women in order to establish a hypothesis and to test methods for conducting a future randomised controlled trial.Design
Prospective, open, uncontrolled, observational study.Setting
Department of Complementary Medicine, University of Exeter.Population
Nineteen women with premenstrual syndrome who were in otherwise good physical and mental health and not taking other treatments for premenstrual syndrome.Method
Volunteers underwent a preliminary screening interview, completed Daily Symptom Ratings for one cycle, and attended a medical screening visit before being diagnosed with premenstrual syndrome. Participants took hypericum tablets for two complete menstrual cycles (1 × 300 mg hypericum extract per day standardised to 900 μg hypericin).Main outcome measures
Symptoms were rated daily throughout the trial using a validated measure. The Hospital Anxiety and Depression scale and modified Social Adjustment Scale were administered at baseline and after one and two cycles of treatment.Results
There were significant reductions in all outcome measures. The degree of improvement in overall premenstrual syndrome scores between baseline and the end of the trial was 51%, with over two thirds of the sample demonstrating at least a 50% decrease in symptom severity. Tolerance and compliance with the treatment were encouraging.Conclusion
The results of this pilot study suggest that there is scope for conducting a randomised, placebo‐controlled, double‐blind trial to investigate the value of hypericum as a treatment for premenstrual syndrome.
Epilepsy and pregnancy: effect of antiepileptic drugs and lifestyle on birthweight
Authors: Hvas Christian Lodberg , Henriksen Tine Brink , østergaard John R. , Dam Mogens 
Published: August 2005

Objective
To investigate the impact of epilepsy and antiepileptic drugs on length of gestation and anthropometric measures of the newborn.Design
Cohort study based on questionnaires mailed to all pregnant women who attended for prenatal care at our department from August 1989 to January 1997.Setting
Department of Obstetrics and Gynaecology at Aarhus University Hospital, Denmark.Participants
One hundred and ninety‐three singleton pregnancies in women with epilepsy were compared with 24,094 singleton pregnancies in women without epilepsy.Main outcome measures
Preterm delivery, small for gestational age, mean gestational age, gestational age‐adjusted birthweight, head circumference, and body length.Results
Children of women with epilepsy who smoked had lower gestational age and were at increased risk of preterm delivery (OR 3.4; 95% CI 1.8–6.5), compared with children born by nonepileptic women who smoked. Birthweight adjusted for gestational age was reduced by 102 g (95% CI 40–164) in women with epilepsy, and the risk of delivering a child who was small for gestational age was increased (adjusted OR 1.9, 95% CI 1.3–2.7), compared with women without epilepsy. Newborn babies of women with epilepsy treated by drugs had a reduced adjusted birthweight (208 g, 95% CI 116–300), head circumference (0.4 cm, 95% CI 0.0.0.7), and body length (0.5 cm, 95% CI 0.1–1.0), compared with the newborn infants of women without epilepsy.Conclusions
Women with epilepsy who smoked were at increased risk of preterm delivery compared with healthy smokers. Children of women with drug treated epilepsy had lower birthweight, length, and head circumference than children of women without epilepsy.
A randomised controlled trial and meta‐analysis of active management of labour
Authors: Sadler L. C. , Davison T. , McCowan L. M. E. 
Published: August 2005

