bluuebunny/crossref_metadata_2025_split huggingface dataset:
Attitudes of New York City High School Students Regarding Firearm Violence
Authors: Kahn Doron J. , Kazimi Marwan M. , Mulvihill Michael N. 
Published: August 2004

Objectives.To assess prevalence of gun possession, attitudes regarding gun possession and gun violence, knowledge and influences of gun violence, and the potential role of physicians in gun violence prevention education among adolescents.Methods.An anonymous questionnaire was distributed to 9th through 12th grade high school students at 3 public high schools in New York City.Results.Three hundred forty-two surveys were distributed and returned. The prevalence of guns in the homes was 19.6%. Of respondents, 43.2% thought it was okay for anyone to have guns, and 57.3% had been injured or have had a relative injured by a gun. Although 11.6% of adolescents had felt the need to talk to an adult about guns, only 3.0% listed their physicians as one of these adults. However, if asked by their physician, 63.8% would discuss the issue with them. Only 5.7% of adolescents have had a physician speak to them about guns.Conclusions.The adolescent population surveyed is frequently exposed to gun violence. Although physicians rarely counsel adolescents regarding gun violence and firearm safety, many adolescents would be receptive to this mode of intervention.adolescence, attitude, firearm ownership, firearm violence, physician role.
Why Don't Low-Income Mothers Worry About Their Preschoolers Being Overweight?
Authors: Jain Anjali , Sherman Susan N. , Chamberlin DPA; Leigh A. , Carter Yvette , Powers Scott W. , Whitaker Robert C. 
Published: August 2004

Context.
Mothers are in an important position to prevent obesity in their children by shaping early diet and activity patterns. However, many mothers of overweight preschool children are not worried about their child's weight.

Objective.
To explore mothers' perceptions about how they determine when a child is overweight, why children become overweight, and what barriers exist to preventing or managing childhood obesity.

Design.
Three focus groups with 6 participants in each. Participant comments were transcribed and analyzed. Themes were coded independently by the 6 authors who then agreed on common themes.

Setting.
A clinic of the Special Supplemental Nutrition Program for Women, Infants, and Children in Cincinnati, Ohio.

Participants.
Eighteen low-income mothers (13 black, 5 white) of preschool children (mean age of 44 months) who were at-risk for later obesity. All but 1 mother had a body mass index (BMI) ≥25 kg/m2, and 12 mothers had a BMI ≥30 kg/m2. All but 1 child had a BMI ≥85th percentile for age and sex, and 7 had a BMI ≥95th percentile.

Results.
Mothers did not define overweight or obese in their children according to how height and weight measurements were plotted on the standard growth charts used by health professionals. Instead, mothers were more likely to consider being teased about weight or developing limitations in physical activity as indicators of their child being overweight. Children were not believed to be overweight if they were active and had a healthy diet and/or a good appetite. Mothers described overweight children as thick or solid. Mothers believed that an inherited tendency to be overweight was likely to be expressed in the child regardless of environmental factors. In trying to shape their children's eating, mothers believed that their control over the child's diet was challenged by other family members. If a child was hungry, despite having just eaten, it was emotionally difficult for mothers to deny additional food.

Conclusions.
Health professionals should not assume that defining overweight according to the growth charts has meaning for all mothers. Despite differing perceptions between mothers and health professionals about the definition of overweight, both groups agree that children should be physically active and have healthy diets. Health professionals may be more effective in preventing childhood obesity by focusing on these goals that they share with mothers, rather than on labeling children as overweight.
Evaluation and Management of Children Younger Than Two Years Old With Apparently Minor Head Trauma: Proposed Guidelines
Authors: Schutzman Sara A. , Barnes Patrick , Duhaime Anne-Christine , Greenes David , Homer Charles , Jaffe David , Lewis Roger J. , Luerssen Thomas G. , Schunk Jeff 
Published: August 2004

Objective.In children &lt;2 years old, minor head trauma (HT) is a common injury that can result in skull fracture and intracranial injury (ICI). These injuries can be difficult to detect in this age group; therefore, many authors recommend a low threshold for radiographic imaging. Currently, no clear guidelines exist regarding the evaluation and management of head-injured infants. We sought to develop guidelines for management based on data and expert opinion that would enable clinicians to identify children with complications of HT and reduce unnecessary imaging procedures.Methods.Evidence: References addressing pediatric HT were generated from a computerized database (Medline). The articles were reviewed and evidence tables were compiled.Expert Panel: The multidisciplinary panel was comprised of nine experts in pediatric HT.Consensus Process: A modified Delphi technique was used to develop the guidelines. Before the one meeting, panel members reviewed the evidence and formulated answers to specific clinical questions regarding HT in young children. At the meeting, guidelines were formulated based on data and expert consensus.Results.A management strategy was developed that categorizes children into 4 subgroups, based on risk of ICI. Children in the high-risk group should undergo a computed tomography (CT) scan. Those in the intermediate risk group with symptoms of possible ICI should either undergo CT scan or observation. Those in the intermediate risk group with some risk for skull fracture or ICI should undergo CT and/or skull radiographs or observation. Those in the low-risk group require no radiographic imaging.Conclusions.We have developed a guideline for the evaluation of children &lt;2 years old with minor HT. The effect of these guidelines on clinical outcomes and resource utilization should be evaluated.
A Syndrome of Transient Encephalopathy Associated With Adenovirus Infection
Authors: Straussberg Rachel , Harel Liora , Levy Yael , Amir Jacob 
Published: August 2004

