bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Clinical Decision Rule to Identify Children at Low Risk for Appendicitis
Authors: Kharbanda Anupam B. , Taylor George A. , Fishman Steven J. , Bachur Richard G. 
Published: September 2005

Objective. Computed tomography (CT) has gained widespread acceptance in the evaluation of children with suspected appendicitis. Concern has been raised regarding the long-term effects of ionizing radiation. Other means of diagnosing appendicitis, such as clinical scores, are lacking in children. We sought to develop a clinical decision rule to predict which children with acute abdominal pain do not have appendicitis.Methods. Prospective cohort study was conducted of children and adolescents who aged 3 to 18 years, had signs and symptoms suspicious for appendicitis, and presented to the emergency department between April 2003 and July 2004. Standardized data-collection forms were completed on eligible patients. Two low-risk clinical decision rules were created and validated using logistic regression and recursive partitioning. The sensitivity, negative predictive value (NPV), and negative likelihood ratio of each clinical rule were compared.Results. A total of 601 patients were enrolled. Using logistic regression, we created a 6-part score that consisted of nausea (2 points), history of focal right lower quadrant pain (2 points), migration of pain (1 point), difficulty walking (1 point), rebound tenderness/pain with percussion (2 points), and absolute neutrophil count of &gt;6.75 × 103/μL (6 points). A score ≤5 had a sensitivity of 96.3% (95% confidence interval [CI]: 87.5–99.0), NPV of 95.6% (95% CI: 90.8–99.0), and negative likelihood ratio of .102 (95% CI: 0.026–0.405) in the validation set. Using recursive partitioning, a second low-risk decision rule was developed consisting of absolute neutrophil count of &lt;6.75 × 103/μL, absence of nausea, and absence of maximal tenderness in the right lower quadrant. This rule had a sensitivity of 98.1% (95% CI: 90.1–99.9), NPV of 97.5% (95% CI: 86.8–99.9), and negative likelihood ratio of 0.058 (95% CI: 0.008–0.411) in the validation set. Theoretical application of the low-risk rules would have resulted in a 20% reduction in CT.Conclusions. Our low-risk decision rules can predict accurately which children are at low risk for appendicitis and could be treated safely with careful observation rather than CT examination.
Obesity, Shame, and Depression in School-Aged Children: A Population-Based Study
Authors: Sjöberg Rickard L. , Nilsson Kent W. , Leppert Jerzy 
Published: September 2005

Objectives. To investigate whether there is an association between adolescent obesity and depression in a nonclinical population and whether psychosocial and economic status and subjective experiences of shame (defined as experiences of being degraded or ridiculed by others) may account for such an association.
Method.We examined associations between self-reported body mass index (BMI) and depression, controlling for gender, shame, parental employment, parental separation, and economy. The study was performed on a sample of 4703 adolescents (71% of the target population of 15- and 17-year-old students in 1 Swedish County) who answered the Survey of Adolescent Life in Vestmanland 2004.
Results.Obesity was significantly related to depression and depressive symptoms among 15- and 17-year-olds. Obesity was also significantly related to experiences of shame. All significant association between BMI grouping and depression according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition disappeared when shaming experiences, parental employment, and parental separation were controlled for. Adolescents who reported many experiences of shame had an increased risk (odds ratio: 11.3; confidence interval: 8.3–14.9) for being depressed.
Conclusions.There is a significant statistical association between adolescent obesity and depression. Effects of experiences of shame, parental separation, and parental employment explain this association. These results suggest that clinical treatment of obesity may sometimes not just be a matter of diet and exercise but also of dealing with issues of shame and social isolation.
Worse Quality of Life for Children With Newly Diagnosed Attention-Deficit/Hyperactivity Disorder, Compared With Asthmatic and Healthy Children
Authors: Escobar Rodrigo , Soutullo Cesar A. , Hervas Amaia , Gastaminza Xavier , Polavieja Pepa , Gilaberte Inmaculada 
Published: September 2005

