bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neonatal hypoglycaemia in infants of diabetic mothers
Authors: Agrawal Rk , Lui K , Gupta Jm 
Published: March 2003

Objective: To determine whether umbilical cord blood glucose correlates with subsequent hypoglycaemia after birth in infants of well‐controlled diabetic mothers. Methodology: Thirty‐eight term infants of well‐controlled diabetic mothers were enrolled. Five mothers had pre‐existing diabetes. Of the 33 gestational diabetic mothers, 16 were managed on insulin and 17 on diet. Maternal blood glucose was maintained between 4 and 8 mmol/L during labour and delivery. Infants’ plasma glucose levels were measured from venous cord blood and serially, at less than 30 min, 1 h and 2 h of life by glucose hexokinase method. Blood glucose levels were further monitored by bedside Dextrostix for 24 h. Results: Eighteen (47%) infants developed hypoglycaemia (blood glucose level less than 2 mmol/L) during the first 2 h of life. There was no difference in the cord blood glucose levels between infants with or without hypoglycaemia (3.7 ± 1.1 vs 4.5 ± 1.1 mmol/L, respectively). Infants of mothers with diabetes diagnosed prior to 28 weeks gestation were at a higher risk of developing hypoglycaemia (8 of 10 vs 10 of 28, OR 7.2, 95%CI 1.3–40.7). Hypoglycaemic infants were of significantly higher birthweight, and were more likely to be born to Caucasian mothers and by Caesarean section. Raised maternal fructosamine blood level, the need for insulin treatment or the infant’s haematocrit were not different between infants with or without hypoglycaemia. Conclusions: In well‐controlled diabetic mothers, the incidence of early hypoglycaemia in infants is still high, particularly in those mothers who had a longer duration of diabetes. Cord blood glucose level did not identify the infants with hypoglycaemia.
Epstein–Barr virus associated with immune thrombocytopenic purpura in childhood: A retrospective study
Authors: Hsiao C‐C 
Published: March 2003

Objective: Although Epstein–Barr virus (EBV) is known to cause immune thrombocytopenic purpura (ITP), the epidemiology of this pathogen in children with ITP is not known. In the present study, the clinicoepidemiology and laboratory characteristics of EBV‐associated ITP in childhood were analysed retrospectively. Methods: The study cohort consisted of 108 children in whom ITP was diagnosed between 1990 and 1998. Patients were divided into EBV or non‐EBV groups according to their serological status at diagnosis. Results: Thirty‐five (32.4%) of 108 children had ITP associated with acute EBV infection. The clinical manifestations and laboratory data were similar in children with and without acute EBV. Responses to various modalities of therapy were analysed. The average time to achieve complete remission (platelet count ≥ 150 × 109/L) in EBV and non‐EBV groups was 26 and 16 days, respectively. Conclusions: The incidence of childhood ITP associated with acute EBV infection is relatively high in Taiwan. Patients with EBV‐associated ITP tended to resolve more slowly than those without EBV infection.
Epidemiology of Munchausen syndrome by proxy in New Zealand
Authors: Denny SJ , Grant CC , Pinnock R 
Published: March 2003

Objective: To determine the epidemiology of Munchausen syndrome by proxy (MSBP) in New Zealand and describe the effects of this condition on children and their paediatricians. Methodology: A mail‐out survey was sent to all paediatricians in New Zealand in 1999. Paediatricians were asked to identify all cases of MSBP, non‐accidental poisoning or non‐accidental suffocation diagnosed or suspected in children less than 16 years of age that had been seen in the past 12 months. Those paediatricians who identified a case were then interviewed by telephone to ensure that identified cases were new cases and that they were unique. Results: Responses were obtained from 148 (95%) of 156 practising paediatricians in New Zealand. Eighteen unique cases of MSBP were identified where the diagnosis had been made in the preceding 12 months. The incidence rate for MSBP in children aged less than 16 years was 2.0/100 000 children. Eleven (61%) of the 18 cases were referred to child protection agencies or the police. The mean time taken to diagnosis from initial presentation was 7 months in the cases referred to child protection agencies and 23 months in cases not referred. The median age at diagnosis was 2.7 years. The mother was the suspected perpetrator in all cases. Most children (72%) presented with multiple symptoms. Over half (55%) had an underlying chronic illness. The morbidity for the child in the majority of cases was not severe, and in nine (50%) cases it was noted that following diagnosis there was improvement or resolution of symptoms. Ten (56%) of the 18 paediatricians involved with cases reported experiencing considerable stress. Conclusions: The annual incidence in New Zealand of MSBP in children under 16 years is higher than that reported from other countries. Chronic illness is often associated with this condition. The morbidity for the majority of children was not severe and often improved with diagnosis. Paediatricians reported stress and difficulty in association with caring for children with this syndrome of child abuse.
Maternal awareness of sudden infant death syndrome in North Queensland, Australia: An analysis of infant care practices
Authors: Douglas TA , Buettner PG , Whitehall J 
Published: March 2003