Background and Objective.
Adenovirus is a common pathogen in the pediatric population. Respiratory, gastrointestinal, or renal systems are often involved in adenovirus infections. Several neurologic syndromes have been attributed to adenovirus, such as adenovirus aseptic meningitis, myelitis, subacute focal encephalitis, and Reye-like syndrome. The purpose of this study was to describe the clinical features and encephalography findings in 7 infants treated in our center for a syndrome of transient encephalopathy associated with adenovirus infection.

Study Participants.
Three females and 4 males ages 7 to 34 months seen in our department between July 1983 and February 1984 and September 1998 and May 1999 presented with fever of at least 7 days' duration and a gradual decline in the state of alertness. Score on the Glasgow Coma Scale ranged from 9 to 12. Findings on lumbar puncture were normal. In all 7 patients, the encephalogram showed moderate to severe background slowing compatible with encephalopathy. All patients were catarrheal and had mild hepatomegaly with slight elevation of liver enzymes. Some had bronchopneumonia, diarrhea, and conjunctivitis either isolated or in combination.

Methods and Results.
Adenovirus was isolated by immunfluorescence technique in all patients—from the sputum in 3 patients, nasopharynx in 5, conjunctiva in 4, and rectal swab in 5. In 5 patients, serotyping was performed by an antibody neutralization method. Adenovirus type 3 was ascertained from a nasal swab in 1 patient, sputum specimens in 3, throat swab in 3, and rectal cultures in 5. The clinical course was characterized by a progressive recovery of alertness. After several days, there was a complete reversal of neurologic findings.

Conclusion.
We suggest that this syndrome of transient encephalopathy is a distinct entity and should be considered as another of the several neurologic syndromes known to be associated with adenovirus infection.
Repeated Doses of Porcine Secretin in the Treatment of Autism: A Randomized, Placebo-Controlled Trial
Authors: Roberts Wendy , Weaver Lana , Brian Jessica , Bryson Susan , Emelianova Svetlana , Griffiths Anne-Marie , MacKinnon Bonnie , Yim Conrad , Wolpin Jacob , Koren Gideon 
Published: August 2004

Background and Objectives.
Anecdotal reports on the efficacy of secretin in autism raised great hopes for the treatment of children with this disorder. Initial single-dose, randomized, controlled trials failed to demonstrate any therapeutic effects of secretin. The present study is the first to test the outcome of repeated doses and to examine whether there is a subgroup of children who are more likely to achieve positive effects.

Method.
Sixty-four children with autism (ages 2–7 years; 55 boys and 9 girls) with a range of intelligence quotient and verbal ability were randomly assigned, in a double-blind manner, to secretin or placebo groups. Children received 2 doses of placebo or porcine secretin, 6 weeks apart. Assessments were performed at baseline and 3 weeks after each injection using several outcome measures.

Results.
There were no group differences on formal measures of language, cognition, or autistic symptomatology. Subgroupings based on cognitive level, the presence or absence of diarrhea, or a history of regression failed to show any significant therapeutic effects of secretin.

Conclusion.
No evidence is provided for the efficacy of repeated doses of porcine secretin in the treatment of children with autism. The possible relationship between relief of biological symptoms and enhanced skill performance is discussed.
Dating Violence and the Sexual Health of Black Adolescent Females
Authors: Wingood Gina M. , DiClemente Ralph J. , McCree Donna Hubbard , Harrington Kathy , Davies Susan L. 
Published: August 2004

Objective.
This study examines the association between having a history of dating violence and the sexual health of adolescent females.

Methods.
Black adolescent females (n = 522) completed a survey that assessed dating violence, defined as ever having a physically abusive boyfriend, and an interview that assessed sexual behaviors.

