bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neonatal resuscitation: Review of ventilation equipment and survey of practice in Australia and New Zealand
Authors: O'Donnell CPF , Davis PG , Morley CJ 
Published: March 2004

Objective:  The equipment used to provide positive pressure ventilation at neonatal resuscitation varies between institutions. Available devices were reviewed and their use surveyed in a geographically defined region. The aim of this study was to establish which resuscitation equipment is used at neonatal intensive care units in Australia and New Zealand.Methods:  A questionnaire was sent to a neonatologist at each of the 29 neonatal intensive care units in Australia and New Zealand, asking which resuscitation equipment they used. If it was not returned, follow up was by email and telephone.Results:  Data was obtained from all units. Round face masks are used at all centres. Anatomically shaped masks are infrequently used at two of the three centres (10%) that have them. Straight endotracheal tubes are used exclusively at 23 (79%) centres. Shouldered tubes are used infrequently at three of the six centres that have them. The Laerdal Infant Resuscitator self‐inflating bag is used at 22 (76%) centres. Flow‐inflating bags are used at 12 (41%) centres. The Neopuff Infant Resuscitator is used at 14 (48%) centres. Varying oxygen concentrations are provided at delivery at 6/25 (24%) centres.Conclusions:  There is a paucity of evidence for the efficacy of the equipment used currently to resuscitate newborn infants. This complete survey of the tertiary centres in a geographical region shows considerable variation in practice, reflecting this lack of evidence and consequent uncertainty among clinicians. Further research is necessary to determine which devices are preferable for this most important and common intervention.
Paracetamol pro re nata orders: An audit
Authors: Lamb SA , Henry RL 
Published: March 2004

Objectives:  Paracetamol is used widely in hospital practice, but little is known of the details concerning prescribing practices. This study compared the prescribing habits of physicians with regard to paracetamol, pro re nata (PRN), with the nursing interpretation of the order and with evidence‐based practice.Methods:  The charts of 313 children were reviewed. An audit of 100 children, in whom paracetamol PRN had been prescribed, noted whether an indication for its use was written by the physician. The physician was asked what he/she intended the prescription to mean. The nurses who had signed for administration were asked what their indications were for giving the paracetamol. The hospital guidelines on the prescribing of paracetamol were compared to the clinical practices of the doctors and nurses.Results:  Seventy‐four percent of all the charts had an order for paracetamol. An audit of 100 children revealed that only one physician had provided written indications for administration of paracetamol. There were frequent miscommunications between physicians and nurses about the intention of the order for paracetamol. Nurses tended to administer paracetamol at lower temperatures than doctors had intended. In other cases, what the physician had intended as the indication for paracetamol was quite different from what the nurse understood. There were also considerable variations in interpretations within their craft groups.Conclusion:  What was observed in this study was idiosyncratic ordering and administration of paracetamol. It is unlikely that this problem is unique to a single hospital. The current situation needs to be addressed as a system issue, with the challenge being to develop more objective indications for the use of paracetamol, and to ensure the medical staff are more explicit in what their orders mean.
One‐year neurodevelopmental outcome after moderate newborn hypoxic ischaemic encephalopathy
Authors: Carli G , Reiger I , Evans N 
Published: March 2004

