bluuebunny/crossref_metadata_2025_split huggingface dataset:
Child Neglect: Outcomes in High-Risk Urban Preschoolers
Authors: Dubowitz Howard , Papas Mia A. , Black Maureen M. , Starr Raymond H. 
Published: August 2004

Background. Limited longitudinal research has been conducted on the impact of neglect on children’s health and well-being. There is a need to consider the impact of specific subtypes of neglect on children’s functioning. In addition, there is interest in examining the cumulative effect of experiencing &gt;1 subtype of neglect.Objective. To examine the individual and cumulative relationships among physical, psychological, and environmental neglect and children’s behavior and development at age 3, and the impact on changes in children’s behavior and development between ages 3 and 5.Methods. One hundred thirty-six children and their primary caregivers participating in a prospective longitudinal study of children’s development and maltreatment were assessed when the children were aged 3 and 5 years. The children were recruited from primary care clinics because of failure to thrive, risk for human immunodeficiency virus, or as a comparison group. Evaluations were conducted in laboratory and home settings using observations, maternal self-report, and standardized testing of the children. Scores on physical, psychological, and environmental neglect were combined into a Cumulative Neglect Index. Regression analyses were run to examine the association of specific subtypes of neglect and of cumulative neglect with children’s functioning at age 3, controlling for group, sociodemographic risk, and maternal depression. The analyses were repeated examining the impact on child outcomes at age 5, controlling for the above 3 variables as well as the children’s cognitive development and behavior at age 3.Results. Of the subtypes of neglect at age 3, only psychological neglect was significantly associated with increased internalizing and externalizing behavior problems at age 3; the Cumulative Neglect Index was associated with internalizing problems. None of the neglect subtypes or cumulative neglect were predictive of changes in children’s behavior and development between ages 3 and 5. Cognitive development of the entire sample was impaired at age 5, averaging 0.85 standard deviations below the norm, and their average externalizing behavior score was significantly problematic with an average of 0.60 standard deviations above the norm.Conclusions. In the context of poverty where many preschool children have poor cognitive development and increased behavior problems, psychological neglect is significantly related to reported behavior problems. Children who experienced multiple types of neglect had increased internalizing problems. Neglect did not explain changes in children’s behavior or development between ages 3 and 5. There is a need for pediatricians to identify and address child neglect, particularly psychological neglect, as early as possible. Pediatricians should also screen for maternal depression.
Accuracy of Infant Admission Lengths
Authors: Corkins Mark R. , Lewis Pam , Cruse Wendy , Gupta Sandeep , Fitzgerald Joseph 
Published: August 2004

Objective. A variety of methods are used to assess the length of infants at hospital admission. A tape-measure technique is commonly used; however, this measure is potentially inaccurate. We aimed to assess accuracy of tape measurement of infant lengths by comparison with the more accurate length-board technique.
Methods. During a 1-year period, 25 infants who were younger than 36 months were seen for a nutrition consultation. The length obtained at admission was compared with that obtained with a length-board by a trained dietitian.
Results. Overall, the lengths varied enough both positively and negatively that no overall statistical difference was seen; however, the average difference between the tape measure and the length-board was 2.23 cm. The change in length resulted in a change in the weight-for-length percentile range in 13 of 25 patients.
Conclusion. The more accurate length-board measurement should be applied at the time of admission of an infant.
Decreased Arousals in Infants Who Sleep With the Face Covered by Bedclothes
Authors: Franco Patricia , Lipshutz Willy , Valente Filomena , Adams Stephan , Scaillet Sonia , Kahn André 
Published: August 2004