Objectives: To assess awareness of sudden infant death syndrome (SIDS) and risk reducing recommendations in a sample of mothers in North Queensland, Australia, and to examine their infant care practices. Method: Interviews conducted with 195 women using a standardized questionnaire between October 1997 and January 1998. Results: 191 questionnaires analyzed; 134 (70.2%) Caucasian and 57 (29.8%) indigenous women. Four women with previous SIDS experience were excluded from the analysis. Eight (4.2%) had never heard of SIDS. Twenty‐nine (15.2%) had heard of SIDS and 154 (80.6%) had heard of SIDS and could list risk recommendations to reduce its incidence. Multivariate analysis identified ethnicity as the only significant predictor of maternal knowledge. Indigenous mothers knew less about SIDS: adjusted odds ratio (OR) = 5.4; 95% confidence interval (CI) = [2.1–14.0]. Avoidance of prone sleeping was the most frequently identified recommendation (n = 132), with no smoking in pregnancy (n = 48) and breastfeeding (n = 40) identified least frequently. There were 80.2% of mothers who put their infant in non‐prone positions to sleep. Only 48 (25%) women identified smoking in pregnancy, and 93 (48.6%) smoking in the infant’s environment as risk factors. Indigenous women were more likely to smoke in their pregnancy (P = 0.004), bed share with their infant (P = 0.0001), and have smokers in the home. Conclusion: There is a high level of awareness of SIDS and the main associated risk factor of infant prone sleeping, but the link between SIDS and smoking requires further emphasis. Future campaigns should ensure the SIDS message is delivered more effectively to the indigenous communities.
The effect of breastfeeding on child development at 5 years: A cohort study
Authors: Quinn PJ , O'Callaghan M , Williams GM , Najman JM , Andersen MJ , Bor W 
Published: March 2003

Objective: It is uncertain to what degree the relationship between breastfeeding and later cognitive development is a true biological effect, or is confounded by psychosocial factors. The study aim was to further investigate this relationship and the effect of duration of breast feeding on cognitive development. Methods: A total of 3880 children were followed from birth. Breastfeeding duration was measured by questionaire at 6 months of age and a Peabody Picture Vocabulary Test Revised (PPVT‐R) was administered at 5 years. PPVT‐R scores were adjusted for the effects of a large array of biological and psychosocial confounders. The relationship between breastfeeding and the mean PPVT‐R scores were examined using analysis of variance and multiple linear regression. Results: A strong positive relationship was demonstrated between breastfeeding and the PPVT‐R scores with increasing scores with increased duration of breastfeeding. After adjusting for a wide range of biological and social factors, the adjusted mean for those breastfed for 6 months or more was 8.2 points higher for females and 5.8 points for males when compared to those never breastfed. Conclusion: These findings suggest a significant benefit to child development is conferred by breastfeeding and is related independently to longer periods of breastfeeding.
Is bag urine culture useful in monitoring urinary tract infection in infants?
Authors: Li PS , Ma LC , Wong SN 
Published: March 2003