Objective. To evaluate the quality of life (QOL) of untreated children with newly diagnosed attention-deficit/hyperactivity disorder (ADHD), compared with asthmatic and healthy children.
Methods. This prospective, case-control study included a group of 120 children, 6 to 12 years of age, with newly diagnosed ADHD according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Subjects were matched according to age, gender, and health care area with 2 control groups, ie, 93 asthmatic children and 120 healthy children. Sociodemographic characteristics and Child Health Questionnaire scores were collected.
Results. The QOL of children with ADHD was rated worse than that of asthmatic or healthy children for most Child Health Questionnaire domains. The greatest differences were found in behavior, social limitations attributable to physical problems, emotional impact on parents, and family activities. Almost every psychosocial domain was more affected in comparison with asthmatic children and both psychosocial and physical domains in comparison with healthy children.
Conclusions. ADHD interferes with the daily lives of children, parents, and families even more than asthma, primarily in areas related to psychosocial functioning, although evidence of impaired physical functioning also emerged. Delays in recognition, assessment, and management of ADHD may affect negatively the QOL of those children.
Are Language Barriers Associated With Serious Medical Events in Hospitalized Pediatric Patients?
Authors: Cohen Adam L. , Rivara Frederick , Marcuse Edgar K. , McPhillips Heather , Davis Robert 
Published: September 2005

Objective. Language barriers may lead to medical errors by impeding patient-provider communication. The objective of this study was to determine whether hospitalized pediatric patients whose families have language barriers are more likely to incur serious medical errors than patients whose families do not have language barriers.
Methods. A case-control study was conducted in a large, academic, regional children's hospital in the Pacific Northwest. Case patients (n = 97) included all hospitalizations of patients who were younger than 21 years and had a reported serious medical event from January 1, 1998, to December 31, 2003. Control patients (n = 475) were chosen from hospitalizations without a reported serious medical event and were matched with case patients on age, admitting service, admission to intensive care, and date of admission. The main exposure was a language barrier defined by self- or provider-reported need for an interpreter. Serious medical events were defined as events that led to unintended or potentially adverse outcomes identified by the hospital's quality improvement staff.
Results. Fourteen (14.4%) of the case patients and 53 (11.2%) of the control patients were assigned an interpreter during their hospitalization. Overall, we found no increased risk for serious medical events in patients and families who requested an interpreter compared with patients and families who did not request an interpreter (odds ratio: 1.36; 95% confidence interval: 0.73–2.55). Spanish-speaking patients who requested an interpreter comprised 11 (11.3%) of the case patients and 26 (5.5%) of the control patients. This subgroup had a twofold increased risk for serious medical events compared with patients who did not request an interpreter (odds ratio: 2.26; 95% confidence interval: 1.06–4.81).
Conclusions. Spanish-speaking patients whose families have a language barrier seem to have a significantly increased risk for serious medical events during pediatric hospitalization compared with patients whose families do not have a language barrier.
Decline in the Prevalence of Spina Bifida and Anencephaly by Race/Ethnicity: 1995–2002
Authors: Williams Laura J. , Rasmussen Sonja A. , Flores Alina , Kirby Russell S. , Edmonds Larry D. 
Published: September 2005