Results.
Dating violence was reported by 18.4% of adolescents (n = 96). Adolescents with a history of dating violence were, in the past 6 months, 2.8 times more likely to have a sexually transmitted disease, 2.8 times more likely to have nonmonogamous male partners, and half as likely to use condoms consistently. Furthermore, adolescents with a history of dating violence were significantly more likely to fear the perceived consequences of negotiating condom use (odds ratio [OR] = 2.8); fear talking with their partner about pregnancy prevention (OR = 2.6); have a higher perceived risk of acquiring a sexually transmitted disease (OR = 2.1); perceive less control over their sexuality (OR = 2.4); have peer norms nonsupportive of using condoms (OR = 3.1); and have norms nonsupportive of having a healthy relationship (OR = 2.1).

Conclusions.
Adolescents who have experienced dating violence are more likely to exhibit a spectrum of unhealthy sexual behaviors, attitudes, beliefs, and norms.
The Search for Congenital Malformations in Newborns With Fetal Cocaine Exposure
Authors: Behnke Marylou , Eyler Fonda Davis , Garvan Cynthia Wilson , Wobie Kathleen 
Published: August 2004

Context.The association between prenatal cocaine exposure and congenital anomalies is not definitive.Objective.To determine whether prenatal cocaine exposure results in an increased number or identifiable pattern of abnormalities.Design.A prospective, longitudinal cohort enrolled between 1991 and 1993.Setting.Rural public health population delivering at a regional tertiary medical center.Patients.Two hundred seventy-two offspring of 154 prenatally identified crack/cocaine users and 154 nonusing controls were matched on race, parity, location of prenatal care (that related to level of pregnancy risk), and socioeconomic status. Drug use was determined through repeated in-depth histories and urine screens. Infants not examined within 7 days of birth were excluded.Outcome Measures.Assessments were made by experienced examiners masked to maternal drug history. Included were 16 anthropometric measurements and a checklist of 180 physical features defined and agreed upon in advance.Results.There were no differences on major risk variables between the included and excluded infants. There were significantly more premature infants in the cocaine-exposed group. Cocaine-exposed infants were significantly smaller in birth weight, length, and head circumference but did not differ on remaining anthropometric measurements. There was no difference in type or number of abnormalities identified between the exposed and nonexposed groups. There was no relationship between amount or timing of exposure and any of the outcomes.Conclusions.This prospective, large-scale, blinded, systematic evaluation for congenital anomalies in prenatally cocaine-exposed children did not identify an increased number or consistent pattern of abnormalities.
Influence of Day Care Attendance on the Use of Systemic Antibiotics in 0- to 2-Year-Old Children
Authors: Thrane Nana , Olesen Charlotte , MD Jens Tølbøll Mortensen , Søndergaard Charlotte , Schønheyder Henrik Carl , Sørensen Henrik Toft 
Published: August 2004

Objective.To examine the association between time spent in different public day care settings and prescription of systemic antibiotics.Design.Population-based cohort study of 5035 Danish children born in 1997 followed from birth to June 30, 1999.Methods.The study was performed by the linkage of records drawn from administrative registries. Exposure was the total time spent in a day care home or day care center. Outcome was the first prescription of a systemic antibiotic. Possible perinatal and sociodemographic confounding factors were considered by statistical analysis.Results.During the first year of life, 39.8% of the girls and 51.1% of the boys received at least 1 antibiotic prescription drug. Enrollment in a day care setting doubled a child's risk of receiving a prescription drug (adjusted relative risk in day care home 1.9, 95% confidence interval: 1.7–2.0; adjusted relative risk in day care center 2.0, 95% confidence interval: 1.7–2.3). Only age confounded the analyses. Age &gt;1 year at the starting time in day care reduced the risk of receiving antibiotic prescriptions during the first 3 months after enrollment.Conclusions.Enrollment in public day care facilities raised the risk of receiving an antibiotic prescription drug to the same extent in day care homes as well as in day care centers, so we cannot recommend one facility over the other based on the present study. Children &lt;1 year old at enrollment were most at risk, suggesting that extension of parental leave may reduce the use of antibiotics.
The Effect of Protease Inhibitor Therapy on Growth and Body Composition in Human Immunodeficiency Virus Type 1-Infected Children
Authors: Miller Tracie L. , Mawn Barbara E. , Orav E. John , Wilk David , Weinberg Geoffrey A. , Nicchitta Jeanne , Furuta Lauren , Cutroni Roseann , McIntosh Kenneth , Burchett Sandra K. , Gorbach Sherwood L. 
Published: August 2004