Objectives:  To define the 1‐year neurodevelopmental outcome for survivors of moderate (Sarnat stage 2) neonatal hypoxic‐ischaemic encephalopathy (HIE) to facilitate appropriate parental counselling.Methods:  Hospital‐based retrospective review of admissions to a tertiary newborn intensive care unit between 1988 and 2000. All babies admitted for seizures were reviewed and those in whom the probable diagnosis was moderate HIE were identified from chart review. Perinatal variables, number of anticonvulsants, duration of hospital stay and 1‐year neurodevelopmental outcome was recorded in survivors.Results:  Fifty‐three babies who survived probable moderate HIE were identified. Forty‐two of these were seen at 1 year of age. Of these, 22 (52%) had normal development and neurological examination and four (9.5%) had mild developmental delay with normal neurological examination. Thirteen babies (31%) had cerebral palsy, 11 of whom also had developmental delay. Two infants (5%) who had been severely impaired at 6 months died before 1 year of age. Overall, 36% of survivors of the neonatal period had significant disability and or had died by 1 year of age. Duration of anticonvulsant treatment and length of hospital stay were significantly related to adverse outcome.Conclusions:  These data suggest morbidity rates after moderate HIE in the upper end of the range previously described in the literature. Systematic longer‐term follow up of this high‐risk group of infants is needed.
Growth hormone and insulin‐like growth factor 1 levels and their relation to survival in children with bacterial sepsis and septic shock
Authors: Önenli‐Mungan N , Yildizdas D , Yapicioglu H , Topaloglu AK , Yüksel B , Özer G 
Published: March 2004

Objectives:  Despite improved supportive care, the mortality of sepsis and septic shock is still high. Multiple changes in the neuroendocrine systems, at least in part, are responsible for the high morbidity and mortality. A reduced circulating level of insulin‐like growth factor and an elevated level of growth hormone are the reported characteristic findings early in the course of sepsis and septic shock in adults. The aim of this study was to evaluate the changes of growth hormone/insulin‐like growth factor 1 axis in sepsis and septic shock and investigate the relationship between these hormones and survival.Methods:  Fifty‐one children with sepsis (S), 21 children with septic shock (SS) and 30 healthy, age‐ and sex‐matched children (C) were enrolled in this study. Growth hormone, insulin‐like growth factor 1 and cortisol levels of the sepsis and septic shock groups were obtained before administration of any inotropic agent.Results:  Growth hormone levels were 32.3 ± 1.5 µIU/mL (range 4−56), 15.9 ± 0.6 µIU/mL (range 11−28) and 55.7 ± 2.7 µIU/mL (range 20−70) in S, C and SS groups, respectively. The difference between the growth hormone levels of the S and C groups, S and SS groups, and C and SS groups were significant (P < 0.001). Non‐survivors (54.7 ± 1.6 µIU/mL) had significantly higher growth hormone levels than survivors (29.4 ± 1.5 µIU/mL) (P < 0.001). Insulin‐like growth factor 1 levels were 38.1 ± 2.1 ng/mL (range 19−100), 122.9 ± 9.6 ng/mL (range 48−250) and 22.2 ± 1.9 ng/mL (range 10−46) in the S, C and SS groups, respectively, and the difference between the insulin‐like growth factor 1 levels of the S and C, S and SS, and C and SS groups were significant (P < 0.001). Non‐survivors (8.8 ± 1.1 µg/dL) had significantly lower cortisol levels than survivors (40.9 ± 2.1 µg/dL) (P < 0.001). We detected a significant difference between the levels of cortisol in non‐survivors (19.7 ± 1.8 µg/dL) and survivors (33.9 ± 0.9 µg/dL) (P < 0.01).Conclusions:  There were elevated levels of growth hormone with decreased levels of insulin‐like growth factor 1 in children during sepsis and septic shock compared to healthy subjects. In addition, there were even higher levels of growth hormone and lower levels of insulin‐like growth factor 1 in non‐survivors than in survivors. We think that both growth hormone and insulin‐like growth factor 1 may have potential prognostic value to serve as a marker in bacterial sepsis and septic shock in children. As there is insufficient data in the paediatric age group, more studies including large numbers of patients and additionally evaluating cytokines and insulin‐like growth factor binding proteins are needed.
Sociology and political arithmetic: some principles of a new policy science1
Authors: Lauder Hugh , Brown Phillip , Halsey A.H. 
Published: March 2004