Objective. In an effort to reduce the occurrence of neural tube defects (NTDs), folic acid fortification of US enriched grain products was authorized by the Food and Drug Administration in March 1996 and required by January 1998. Fortification has been shown to result in an important decline in the prevalence of spina bifida and anencephaly in the general US population; however, fortification's impact on specific racial/ethnic groups has not been well described. We sought to characterize the decline in the prevalence of spina bifida and anencephaly among specific racial/ethnic groups during the transition to mandatory folic acid fortification in the United States.Methods. Data from 21 population-based birth defects surveillance systems were used to examine trends in prevalence of spina bifida and anencephaly for specific racial/ethnic groups for the years 1995–2002. These years were divided into 3 periods: prefortification, optional fortification, and mandatory fortification. Race/ethnicity was defined as Hispanic, non-Hispanic white, and non-Hispanic black. Prevalence ratios were calculated for each racial/ethnic group by dividing the prevalence from the mandatory fortification period by the prevalence in the prefortification period.Results. The study included data on 4468 cases of spina bifida and 2625 cases of anencephaly. The prevalence of spina bifida and anencephaly was highest among Hispanic births, followed by non-Hispanic white births, with the lowest prevalence among non-Hispanic black births. Significant declines in spina bifida and anencephaly were observed among Hispanic births and non-Hispanic white births. The prevalence ratio for non-Hispanic black births was of borderline significance for spina bifida and was not significant for anencephaly.Conclusions. The results of this study suggest that folic acid fortification is associated with significant decreases in the prevalence of spina bifida and anencephaly among non-Hispanic white and Hispanic births. The magnitude of the reduction was similar between these 2 groups and was more pronounced for spina bifida than for anencephaly. The decline in the prevalence of spina bifida and anencephaly among non-Hispanic black births did not reach statistical significance. Efforts to increase folic acid consumption for the prevention of NTDs in pregnancies among women of all races/ethnicities should be continued, and studies to identify and elucidate other risk factors for NTDs are warranted.
Partial Overhead Tank Cover Use during Feral Brown Trout Rearing
Authors: Barnes Michael E , Miller Jess , Durben Dan J 
Published: August 2005

Abstract
Overhead cover is an essential component of the habitat of wild brown trout Salmo trutta but is typically lacking during hatchery rearing. To evaluate the effect of cover during hatchery rearing, we grew feral brown trout in circular tanks that were either completely open on top or partially (29%) covered. After 51 d of rearing in 2001, the total biomass of fish per tank was significantly greater in the partially covered tanks than in the completely open tanks. Feed conversion was also significantly reduced by the use of partial tank covers (1.13 versus 1.29 in the open tanks). After 45 d of rearing in 2003, the mean total weight gain of fish per tank was 13.8 kg in tanks with partial covers and 12.9 kg in uncovered tanks, and feed conversion was 0.79 for partially covered tanks and 0.85 for uncovered tanks. In addition, fish reared in tanks with partial covers were significantly longer and heavier (56.3 mm, 1.62 g) than fish reared in open tanks (54.1 mm, 1.42 g), although there was no significant difference between the open or partially covered tanks in total tank weight gain or conversion in 2003. No significant differences in percent mortality were observed between groups reared in partially covered and uncovered tanks. The use of partial tank covers can increase the growth of feral juvenile brown trout in circular tanks during hatchery rearing.
Sprint Swimming Performance of Juvenile European Sea Bass
Authors: Nelson Jay A. , Claireaux Guy 
Published: August 2005

AbstractDespite its potential for determining animal success in a variety of ecologically important situations, very little is known about the sprint swimming performance of fishes. To evaluate whether selection on sprint swimming performance occurs in the wild, one must first demonstrate measurable and reproducible variation of sprint performance. In this study, we employ a computer‐controlled laser detection system to study the sprint performance of 75 juvenile European sea bass Dicentrarchus labrax raised under uniform conditions in the laboratory. This percichthyid is a prized sport and food fish in Europe and similar ecologically to the North American striped bass Morone saxatilis. Individual European sea bass were subjected to endurance swimming performance tests and had their active metabolic rates measured to test hypotheses concerning relationships between these measures and sprint performance. Maximal velocity obtained by an individual during repetitive sprint performance trials was very reproducible but varied substantially among individuals. Consecutive sprint trials with an individual revealed that maximal capacity for sprinting could only be ascertained through multiple trials (at least four). The sprint performance test described in this study should be useful for large‐scale studies in which investigators desire performance information on a large number of animals relatively quickly. However, active metabolic rate measurements and an endurance test were not considered effective performance measures for juvenile European sea bass, and there was no relationship between sprint swimming performance and either of the tests.
Population Characteristics and Assessment of Overfishing for an Exploited Paddlefish Population in the Lower Tennessee River
Authors: Scholten George D. , Bettoli Phillip W. 
Published: August 2005