Objective.To determine the effect of protease inhibitors (PIs) on growth and body composition in children with human immunodeficiency virus type 1 (HIV-1) infection.Background.HIV-1-infected children have chronic problems with both linear growth and weight gain. Viral load may directly influence growth and nutritional status of HIV-1-infected children with reduction of viral load improving the nutritional condition.Design/Methods.Data from 67 patients who initiated PI therapy between 1996 and 1999 and who were enrolled in a prospective, longitudinal study of growth and nutrition in HIV-1-infected children were analyzed. Outcomes included pre-PI versus post-PI measures of height, weight, weight-for-height, triceps skinfold thickness, and arm muscle circumference. Predictor covariates included age, race, gender, Tanner stage, CD4 z score, Centers for Disease Control and Prevention stage, route of infection, plasma HIV-1 RNA, other antiretroviral therapy, recommended daily allowances for calories, treatment with megestrol acetate, and PI therapy.Results.Sixty-seven children were followed for a median of 2.4 years with a total of 362 visits (median: 5 visits; range: 1–12). During follow-up, they received PIs for a median of 5 months. Fifty-one percent were girls, 54% black, 15% Hispanic, and 25% white. The mean age at first visit was 6.8 years. In a univariate analysis, weight z score (−0.67 to −0.35) and weight/height z score (0.25–0.76) improved on PI therapy. Using repeated-measures regression analysis, controlling for the above named covariates, PI treatment showed a significant effect on weight z score (increase in z score by 0.46), weight/height z score (increase inz score by 0.49), and arm muscle circumference (increase in percentile by 11.5). A borderline effect was found for heightz score (increase in z score by 0.17) and no effect was found for triceps skinfold thickness. In a separate analysis, PI therapy increased CD4 counts twofold and reduced plasma HIV-1 RNA copies by 79%.Conclusion.In addition to a significant reduction in viral load, PI therapy in children has a positive effect on several growth parameters, including weight, weight/height, and muscle mass.
Sensitization to Silk and Childhood Asthma in Rural China
Authors: Celedón Juan C. , Palmer Lyle J. , Xu Xiping , Wang Binyan , Fang Zhian , Weiss Scott T. 
Published: August 2004

Objective.
Sensitization to perennial aeroallergens is associated with asthma in industrialized countries with a Western lifestyle. Because silk products are commonly used in Chinese society, we were interested in examining the relation between sensitization to silk and asthma.

Design.
Cross-sectional study of 871 children in 503 families living in Anqing, a predominantly rural province of China.

Results.
After adjustment for age, gender, familial correlations, and sensitization to other aeroallergens, skin test reactivity to silk was an independent predictor of asthma (odds ratio = 2.6; 95% confidence interval = 1.2–5.7). This association became stronger after inclusion of the eosinophil count and history of parasitic diseases of the participants in the multivariate model (odds ratio = 3.6; 95% confidence interval = 1.4–8.9).

Conclusion.
Because sericulture is an important activity in China and other countries throughout the world, sensitization to silk may influence the pathogenesis and severity of asthma in people living in these nations.
A Comparison of Elevated Blood Lead Levels Among Children Living in Foster Care, Their Siblings, and the General Population
Authors: Chung Esther K. , Webb David , Clampet-Lundquist Susan , Campbell Carla 
Published: August 2004

Objectives.To assess the prevalence of elevated blood lead levels (EBLLs) among children before and after foster care placement, and to compare the prevalence of EBLLs among children in foster care with that of their siblings and the general population.Methods.We conducted a retrospective cohort study using administrative databases from the Philadelphia Department of Human Services and the Birth Certificate Registry and the Childhood Lead Poisoning Prevention Program at the Philadelphia Department of Public Health. Logistic regression analyses were performed to control for confounding variables, including age, race, gender, and the year, seasonal timing, and source (capillary vs venous) of test.Results.From June 1992 to May 1997, there were 1824 children in foster care with available blood lead results in the Childhood Lead Poisoning Prevention Program database. Of these, 519 (28%) had initial lead screening before foster care placement and 654 (36%) after placement. There were 821 siblings and 73 608 children in the general population with available blood lead results.Before entering foster care, children were nearly twice as likely to have EBLLs as their siblings (adjusted odds ratio [OR] = 1.7; 95% confidence interval [CI] = 1.4, 2.0), those in placement (adjusted OR = 1.9; 95% CI = 1.6, 2.2), and the general population (adjusted OR = 1.7; 95% CI = 1.5, 2.0). At the highest point prevalence, 50% of children before placement had lead levels ≥20 μg/dL, and nearly 90% had levels ≥10 μg/dL. For all age categories, siblings of children in foster care placement had a higher prevalence of EBLLs than did the general population. After placement, children in foster care were nearly half as likely as the other groups to have EBLLs.Conclusions.Our findings suggest that children are at high risk for lead poisoning before entering foster care and that placement in foster care may have a beneficial effect on lead exposure. Children before foster care placement are nearly twice as likely to have EBLLs compared with children in foster care placement, the general population, and their siblings. Furthermore, siblings of children in foster care are at high risk for lead poisoning. Children receiving social services in their own homes and children suffering from abuse and neglect should be actively screened for lead poisoning. Greater efforts at preventing lead poisoning among these children must be made.