Objective. The risk of becoming a victim of sudden infant death syndrome is increased in infants who sleep with their face under bedding items. The present study was designed to evaluate auditory arousal thresholds of infants who sleep with their face covered by bedclothes.
Methods. Twenty healthy infants with a median age of 11.5 weeks (range: 4–22 weeks) were recorded polygraphically for 1 night. Although they slept in their usual supine position, a bed sheet was placed over their face for 60 minutes. Fifteen of the 20 infants were chosen at random and were exposed to white noises of increasing intensities to determine their auditory arousal thresholds. All infants were challenged with the face covered and with the face free during both rapid eye movement (REM) and non-REM (NREM) sleep. Seven infants were first challenged with the face covered, and 8 were challenged with the face free. The following variables were recorded simultaneously: electroencephalogram, breathing and heart rates, and rectal and pericephalic temperatures. In 5 infants who were not exposed to the auditory challenges, end tidal CO2 was recorded for 30 minutes while sleeping with the face covered.
Results. During REM sleep, arousals occurred for significantly more intense auditory stimuli when the infant’s face was covered than when free. No significant difference was seen in NREM sleep. Compared with the face-free periods, the face-covered sleep periods were characterized by greater rectal and pericephalic temperatures, a greater density of body movements, and a decrease in NREM sleep. Respiratory frequency was increased during the face-covered periods in both REM and NREM sleep. No differences were seen in the frequency or duration of apnea. There was a tendency for heart rate to increase during both sleep stages when the face was covered, compared with the face-free periods, but the changes were not statistically significant. A positive correlation was found between pericephalic temperatures and arousal thresholds (r = 0.60) during REM sleep. End tidal CO2 values increased when the face was covered, reaching a maximum value during the first 5 minutes of the experiment. No fall in oxygen saturation was seen.
Conclusions. Covering the infant’s face with a bed sheet was associated with a significant increase in auditory arousal threshold. The finding could be related to an elevation in temperatures within the infant’s microenvironment.
Comparison Between Pediatricians and Family Practitioners in the Use of the Prokinetic Cisapride for Gastroesophageal Reflux Disease in Children
Authors: Shaoul Ron , Shahory Ron , Tamir Ada , Jaffe Michael 
Published: August 2004

Objective. The North American Society for Pediatric Gastroenterology, Hepatology and Nutrition and the European Society of Pediatric Gastroenterology, Hepatology and Nutrition have recently issued treatment guidelines for the use of cisapride in children. Our hypothesis was that cisapride is misused in the community and is not prescribed according to suggested recommendations. Therefore, the aim of this study was to evaluate the knowledge of pediatricians and family practitioners regarding the prescribing practice and adverse effects of cisapride.Methods. A standardized questionnaire was sent to a randomly selected group of pediatricians and family practitioners in Northern Israel. The questionnaire was designed to evaluate the knowledge of the physician regarding the treatment of gastroesophageal reflux disease and the use of cisapride in children (indications, dosages, duration of treatment, limitations in certain age groups, the need for pretreatment laboratory tests, interactions with other drugs, and contraindications). Replies were scored from 0 to 100 according to the treatment guidelines of both the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition and the European Society of Pediatric Gastroenterology, Hepatology and Nutrition. In addition, 2 questions dealt with the subjective efficacy of the drug and its adverse events.Results. The knowledge scores were 62% and 51% in the pediatricians and family practitioners, respectively. Other major findings were as follows: 1) 40% of pediatricians and 65% of family practitioners do not prescribe the recommended dose of cisapride, 2) 6% of pediatricians and 42% of family practitioners prescribe cisapride for infantile colic, 3) only 50% of pediatricians and 22% of family practitioners were aware of possible interactions with macrolides, and 4) only 31% of pediatricians and 54% of family practitioners were aware that cisapride might cause prolongation of the QT interval. Only minor adverse events were reported.Conclusions. The knowledge of both pediatricians and family practitioners in the use of cisapride in children is suboptimal. It is essential to improve the education of community physicians to reduce the potential for adverse events arising from the misuse of this prokinetic agent.
Use of Indoor Tanning Sunlamps by US Youth, Ages 11–18 Years, and by Their Parent or Guardian Caregivers: Prevalence and Correlates
Authors: Cokkinides Vilma E. , Weinstock Martin A. , O’Connell Mary C. , Thun Michael J. 
Published: August 2004