AbstractPaddlefish Polyodon spathula (n = 576) were collected from Kentucky Lake, Kentucky–Tennessee, with experimental gill nets in 2003–2004 to assess population characteristics and the potential for commercial overfishing. Additional data were collected from 1,039 paddlefish caught by commercial gillnetters in this impoundment. Since the most recent study in 1991, size and age structure have been reduced and annual mortality has tripled. In the 1991 study, 37% of the fish collected were older than the maximum age we observed (age 11), and in 2003 annual mortality for paddlefish age 7 and older was high (A = 68%). Natural mortality is presumably low (<10%) for paddlefish; therefore, exploitation in recent years is high. Estimates of total annual mortality were negatively related to river discharge in the years preceding each estimate. The number of paddlefish harvested since 1999 was also negatively related to river discharge because gill nets cannot be easily deployed when discharge exceeds approximately 850 m3/s. Large females spawn annually because all females longer than 1,034 mm eye—fork length (EFL) were gravid. No mature females were protected by the current 864‐mm minimum EFL limit. At a low natural mortality rate, higher size limits when exploitation was high (40–70%) increased simulated flesh yields by 10–20%. Even at low levels of exploitation (21%), spawning potential ratios (SPRs) under the current 864‐mm minimum EFL size limit fell below 20%. If the size limit was raised to 1,016 mm EFL, the population could withstand up to 62% exploitation before the SPR falls below 20%. An analysis of annual mortality caps indicated that the best way to increase the average size of harvested fish is to increase the minimum size limit. Recruitment overfishing probably occurs during drought years; however, variation in river discharge has prevented the population from being exploited at unsustainable rates in the past.
Stream pH as an Abiotic Gradient Influencing Distributions of Trout in Pennsylvania Streams
Authors: Kocovsky Patrick M. , Carline Robert F. 
Published: August 2005

AbstractElevation and stream slope are abiotic gradients that limit upstream distributions of brook troutSalvelinus fontinalisand brown troutSalmo truttain streams. We sought to determine whether another abiotic gradient, base‐flow pH, may also affect distributions of these two species in eastern North America streams. We used historical data from the Pennsylvania Fish and Boat Commission's fisheries management database to explore the effects of reach elevation, slope, and base‐flow pH on distributional limits to brook trout and brown trout in Pennsylvania streams in the Appalachian Plateaus and Ridge and Valley physiographic provinces. Discriminant function analysis (DFA) was used to calculate a canonical axis that separated allopatric brook trout populations from allopatric brown trout populations and allowed us to assess which of the three independent variables were important gradients along which communities graded from allopatric brook trout to allopatric brown trout. Canonical structure coefficients from DFA indicated that in both physiographic provinces, stream base‐flow pH and slope were important factors in distributional limits; elevation was also an important factor in the Ridge and Valley Province but not the Appalachian Plateaus Province. Graphs of each variable against the proportion of brook trout in a community also identified apparent zones of allopatry for both species on the basis of pH and stream slope. We hypothesize that pH‐mediated interspecific competition that favors brook trout in competition with brown trout at lower pH is the most plausible mechanism for segregation of these two species along pH gradients. Our discovery that trout distributions in Pennsylvania are related to stream base‐flow pH has important implications for brook trout conservation in acidified regions. Carefully designed laboratory and field studies will be required to test our hypothesis and elucidate the mechanisms responsible for the partitioning of brook trout and brown trout along pH gradients.
Effects of South African Men’s Having Witnessed Abuse of Their Mothers During Childhood on Their Levels of Violence in Adulthood
Authors: Abrahams Naeemah , Jewkes Rachel 
Published: August 2005