AbstractThis paper advances the position that sociology needs to develop an approach to research which focuses on fundamental social problems. In doing so it shares many of the intellectual values and goals of political arithmetic while seeking to move methodologically beyond it. Since such problems are complex they will require, typically, interdisciplinary input and a concomitant approach to the development and appraisal of theories. We are not, therefore, advocating the primacy of sociology but arguing that it has a distinctive part to play in addressing the fundamental problems of the twenty‐first century. However, a policy‐oriented sociology has also to take up the task, so clearly defined by the tradition of political arithmetic, which is to hold governments to account. Consequently a central principle of a new policy science is that it should contribute to democratic debate about policy.
Talking about money: public participation and expert knowledge in the Euro referendum1
Authors: Evans Robert 
Published: March 2004

AbstractThis paper uses the proposed UK referendum on the single European currency as a means of investigating the effect of democratizing science on the scrutiny of conflicting expert advice. Although the referendum has not happened yet, and may not happen at all, the campaigners for and against the Euro have none the less been working for several years to ensure that if, and when, it does happen they are in a position to win it. By exploring how campaigners on both sides of the debate understand the concerns of voters, the paper shows how they are working towards a referendum in which the political dimensions of the Euro are actively minimized in order to avoid alienating key ‘floating voters’. Instead, the campaign is expected to focus on the economic costs and benefits of the Euro for individuals and households, with only limited discussion of issues relating to sovereignty. Whether or not the campaign groups, particularly those that oppose the Euro, can maintain this line remains to be seen but if there is a full and frank public debate about the economic, social and political stakes, then this will be despite the referendum rather than because of it.
Social influences on corporate political donations in Britain1
Authors: Bond Matthew 
Published: March 2004

AbstractIt is argued that institutional features of the British state create collective action problems for the mobilization of corporations as donors to the Conservative Party. Social factors are necessary for overcoming these problems. Using social network analyses, the effect that interlocking directorates have on 250 large British corporations’ decisions to donate are analysed. Instead of the central mobilizing factor being diffuse inner circle mechanisms positively influencing the decision to make a donation, the results show that more particularistic mechanisms such as information bias and control are equally important.
The sociology of subjectivity, and the subjectivity of sociologists: a critique of the sociology of gender in the Australian family
Authors: Uhlmann Allon J. 
Published: March 2004

AbstractIn this era of reflexive sociology it is commonplace that subjectivity is of great sociological concern, and that the comprehension by social researchers of their own subject position is essential. Still, old habits die hard. Focusing on selected texts in the sociology of the Australian family, this paper traces the effects of failing to focus the sociological gaze on subjectivity and its variation across society. Highlighted are some patterns of analytic misconstruction of subjectivity, especially the substitution of measurement for a theory of practice, and the projection by sociologists of their own class‐specific subjectivity onto society at large. Ultimately, this misconstruction turns works like those discussed in this paper into a powerful denial of alternative subjectivities, and a reinforcement of the socially dominant perspective.
Working part‐time: achieving a successful ‘work‐life’ balance?1
Authors: Warren Tracey 
Published: March 2004

AbstractThe role of part‐time employment in the balancing of women's employment and family lives has generated an immense literature. Using data on women working part‐time and full‐time in different level occupations in theBritish Household Panel Survey, this paper argues that it is now vital to move these balancing debates on from their location within work–family rhetoric and to re‐position the study of women's working time in broader work‐life discussions. Work–family debates tend to neglect a number of key domains that women balance in their lives, in addition to family and employment, including their financial security and their leisure. The paper shows that examining the financial situations and the leisure lives of female part‐timers in lower level jobs reveals a less positive picture of their ‘life balancing’ than is portrayed in much work–family literature. Instead, they emerged as the least financially secure employees and, linked to this, less satisfied with their social lives too. It is concluded that since the work‐life system is multi‐ and not just two‐dimensional, it is important to examine how all life domains interrelate with each other. In this way, we would be in a better position to begin to assess all the benefits and disadvantages associated with working part‐time and with other work‐life balancing strategies.
Long term effects of oestrogen therapy on bone loss in postmenopausal women: a 23 year prospective study
Authors: Ahlborg Henrik G. , Johnell Olof , Karlsson Magnus K. 
Published: March 2004