Background. Tanning parlors have become common in the United States. Artificial ultraviolet radiation exposure from this source may be harmful and may increase the risk of melanoma, particularly when done for recreational purposes during childhood and early adult years. Population-based data on the prevalence and correlates of this activity is important in the evaluation of potential public health interventions for skin cancer prevention.Study Design. In 1998, we conducted a population-based telephone survey of youth and their primary caregiver. The sample (N = 1192) was weighted to represent the population of US youth living in households with a primary caregiver. Interviewers used a standardized questionnaire to document the characteristics of the participant and their practices, attitudes, and experiences regarding ultraviolet exposures.Method of Analysis. Weighted prevalence and adjusted prevalence odds ratios (aPOR) and 95% confidence interval (95% CI) were estimated. Independent factors were evaluated with multivariate logistic regression.Results. Ten percent of youth and 8% of their primary caregivers used indoor tanning sunlamps in the previous year. Thirty percent of the youth whose caregivers used indoor tanning sunlamps did so themselves as well. Independent predictors associated with indoor tanning sunlamp use were as follows: age 17 to 18 years (aPOR = 11.1; 95% CI: 5.0, 25.0); female (aPOR = 8.3; 95% CI: 3.6, 19.2); having a parent who used indoor tanning sunlamps in the previous year (aPOR = 8.7; 95% CI: 4.0, 18.9); nonuser of Sun Protection Factor 15 sunscreen at the beach or pool (aPOR = 1.9; 95% CI: 1.0, 3.4); and low sun sensitivity (aPOR = 2.3; 95% CI: 1.0, 5.3).Conclusion. A substantial minority of American youth engages in indoor tanning. However, it is particularly prevalent among older youth, girls, and youth whose parents themselves use indoor tanning sunlamps. The knowledge of these trends may help focus public health initiatives.
Insulin-like Growth Factor I and Leptin in Umbilical Cord Plasma and Infant Birth Size at Term
Authors: Vatten Lars J. , Nilsen Stein Tore , Ødegård Rønnaug A. , Romundstad Pål R. , Austgulen Rigmor 
Published: August 2004

Objective. To determine the independent contributions to infant birth size of insulin-like growth factor I (IGF-I) and leptin measured in umbilical cord plasma.Methods. Umbilical cord blood was collected in 12 804 consecutive deliveries, and cord plasma from 585 singleton infants born at term after uncomplicated pregnancies was analyzed for leptin, IGF-I, and 2 IGF-binding proteins (IGFBP-1 and IGFBP-3). In multivariable analyses, we assessed maternal and infant covariates of leptin and IGF-I, and we evaluated the independent contribution of cord levels of leptin and IGF-I on infant birth size.Results. Cord plasma levels of IGF-I were lower in women who reported smoking at the beginning of pregnancy compared with nonsmokers. In female infants, levels of IGF-I and leptin were higher than in male infants after adjustment for ponderal index and maternal factors. We found a strong parallel increase in umbilical IGF-I and leptin with increasing birth weight and birth length. For IGFBP-1, there was an opposite pattern: IGFBP-1 increased with decreasing birth size. The multivariable analysis, adjusted for length of gestation and maternal age, parity, prepregnancy weight, smoking during pregnancy, and offspring sex, showed that IGF-I and leptin, independent of each other, were associated with birth weight and birth length.Conclusions. Levels of IGF-I and leptin in umbilical cord plasma were higher in girls than in boys, but in both sexes, these 2 factors contributed independently and positively to birth weight and length. For IGFBP-1, high levels were associated with low birth weight and reduced length. If intrauterine growth is related to the risk of developing adult diseases, IGF-I, IGFBP-1, and leptin may be involved in the underlying processes.1131–1135 insulin like growth factors, leptin, umbilical cord plasma, birth weight.
Enhancing Their Likelihood for a Positive Future: The Perspective of Inner-City Youth
Authors: Ginsburg Kenneth R. , Alexander Penny M. , Hunt Jean , Sullivan Maisha , Zhao Huaqing , Cnaan Avital 
Published: August 2004