Objective
To test whether a policy of active management of nulliparous labour would reduce the rate of caesarean section and prolonged labour without influencing maternal satisfaction.Design
Randomised controlled trial.Setting
Tertiary referral obstetric unit, Auckland, New Zealand.Population
Nulliparous women in spontaneous labour at term with singleton pregnancy and cephalic presentation and without fetal distress.Methods
After the onset of active labour, previously consented women were randomly assigned to active management (n= 320) or to routine care (n= 331). Active labour was defined as regular painful contractions, occurring at least once in five minutes, lasting at least 40 seconds, accompanied by either spontaneous rupture of the membranes, or full cervical effacement and dilatation of at least two centimetres. Active management included early amniotomy, two‐hourly vaginal assessments, and early use of high dose oxytocin for slow progress in labour. Routine care was not prespecified. Prolonged labour was > 12 hours duration. Maternal satisfaction with labour care was assessed by postal questionnaire at six weeks postpartum.Main outcome measures
Mode of delivery, duration of labour, and maternal satisfaction.Results
Active management of labour did not reduce the rate of caesarean section 30/320 (9.4%), compared with 32/331 (9.7%) for routine care, but did shorten the length of first stage of labour (median 240 min vs 290 min; P= 0.02), and reduce the relative risk of prolonged labour (RR 0.39; 95% CI 0.22, 0.71). There were no differences between groups in the rates of newborn nursery admission, neonatal acidosis, low Apgar scores, or postpartum haemorrhage. Satisfaction with labour care was high (77%) and did not differ between groups.Conclusions
Active management of labour reduced the duration of the first stage of labour without affecting the rate of caesarean section, maternal satisfaction, or other maternal or newborn morbidity.
How can the incidence of negative specimens resulting from large loop excision of the cervical transformation zone (LLETZ) be reduced? An analysis of negative LLETZ specimens and development of a predictive model
Authors: Howells R. E. J. , O'Mahony F. , Tucker H. , Millinship J. , Jones P. W. , Redman C. W. E. 
Published: August 2005

Objective
To analyse biopsies of large loop excision of the transformation zone of the cervix; to identify factors associated with negative histology; and to develop predictive models in order to reduce the number of negative loop excisions.Design
Retrospective analysis of patient notes and audit database.Setting
Colposcopy clinic of a large district general hospital in North Staffordshire.Population
Four hundred and fifty‐two women who underwent a large loop excision of the transformation zone (LLETZ) procedure for suspected cervical intraepithelial neoplasia.Methods
Women who underwent a LLETZ procedure were placed in two different groups, one positive for cervical intra epithelial neoplasia and the other negative for cervical intra epithelial neoplasia. Information was obtained on a number of clinical and colposcopic variables. Analysis was undertaken to determine if there were any differences between the two groups. These factors were then identified and three predictive models generated. Receiver‐operator characteristic curves were used to assess and test these models.Main outcomes measures
To identify factors associated with negative histology on a LLETZ specimen. To predict how to reduce the number of negative LLETZ specimens.Results
Four hundred and fifty‐two women underwent a LLETZ procedure, 88 were negative (19%) and 364 were positive (81%). In women who were treated at their first visit, 56/316 (18%) had negative histology. There were significant associations between negative histology in the LLETZ and negative or low grade cytological atypia, negative colposcopic findings and years of age > 50 in both bivariate analysis and stepwise logistic regression. In the predictive models, the sensitivity ranged between 72% and 80%, the specificity 59%–72%, and the area under the receiver‐operator characteristic was 0.75–0.77. If we had used the predictor models and managed women with negative or low grade cervical atypia and negative colposcopy findings conservatively, we would have reduced the negative biopsy rate from 19% to 14%, but five cases of high grade disease and 25 cases of low grade disease would have been missed. If we had also included women aged > 50 years in this model, the negative biopsy rate would have dropped from 19% to 15%, with only one case of high grade disease and 11 cases of low grade disease missed. All these women would require continued cytological and colposcopic surveillance. Importantly, no cases of invasion would have been missed.Conclusion
Using a predictive model can reduce the number of negative LLETZ specimens, but at the expense of continued cytological and colposcopic surveillance and cannot be recommended in normal practice. This raises the question whether current standards for negative histology in LLETZ specimens are set unrealistically high.
A discrepancy between gestational age estimated by last menstrual period and biparietal diameter may indicate an increased risk of fetal death and adverse pregnancy outcome
Authors: Nguyen Tri huu , Larsen Torben , Engholm Gerda , Møller Henrik 
Published: August 2005