Objectives:  We studied the false‐positive rate of bag urine cultures in diagnosing bacteriuria in infants and examined the factors responsible for contamination.Methods:  One hundred asymptomatic patients with previous urinary tract infections (UTI; age range 5−23 months; sex ratio M : F 73:27) were screened by bag urine cultures and confirmed by suprapubic aspiration or catheterization. Those producing contaminated and clean samples were interviewed with a standard questionnaire.Results:  Sixty patients had insignificant growth and 40 had doubtful or mixed growth. After further interview and instructions, the latter group produced a second bag urine sample with negative results in 23 and positive results in 17. Among the latter, UTI was confirmed in five and excluded in 12 cases. The false‐positive rate of first urine collection was 36.8%. Comparing patients with contaminated urine to those with negative urine samples, we found the former were associated with waiting for more than one void to complete urine collection, and with uncircumcised boys. Other factors did not reach statistical significance. Proper counselling and repeating a second culture reduced the overall false‐positive rate to 12.6%.Conclusion:  In our population, the contamination rate of one bag urine culture was 36.8%, which is unacceptable and alternative methods need to be sought. Contamination was associated with improper collection procedures and with uncircumcised boys. Proper instructions and doing a second urine culture reduced the overall rate to 12.6%, but at the expense of delaying diagnosis and treatment.
Ivermectin is better than benzyl benzoate for childhood scabies in developing countries
Authors: Brooks PA , Grace RF 
Published: March 2003

Objective:  To compare single dose oral ivermectin with topical benzyl benzoate for the treatment of paediatric scabies.Methods:  An observer‐blinded randomized controlled trial was undertaken at Vila Central Hospital, Vanuatu. One hundred and ten children aged from 6 months to 14 years were randomized to receive either ivermectin 200 µg/kg orally or 10% benzyl benzoate topically. Follow up was at 3 weeks post‐treatment. Primary outcome measures were the number of scabies lesions, the itch visual analogue score and nocturnal itch. Secondary outcome measures were the skin's reaction to treatment, the passage of worms in stool and other side effects.Results:  Eighty patients completed the study protocol. There was no significant difference between the two treatments; both produced a significant decrease in the number of scabies lesions seen at follow up. Ivermectin cured 24 out of 43 patients (56%), and benzyl benzoate 19 out of 37 patients (51%) at 3 weeks post‐treatment. No serious side effects were noted with either treatment, but benzyl benzoate was more likely to produce local skin reactions (P = 0.004, OR 6.4, 95% CI 1.6−25.0)Conclusions:  Ivermectin is cheap and effective in the treatment of paediatric scabies. Ivermectin has minimal observed toxicity and has the additional beneficial effects of antiparasitic action in onchocerciasis, filariasis and strongyloidiasis. Ivermectin is better than benzyl benzoate for the treatment of paediatric scabies in developing countries.
Parvovirus B19 in the acute arthropathies and juvenile rheumatoid arthritis
Authors: Oğuz F , Akdeniz C , Ünüvar E , Küçükbasmaci Ö , Sidal M 
Published: March 2003

Objective: To evaluate the prevalence of recent parvovirus B19 infection in a cohort of children presenting with acute arthropathy and to determine the prevalence of a subsequent diagnosis of juvenile rheumatoid arthritis in this cohort. Method: In this prospective study, parvovirus B19 IgM antibody was investigated in 75 patients who were referred to our clinic with acute joint complaints and also in 75 healthy controls. One patient in each group was excluded due to neuroblastoma and acute lymphoblastic leukaemia. The characteristics of parvovirus B19 IgM positive patients who were accepted as parvovirus B19 arthropathy were further evaluated. All the patients were followed up for at least 6 weeks and the patients with chronic progression of joint complaints were followed for at least 6 months to determine their progress. The cases of juvenile rheumatoid arthritis in this chronic group were identified. Results: Parvovirus B19 IgM was detected in 16 of 74 patients (21.6%) with acute arthropathy compared with 3 of 74 (4.1%) in the healthy control group (χ2 = 8.67; P = 0.003). The parvovirus B19 positive patients with arthropathy were more likely to become chronic (P = 3.7 × 10−7) and to be diagnosed as juvenile rheumatoid arthritis (P = 0.03) than the parvovirus B19 IgM negative group with arthropathy. Additional joint destruction developed in one case who was parvovirus B19 IgM positive in whom juvenile rheumatoid arthritis was diagnosed during follow up. Conclusion: These data support the hypothesis that parvovirus B19 infection may be associated with the onset of juvenile rheumatoid arthritis in a proportion of patients.
Summer classification of Southern Hemisphere temperate lakes (Patagonia, Argentina)
Authors: Diaz Mónica , Pedrozo Fernando , Baccala Nora 
Published: March 2003