Inner-city youth must overcome many environmental challenges as they strive for success. Their outcome is influenced by the interplay of protective forces and risk factors.
Objective. To learn directly from youth what solutions they believe would most influence their likelihood of achieving a positive future.
Design. In-school 8th-, 9th-, and 12th-graders in north Philadelphia generated, prioritized, and explained their own solutions through a 4-stage hierarchical process facilitated by AmeriCorps workers. In Stage 1, 60 randomly selected students participated in 8 focus groups to develop the study question. In Stage 2, youth in Nominal Group Technique sessions generated and prioritized solutions. In Stage 3, a survey for each grade that included their top prioritized ideas was distributed, and youth rated each idea on a Likert scale (5= Definitely would make me more likely to have a positive future to 1 = Would definitely not…). One thousand twenty-two ninth-graders (69% of in-school youth at 5 high schools) returned usable surveys. Ninety-three percent of responders were 14 to 16 years old, 44% were male, 54% were black, and 32% were Latino. Four hundred seventeen 8th-graders and 322 12th-graders returned usable surveys. In Stage 4, youth in 10 focus groups added meaning and context to the ideas.
Results. The highest rated items in all grades were solutions that promoted education or increased job opportunities. Ninth-graders ranked helping youth get into college first by the Marginal Homogeneity Test. The creation of more jobs was ranked second. Third rank was shared by more job training, keeping youth from dropping out of school, and better books for schools. The next tier of items focused mostly on opportunities for youth to spend their free time productively and to have interactions with adults. Many items calling for the reduction of risk behaviors or disruptive surroundings were rated lower. The Kruskal-Wallis test found little variation in rating of the ideas by gender, race, or socioeconomic status.
Conclusions. Youth believe that supportive solutions would do more to enhance their likelihood of reaching a positive future than would attempts to reduce “negative” behaviors or disruptive surroundings. This suggests that research and policies should consider how best to augment the protective influences of education, employment, meaningful use of time, and connection to adults.
Gaucher’s Disease and Fatal Hepatic Fibrosis Despite Prolonged Enzyme Replacement Therapy
Authors: Perel Yves , Bioulac-Sage Paulette , Chateil Jean-François , Trillaud Herve , Carles Jacques , Lamireau Thierry , Guillard Jean-Michel 
Published: August 2004

We report on the case of a girl with type 1 Gaucher’s disease, treated from age 9 to 15 with high-dose enzyme replacement therapy. This treatment did not avert the development of an extensive mutilating hepatic fibrosis warranting a liver transplantation, which was followed by death.In some cases of Gaucher’s disease, alternative strategies such as fractionated or further increased ERT, gene therapy, or glucosyltransferase inhibitor should be explored.
Controlled Trial of Early Dexamethasone Treatment for the Prevention of Chronic Lung Disease in Preterm Infants: A 3-Year Follow-up
Authors: Romagnoli Costantino , Zecca Enrico , Luciano Rita , Torrioli Giulia , Tortorolo Giuseppe 
Published: August 2004

Objective. There is increasing concern in regard to the possible long-term adverse effects of postnatal dexamethasone treatment in preterm infants. The purpose of this study was to assess growth and neurodevelopmental outcome in preterm infants at high risk of chronic lung disease (CLD), treated with early (&lt;96 hours) postnatal dexamethasone.
Design. Three-year follow-up data of physical growth and neurodevelopmental outcome of preterm infants enrolled in a controlled trial to study the effectiveness of early postnatal dexamethasone administration for the prevention of CLD were reviewed. The original trial included 25 treated neonates who received dexamethasone intravenously from the fourth day of life for 7 days (0.5 mg/kg/d for the first 3 days, 0.25 mg/kg/d the next 3 days, and 0.125 mg/kg/d on the seventh day), and 25 untreated neonates as controls. Forty-five surviving infants (22 untreated and 23 treated) completed the 3-year follow-up.
Results. At the end of follow-up, infants pertaining to both study groups had similar values for body weight, height, and head circumference, and a similar incidence of infants with anthropometrics data below the third percentile. Moreover, no differences were detected between the groups in regard to incidence of major cranial ultrasound abnormalities, cerebral palsy, major neurosensory impairment or IQ scores, and distribution.
Conclusions. Early (&lt;96 hours) postnatal dexamethasone administration at the doses employed in this study did not impair physical or neurodevelopmental outcome in preterm infants at high risk of CLD. However, the small sample size of our study was not tailored to look for long-term outcomes and our results are not in agreement with those of larger trials and systematic reviews. The real risks of postnatal dexamethasone administration could be definitely assessed only when more well-designed trials using long-term neurodevelopmental assessment as the primary outcome will be reported.
Hospitalizations for Kawasaki Disease Among Children in the United States, 1988–1997
Authors: Chang Ruey-Kang R. 
Published: August 2004