Objective
To determine if the discrepancy between gestational age estimated by last menstrual period and by biparietal diameter (GALMP− GABPD) is associated with adverse pregnancy outcome.Design
Population‐based follow up study.Population
Singleton pregnancies were studied when a reliable date of last menstrual period and biparietal diameter measured between 12 and 22 weeks of gestation was available (n= 16,469).Methods
Logistic regression analysis and Kaplan‐Meier survival analysis were used to analyse the association between GALMP− GABPD and adverse pregnancy outcome.Main outcome measures
Adverse outcome was defined as abortion after 12 weeks of gestation, stillbirth or postnatal death within one year of birth, delivery < 37 weeks of gestation, a birthweight < 2500 g or a sex‐specific birthweight lower than 22% below the expected.Results
The risk of death was more than doubled if GALMP− GABPD of ≥ 8 days was compared with GALMP− GABPD of < 8 days (OR 2.2; 95% CI 1.6–3.1). The risk of death was a factor of 6.1 higher if GALMP− GABPD of ≥ 8 days was combined with increased (> 2 × multiple of median) maternal alphafetoprotein measured in the 2nd trimester.Conclusions
A discrepancy between GALMP and GABPD generally reflects the precision of the two methods used to predict term pregnancy. However, a positive discrepancy of more than seven days, particularly with high maternal alpha‐fetoprotein, might indicate intrauterine growth retardation and an increased risk of adverse perinatal outcome.
Evaluation of a human papillomavirus assay in cervical screening in Zimbabwe
Authors: Womack Sharita D. , Chirenje Z. M. , Blumenthal Paul D. , Gaffikin Lynne , McGrath John A. , Chipato T. , Ngwalle E. , Shah Keerti V. 
Published: August 2005

Objective
To determine the utility of an assay for high risk genital human papillomavirus (HPV) in cervical screening in Zimbabwe, Africa.Design
Cross‐sectional study.Setting
Harare, Zimbabwe.Population
Zimbabwe women (n= 2140), 25 to 55 years old, recruited in clinics in Chitungwiza and Greater Harare.Methods
Genital specimens were assessed for HPV, using the HPV DNA test Hybrid Capture II (probe B). Further assessment of the women was conducted using colposcopy and biopsy as indicated. High grade squamous intraepithelial lesions were diagnosed in 215 women. Colposcopy and/or biopsy showed low grade lesions in 346 women.Results
The overall prevalences were: 42.7% for HPV, 10% for high grade squamous intraepithelial lesions and 16% for low grade lesions. Prevalence for HPV decreased significantly with increase in age (P for trend < 0.0001) and increased significantly with increasing disease severity, from 35% in normal women, to 53% in women with low grade lesions and 81% in women with high grade lesions (P for trend < 0.001). In specimens positive for HPV, the amount was 14‐fold higher in women with high grade lesions compared with normal women. In screening for high grade lesions the assay for HPV had a sensitivity of 81% (CI 75%–86%); sensitivity for low grade lesions was 64% (CI 60%–68%). Specificity was 62% (CI 59%–64%) for high grade lesions and 65% (CI 62%–67%) for low grade lesions. The positive predictive value was 19% (CI 17%–22%) for high grade lesions and 39% (CI 36%–42%) for low grade lesions.Conclusion
For high grade squamous intraepithelial lesions the sensitivity of the Hybrid Capture II HPV DNA test was high, but the specificity was relatively low. The test may therefore be most useful in conjunction with other screening tests.
Quality of medical information about menorrhagia on the worldwide web
Authors: Latthe Pallavi M. , Latthe Manish , Khan Khalid S. 
Published: August 2005

Objective
To evaluate the quality of medical information on the management of menorrhagia on the worldwide web.Design and procedures
An on‐line search of the Internet, locating relevant web sites by using key phrases ‘heavy periods’ and ‘patient information’ in seven search engines. Quality was defined as the extent to which the characteristics of a web page satisfied its stated and implied objectives. Assessment focused on credibility and content of each web page. Source, currency and editorial review process assessed credibility and hierarchy and accuracy of evidence assessed content of the web pages.Main outcome measures
Rate of compliance with preset criteria for quality of health information on the Internet.Results
Nine relevant web pages were located, none of which complied with all of the criteria for quality. Seven of these pages displayed the source and five showed the currency of the information, while none described an editorial review process. Four web pages displayed a hierarchy of evidence and one web page depicted all the criteria for accuracy of its contents.Conclusion
None of the web pages provided complete information to women on heavy periods according to the quality criteria. This makes it difficult for the user without medical knowledge to determine which web page is credible and useable and which should be ignored or rejected. There is a need to be vigilant about the quality of information on the Internet.