AbstractThe purpose of this paper was to synthesize observations of 21 cold temperate lakes from Patagonia, Argentina. To do this, objective limnological variables and the phytoplankton summer structure were analysed using multivariate statistical tools. The results suggest that the most important variables defined a trophic gradient based on nutrients, conductivity and phytoplanktonic attributes. Cluster analysis pointed to three groups of lakes. Steppe lakes (group III) were distinguished from mountain‐Andean lakes (groups I and II) through their higher conductivity and ammonia concentration values, higher net phytoplankton density and lower species diversity. The two groups of Andean lakes differed with regard to the biomass of Bacillariophyceae and Prymnesiophyceae, water temperature and dissolved inorganic nitrogen concentration. The influence of the biomass (as biovolume) of each taxonomic group in lakes of different trophic status was examined. Although all Andean lakes appear to be similar, as shown by their similar salt and nutrient concentration values, the phytoplankton biomass split into different taxa and clearly distinguished subgroups. The work presents original information about the phytoplanktonic community structure from all the lakes and the first limnological data on 10 of them, from a region that is poorly known.
Dioxin‐like and non‐dioxin like effects of polychlorinated biphenyls: Implications for risk assessment
Authors: Giesy John P. , Kurunthachalam Kannan 
Published: March 2003

AbstractPolychlorinated biphenyls (PCBs) are persistent, bioaccumulative and toxic contaminants in the environment. Individual PCB congeners exhibit different physicochemical properties and biological activities that result in different environmental distributions and toxicity profiles. The variable composition of PCB residues in environmental matrices and their different mechanisms of toxicity complicate the development of scientifically based regulations for risk assessment. Various approaches for the assessment of risks of PCBs have been critically examined. Recent developments in the toxic equivalency factor (TEF) approach for the assessment of toxic effects due to dioxin‐like PCBs have been examined. The PCB exposure studies that describe non‐dioxin‐like toxic effects, particularly neurobehavioural effects and their effective doses in animals, were compiled. A comparative assessment of effective doses for dioxin‐like and non‐dioxin‐like effects by PCBs has been made to evaluate the relative significance of non‐ortho and ortho‐substituted PCBs in risk assessment. Using mink as an example, relative merits and implications of using TEF and total PCB approaches for assessing the potential for toxic effects in wildlife were examined. There are several advantages and limitations associated with each method used for PCB risk assessment. Toxic effects due to coplanar PCBs occur at relatively smaller concentrations than those due to non‐dioxin‐like PCBs and, therefore, the TEF approach derives the risk assessment of PCBs in the environment. The need for the refinement of the TEF approach for more accurate assessment of risks is discussed.
The reaction of glial progenitor cells in remyelination following ethidium bromide‐induced demyelination in the mouse spinal cord
Authors: Fushimi Shigeko , Shirabe Teruo 
Published: March 2003

The present study investigated how glial progenitor cells participated in the process of remyelination following ethidium bromide (EBr)‐induced demyelination in the adult mouse spinal cord. In situ hybridization techniques for detecting mRNA for platelet‐derived growth factor α receptor (PDGFαR) and proteolipid protein (PLP) were employed to identify glial progenitor cells and mature oligodendrocytes, respectively.During the demyelination stage and early stage of remyelination, large cells strongly expressing PDGFαR mRNA were observed in the border of the demyelinating lesion, and with immunohistochemistry they exhibited positive labeling of the astrocytic marker glial fibrillary acidic protein (GFAP). Other glial progenitor cells expressing PDGFαR mRNA proliferated around the lesion during the demyelination stage. During the remyelination stage, some PDGFαR mRNA‐positive cells partly expressed mRNA for PLP in the periphery of the demyelinating lesion.These results suggest that PDGFαR mRNA‐positive glial progenitor cells may give rise to both astrocytes and oligodendrocytes, which participate in remyelination following demyelination.
Poststructuralism and nursing: uncomfortable bedfellows?
Authors: Francis Becky 
Published: March 2003