Objective  To determine the long term effect of oestrogen therapy on bone loss after menopause.Design  Prospective observational study over 23 years.Setting  Malmö, Sweden.Subjects  Twenty‐eight women taking oestrogen and 196 women not taking oestrogen during the follow up.Methods  Bone mineral density of the forearm was measured by single‐photon absorptiometry at age 48 and 72 years. Use of oestrogen therapy was noted.Main outcome measure  Rate of forearm bone loss between the age of 48 and 72 years.Results  Women taking oestrogen, for a median of 17 years (range 4 to 26), had 8.7 percentage points (95% CI 3.8–13.5) lower rate of bone loss compared with women not taking oestrogen during the same period. Each year of oestrogen therapy reduced the rate of bone loss by 0.8 percentage points (95% CI 0.2–1.4).Conclusions  The use of oestrogen seems to reduce the rate of bone loss over a period of 23 years, and the longer the duration of the therapy, the less bone loss.
Amniotic fluid inflammatory proteins and digestive compounds profile in fetuses with gastroschisis undergoing amnioexchange⋆
Authors: Burc Laurence , Volumenie Jean‐Luc , De Lagausie Pascal , Guibourdenche Jean , Oury Jean‐François , Vuillard Edith , Sibony Olivier , Blot Philippe , Saizou Carole , Luton Dominique 
Published: March 2004

Objective  In gastroschisis, an inflammatory process related to the presence of digestive compounds may be involved in intestinal damage. We measured the amniotic fluid concentrations of total protein, ferritin and amylase, lipase, γ‐glutamyl transferase and bile acids before each amnioexchange performed in women whose infants had gastroschisis. We estimated the correlation among total proteins, ferritin and digestive compounds and postnatal outcome.Design  All women whose infants had gastroschisis in our fetal medicine unit are offered repeated amnioexchange during the third trimester of pregnancy to improve the quality of the exteriorised bowel at birth. Amniotic fluid was sampled at the beginning of each amnioexchange and total proteins, ferritin and digestive compounds were assayed.Setting  This study was conducted in the Department of Perinatology of the University Hospital Robert Debré in Paris.Population  Thirty pregnant women with a gastroschisis affected fetus diagnosed antenatally.Methods  The biological results were expressed as multiples of the median with respect to a control population.Main outcome measure  Gestational age at delivery and the outcome of the infants were recorded and correlated with amniotic fluid total proteins, ferritin and digestive compounds.Results  There was a positive correlation (P < 0.01) between digestive compounds (except amylase at the final amnioexchange) and ferritin on the one hand, and all digestive compounds and total proteins concentration at the final amnioexchange on the other. In addition, among total proteins amylase and lipase, lipase concentrations were related with parameters of short term outcome (P < 0.05).Conclusion  Amniotic total proteins and ferritin are elevated in fetuses presenting with gastroschisis as a consequence of an inflammatory process. Inflammation may be induced by the presence of digestive compounds in the amniotic fluid. The concentrations of which may constitute a marker of short term outcome of the newborn infant.
Is pre‐eclampsia more than one disease?
Authors: Vatten Lars J. , Skjærven Rolv 
Published: March 2004