Objectives. We sought to assess the effects of witnessing violence against their mothers in childhood on men’s use of violence in a range of settings in adulthood. Methods. We conducted a cross-sectional questionnaire survey of 1368 randomly selected male municipal workers in Cape Town, South Africa. Results. Almost a quarter (23.5%; 95% confidence interval [CI]=21.2, 25.7) of the men reported witnessing abuse of their mother, and having witnessed such events was associated with men’s later involvement in physical conflicts in their community (odds ratio [OR]=1.72; 95% CI=1.29, 2.30) and at their place of work (OR = 1.83; 95% CI = 1.30, 2.58), use of physical violence against their partners (OR = 2.61; 95% CI = 1.94, 3.54), and arrest for possession of illegal firearms (OR=2.86; 95% CI=1.29, 6.32). Conclusions. Our results show strong links between “publicly” violent behavior among men and childhood experiences of “private” violence against their mothers. Prevention of domestic violence is essential both in its own right and as part of efforts to reduce broader violence and crime in society.
Medicaid Insurance Policy for Youths Involved in the Criminal Justice System
Authors: Evans Cuellar Alison , Kelleher Kelly J. , Rolls Jennifer A. , Pajer Kathleen 
Published: August 2005

Juvenile justice and Medicaid agencies share an interest in serving delinquent youths, many of whom have a relatively poor health status. However, many state and local Medicaid policies result in these youths having no insurance coverage, making access to needed services difficult. A nationally representative survey of state and community juvenile justice and Medicaid agencies was conducted to assess Medicaid policies. Evidence from the survey suggests that in some areas delinquent youths are actively disenrolled from Medicaid benefits, and in others little effort is made to connect them to Medicaid coverage. Discrepancies between justice agency and Medicaid agency responses point to poor communication and coordination. Overall, the survey identified several opportunities for policy intervention to enhance access to services for justice-involved youths.
Gender-Specific Behavioral Health and Community Release Patterns Among New Jersey Prison Inmates: Implications for Treatment and Community Reentry
Authors: Blitz Cynthia L. , Wolff Nancy , Pan Ko-Yu , Pogorzelski Wendy 
Published: August 2005

Objectives. We describe behavioral health diagnoses and community release patterns among adult male and female inmates in New Jersey prisons and assess their implications for correctional health care and community reentry. Methods. We used clinical and classification data on a census of “special needs” inmates (those with behavioral health disorders) in New Jersey (n=3189) and a census of all special needs inmates released to New Jersey communities over a 12-month period (n=974). Results. Virtually all adult inmates with special needs had at least 1 Axis I mental disorder, and 68% of these had at least 1 additional Axis I mental disorder, a personality disorder, or addiction problem (67% of all male and 75% of all female special needs inmates). Of those special needs inmates released, 25% returned to the most disadvantaged counties in New Jersey (27% of all male and 18% of all female special needs inmates). Conclusions. Two types of clustering were found: gender-specific clustering of disorders among inmates and spatial clustering of ex-offenders in impoverished communities. These findings suggest a need for gendered treatment strategies within correctional settings and need for successful reentry strategies.
The High Costs of Aggression: Public Expenditures Resulting From Conduct Disorder
Authors: Foster E. Michael , Jones Damon E. ,   and The Conduct Problems Prevention Research Group
Published: August 2005

Objectives. We explored the economic implications of conduct disorder (CD) among adolescents in 4 poor communities in the United States. We examined a range of expenditures related to this disorder across multiple public sectors, including mental health, general health, school, and juvenile justice. Methods. We used self- and parental-report data to estimate expenditures during a 7-year period in late adolescence of a sample of youths. We contrasted expenditures for youths with CD and youths with oppositional defiant disorder, elevated symptoms (no CD diagnosis), and all others. Diagnosis was determined with a structured assessment. Results. Additional public costs per child related to CD exceeded $70000 over a 7-year period. Conclusions. Public expenditures on youths with CD are substantially larger than for youths with closely related conditions, reflecting the importance of prevention and early treatment for the disorder.