Poststructuralism and nursing: uncomfortable bedfellows?The benefits and limitations of the application of poststructuralist in nursing research are discussed. The debate concerning the use of poststructuralist theory in feminist research is drawn on to argue a divergence between a deconstructionist poststructuralism and nursing aims. It is argued that there are strong parallels between nursing and social movements such as feminism. The reasons why many feminist and nursing researchers have been attracted to poststructuralist theory are explored, as are the criticisms of poststructuralism as an inadequate, even reactionary theory. It is argued that poststructuralism is useful for examining or deconstructing existing discourse and practice, but incompatible and inadequate for research which aims to develop or change such discourses or practices.
Social poetics as research and practice: living in and learning from the process of research
Authors: Aldridge Dee , Stevenson C. 
Published: March 2003

Social poetics as research and practice: living in and learning from the process of research This paper is both a report of research work carried out by one author of the paper with the other involved in a supervisory role, and a reflection on methodology that was an emergent property of the research process. The research question arose when professional preunderstandings about schizophrenia as a biological disturbance were bracketed as a Husserlian form of phenomenology was adopted. The initial study focused on the meanings three individuals attached to being diagnosed with a mental illness and being involved in psychiatric treatment systems. The exploration of meanings led to the researcher being guided by one study participant in relation to a suitable framework for making sense of her lived experience of being entangled in psychiatric systems. This involved an appreciation of the poetics of interpersonal interaction that was simultaneously fuelled by the researcher’s reading of social poetics in psychology. Thus, the research became a hermeneutic inquiry, focused upon the text of one participant (Beth)1 and the psychiatric system that she and colleagues encountered. Beth’s psychiatric predicament was described by a loss of ‘self’, psychiatric interrogation, and positive and negative features of immersion in the system. A byproduct of taking a poetic approach was that the participant found the research process therapeutic. Thus, social poetics encouraged a beneficial blurring of the boundaries between research and practice. In both arenas, social poetics can lead to a different level of understanding. This is contradictory to mainstream approaches to research that value objectivity with a strict division between the researcher and the subjects, with the aim of producing scientific knowledge.
Conserving the vitality of suffering: addressing family constraints to illness conversations
Authors: Tapp Dianne M. 
Published: March 2003

Conserving the vitality of suffering: addressing family constraints to illness conversationsWhen persons are confronted with life‐threatening or chronic illness, there is always a possibility that family members other than the person experiencing the illness also suffer as they attempt to manage their own distress. This paper describes exemplars from a hermeneutic study that explored therapeutic conversations between nurses and families who were living with a member experiencing ischaemic heart disease. These conversations uncovered the complexity of both individual and family suffering following acute cardiac illness events, and called attention to nursing practices that addressed some of the ways that family members were constrained from having conversations about the illness. When spaces were created for these conversations to occur, possibilities for making sense of illness and suffering were revealed as vital. These understandings support the efforts of family members to sustain and conserve family relationships in the face of illness and suffering, and inform both the professional and personal lives of nurses.
IVF as lottery or investment: contesting metaphors in discourses of infertility
Authors: De Lacey Sheryl 
Published: March 2003

IVF as lottery or investment: contesting metaphors in discourses of infertilityThis paper reports an aspect of a poststructural feminist study in which I explored the discursive formations within which women for whom in vitro fertilisation (IVF) was unsuccessful constitute themselves. In my exploration I draw on data from interviews with women who discontinued infertility treatment, print media material and infertility self‐help books. Specifically, I highlight a metaphor of lottery in discourses of infertility, arguing that it is hegemonic and showing how when women are situated as gamblers, the metaphor is instrumental in polarising them into ‘winners’ or ‘losers’ in relation to the subjectivity of motherhood. I further deconstruct these subjectivities, showing how ‘winners’ are valorised and ‘losers’ are pathologised. But importantly, I show how infertile women who are not mothers resisted locating themselves as ‘losers’ in a metaphor of lottery and instead situated themselves in a contesting metaphor of investment as diligent ‘workers’ and as active agents in choosing the best employment of their bodily and monetary resources. This paper therefore amplifies the marginalised perspective of infertile women who are not mothers.