Objective. To evaluate the epidemiologic pattern of Kawasaki disease (KD) in the United States over 10 years.
Methods. The National Inpatient Sample, a stratified national sample of &gt;900 hospitals in 22 states of the United States, was used. Data on hospital discharges from 1988–1997 were analyzed. Patients &lt;18 years of age with a discharge diagnosis of KD were identified.
Results. There were 6442 patients with KD admitted to 651 hospitals. Median age at hospital admission was 2 years. Peak incidence by year of age was 1 year old. Children &lt;2 years old accounted for 36.6% of all cases; &lt;5 years old, 75.6%; and &lt;10 years old, 95.6%. The age distribution seems to be wider than reported from Japan. The incidence for children &lt;5 years old was 8.1 per 100 000 people in 1988, and increased to 18.5 in 1997. There were 3905 males (60.6%) and 2537 females (39.4%), for a male-to-female ratio of 1.54. The incidences were higher in winter and spring (December to May) and dropped to a nadir between July and September. No apparent change in seasonal pattern was noted over 10 years. The South census region showed a seasonal change 2 to 3 months ahead of other regions. The overall in-hospital mortality rate was 0.17%. The mortality rate in children ≥10 years (1.4%) was significantly higher in than children &lt;10 years (0.11%).
Conclusions. KD affects mainly children under 5 years of age, with a peak incidence in children 1 to 2 years of age. The incidence of KD was rising over the study period. There is a male predominance. Although KD occurs year-round, the lowest incidence is seen from July through September. Such seasonal variation did not change over the 10 years. Seasonal pattern may vary in different geographic regions. Mortality from KD is rare, although children ≥10 years are at higher risk.
Risk Factors of Enterovirus 71 Infection and Associated Hand, Foot, and Mouth Disease/Herpangina in Children During an Epidemic in Taiwan
Authors: Chang Luan-Yin , King Chwan-Chuen , Hsu Kuang-Hung , Ning Hsiao-Chen , Tsao Kuo-Chien , Li Chung-Chen , Huang Yhu-Chering , Shih Shin-Ru , Chiou Shu-Ti , Chen Po-Yen , Chang Hong-Jen , Lin Tzou-Yien 
Published: August 2004

Objective. In 1998, an enterovirus 71 (EV71) epidemic in Taiwan was associated with hand, foot, and mouth disease (HFMD)/herpangina and involved 78 fatal cases. We measured EV71 seroprevalence rates before and after the epidemic and investigated risk factors associated with EV71 infection and illness.
Methods. Neutralizing antibodies to EV71 were assayed for 539 people before the epidemic and 4619 people of similar ages after the epidemic. Questionnaires, which were completed during household interviews after the epidemic, solicited demographic variables, exposure history, and clinical manifestations.
Results. A total of 129 106 cases of HFMD were reported during the epidemic. Age-specific pre-epidemic EV71 seroprevalence rates were inversely related to age-specific periepidemic mortality rates (r = −0.82) or severe case rates (r = −0.93). Higher postepidemic EV71 seropositive rates among children who were younger than 3 years positively correlated with higher mortality rates in different areas (r = 0.88). After the epidemic, 51 (56%) of 91 younger siblings of elder siblings who were EV71-seropositive were EV71-seropositive; otherwise, 2.2% (4 of 186) of younger siblings were EV71-seropositive (matched odds ratio [OR]: 10; 95% confidence interval [CI]: 3.4–29). Stepwise multiple logistic regression revealed other factors associated with EV71 infection to be older age (adjusted OR: 2.5; 95% CI: 1.9–3.4), attendance at kindergartens/child care centers (adjusted OR: 1.8; 95% CI: 1.3–2.5), contact with HFMD/herpangina (adjusted OR: 1.6; 95% CI: 1.2–2.1), greater number of children in a family (adjusted OR: 1.4; 95% CI: 1.1–1.7), and rural residence (adjusted OR: 1.4; 95% CI: 1.2–1.6). Twenty-nine percent of preschool children who were infected with EV71 developed HFMD/herpangina. Younger age and contact with HFMD/herpangina were significant factors for the development of EV71-related HFMD/herpangina in these children.
Conclusions. An increased incidence of EV71 infection in young children occurred more often in geographic areas with increased mortality rates. Intrafamilial and kindergarten transmissions among preschool children were major modes of disease transmission during the widespread EV71 epidemic in Taiwan in 1998.