Objectives The clinical characteristics of pre‐eclampsia (gestational hypertension and proteinuria) may represent separate pathogenetic conditions. Pre‐eclampsia accompanied by restricted fetal growth may originate from abnormal implantation, and appropriate or high birthweights may indicate a mixture of conditions, ranging from mild pre‐eclampsia with modest placental involvement to hypertensive conditions without placental disease.Design Prospective, observational study.Setting General population.Population We used data from the Medical Birth Registry of Norway, a population‐based registry that has recorded births since 1967. For this study, we used information on length of gestation and presence of pre‐eclampsia among 1,679,205 singletons born between 1967 and 1998. Pre‐eclampsia was diagnosed in 44,220 (2.6%) pregnancies.Methods We studied the risk of pre‐eclampsia in relation to standardised measures (zscores) of birthweight, adjusted for length of gestation, and stratified by term and preterm delivery. We also explored whether gestational diabetes was more prevalent in conjunction with preterm than term pre‐eclampsia.Main outcome measures Pre‐eclampsia diagnosed at term or preterm.Results For pre‐eclampsia diagnosed around term, there was a U‐shaped association with birthweight. Compared with appropriate birthweights for gestation, the risk of term pre‐eclampsia was more than fourfold higher (relative risk [RR] 4.5, 95% confidence interval [CI], 4.3 to 4.7) if the baby's birthweight was lower than two standard deviations under the mean. For birthweights three standard deviations or higher than the mean, pre‐eclampsia was more than twice as likely (RR 2.6, 95% CI 2.2–2.9). In contrast, the risk of preterm pre‐eclampsia displayed an L‐shaped association with birthweight. Low birthweight (less than −2 standard deviations) was associated with greatly increased risk (RR 9.9, 95% CI 9.1–10.9), but for high birthweights (≥3 standard deviations), there was no association with the risk of preterm pre‐eclampsia (RR 1.2, 95% CI 0.7–2.1). The prevalence of gestational diabetes was three times (prevalence ratio 3.3, 95% CI 2.6–3.6) higher in preterm than term pre‐eclampsia.Conclusion Whereas pre‐eclampsia with preterm delivery associated with low birthweight may be caused by underlying placental abnormality, pre‐eclampsia delivered at term may represent a mixture of conditions, ranging from mild pre‐eclampsia with moderate placental affection to hypertensive conditions in pregnancy without placental dysfunction.
Non‐protein‐bound iron and free radical damage in fetuses with rhesus haemolytic disease: influence of intrauterine transfusions
Authors: Luykx L.M. , Berger H.M. , Geerdink J. , Kanhai H.H.H. , Egberts J. 
Published: March 2004

Objective  To determine iron‐induced free radical damage in fetal rhesus haemolytic disease (RHD) before and after repeated intrauterine red blood cell transfusions and its relation to hydrops fetalis.Design  Prospective, observational study.Setting  Department of Obstetrics, Leiden University Medical Centre, the Netherlands.Population  Fifty anaemic fetuses, including 13 hydropic ones, 9 preterm and 12 term neonates and 8 female non‐pregnant adults.Methods  Venous blood plasma samples were collected from 50 fetuses suffering from RHD preliminary to the first, and if appropriate, subsequent intrauterine red blood cell transfusions for determination of iron status including non‐protein‐bound iron (NPBI) and iron‐binding primary antioxidant proteins, total plasma anti‐oxidant capacity and its contributing secondary antioxidants (e.g. vitamin C, uric acid, sulphydryl groups and peroxidation products). Results were compared with values of healthy preterm and term neonates directly at birth and adult controls. Within the fetal haemolytic group, 13 hydropic fetuses were analysed as a separate group.Main outcome measures  Non‐protein‐bound iron, antioxidants, total antioxidant capacity and peroxidation products. Sub analysis of the outcome measures of the hydropic fetuses.Results  RHD fetuses had at initial cordocentesis a significantly higher NPBI level and a significantly lower total plasma antioxidant capacity than control babies and adults. Their vitamin C tended to be more oxidised but lipid peroxidation had not increased, when compared with preterm babies. The repeated intrauterine red blood cell transfusions had a positive effect on the total antioxidant capacity of plasma and did not increase the concentration of NPBI. The hydropic fetuses, who had higher NPBI concentrations and lower plasma protein concentrations and total antioxidant capacity, did not show more peroxidation products in plasma than the non‐hydropic fetuses. Fetuses without reversal of hydrops despite intrauterine transfusions showed decreasing levels of proteins with subsequent transfusions but peroxidation products remained constant.Conclusion  Repeated intrauterine red blood cell transfusions do not lead to free radical damage in the fetus in utero. Iron‐induced free radical activity does not appear to play a causative role in the proceeding of hydrops fetalis in RHD.