bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sleep Duration From Infancy to Adolescence: Reference Values and Generational Trends
Authors: Iglowstein Ivo , Jenni Oskar G. , Molinari Luciano , Largo Remo H. 
Published: August 2004

Objective. The main purpose of the present study was to calculate percentile curves for total sleep duration per 24 hours, for nighttime and for daytime sleep duration from early infancy to late adolescence to illustrate the developmental course and age-specific variability of these variables among subjects.
Methods. A total of 493 subjects from the Zurich Longitudinal Studies were followed using structured sleep-related questionnaires at 1, 3, 6, 9, 12, 18, and 24 months after birth and then at annual intervals until 16 years of age. Gaussian percentiles for ages 3 months to 16 years were calculated for total sleep duration (time in bed) and nighttime and daytime sleep duration. The mean sleep duration for ages 1 to 16 years was estimated by generalized additive models based on the loess smoother; a cohort effect also had to be included. The standard deviation (SD) was estimated from the loess smoothed absolute residuals from the mean curve. For ages 3, 6, and 9 months, an alternative approach with a simple model linear in age was used. For age 1 month, empirical percentiles were calculated.
Results. Total sleep duration decreased from an average of 14.2 hours (SD: 1.9 hours) at 6 months of age to an average of 8.1 hours (SD: 0.8 hours) at 16 years of age. The variance showed the same declining trend: the interquartile range at 6 months after birth was 2.5 hours, whereas at 16 years of age, it was only 1.0 hours. Total sleep duration decreased across the studied cohorts (1974–1993) because of increasingly later bedtime but unchanged wake time across decades. Consolidation of nocturnal sleep occurred during the first 12 months after birth with a decreasing trend of daytime sleep. This resulted in a small increase of nighttime sleep duration by 1 year of age (mean 11.0 ± 1.1 hours at 1 month to 11.7 ± 1.0 hours at 1 year of age). The most prominent decline in napping habits occurred between 1.5 years of age (96.4% of all children) and 4 years of age (35.4%).
Conclusions. Percentile curves provide valuable information on developmental course and age-specific variability of sleep duration for the health care professional who deals with sleep problems in pediatric practice.
Parental Factors, Mass Media Influences, and the Onset of Eating Disorders in a Prospective Population-Based Cohort
Authors: Martínez-González Miguel Angel , Gual Pilar , Lahortiga Francisca , Alonso Yolanda , Irala-Estévez Jokin de , Cervera Salvador 
Published: August 2004

Objective. To identify risk factors for eating disorders.
Methods. A community cohort study was conducted in Navarra, Spain. A region-wide representative sample of 2862 girls who were 12 to 21 years of age completed the Eating Attitudes Test (40-item version) and other questionnaires in 1997. Girls who scored high in the Eating Attitudes Test-40 were interviewed by a psychiatrist who applied Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria to diagnose prevalent cases of eating disorders. Girls who were free of any eating disorder in 1997 were reassessed after 18 months of follow-up using the same methods.
Results. Ninety new cases of eating disorders according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria were identified during the follow-up. In the multivariate logistic analysis, a higher risk of incident eating disorder was found for several exposures assessed at the beginning of follow-up, such as younger age, usually eating alone (odds ratio [OR]: 2.9; 95% confidence interval: 1.9–4.6), and frequently reading girls’ magazines or listening to radio programs (OR: 2.1; 1.2–3.8 for those most frequently using both media). No independent association was found for television viewing or socioeconomic status. A marital status of parents different from “being married” was associated with a significantly higher risk in the multivariate analysis (OR: 2.0; 1.1–3.5).
Conclusions. Our results support the role of mass media influences and parental marital status in the onset of eating disorders. The habit of eating alone should be considered as a warning sign of eating disorders.
Genome Scan for Childhood and Adolescent Obesity in German Families
Authors: Saar Kathrin , Geller Frank , Rüschendorf Franz , Reis André , Friedel Susann , Schäuble Nadine , Nürnberg Peter , Siegfried Wolfgang , Goldschmidt Hans-Peter , Schäfer Helmut , Ziegler Andreas , Remschmidt Helmut , Hinney Anke , Hebebrand Johannes 
Published: August 2004

Objective. Several genome scans have been performed for adult obesity. Because single formal genetic studies suggest a higher heritability of body weight in adolescence and because genes that influence body weight in adulthood might not be the same as those that are relevant in childhood and adolescence, we performed a whole genome scan.
Methods. The genome scan was based on 89 families with 2 or more obese children (sample 1). The mean age of the index patients was 13.63 ± 2.75 years. A total of 369 individuals were initially genotyped for 437 microsatellite markers. A second sample of 76 families was genotyped using microsatellite markers that localize to regions for which maximum likelihood binomial logarithm of the odd (MLB LOD) scores on use of the concordant sibling pair approach exceeded 0.7 in sample 1.
Results. The regions with MLB LOD scores &gt;0.7 were on chromosomes 1p32.3-p33, 2q37.1-q37.3, 4q21, 8p22, 9p21.3, 10p11.23, 11q11-q13.1, 14q24-ter, and 19p13-q12 in sample 1; MLB LOD scores on chromosomes 8p and 19q exceeded 1.5. In sample 2, MLB LOD scores of 0.68 and 0.71 were observed for chromosomes 10p11.23 and 11q13, respectively.
Conclusion. We consider that several of the peaks identified in other scans also gave a signal in this scan as promising for ongoing pursuits to identify relevant genes. The genetic basis of childhood and adolescent obesity might not differ that much from adult obesity.
Physical Fitness and C-Reactive Protein Level in Children and Young Adults: The Columbia University BioMarkers Study
Authors: Isasi Carmen R. , Deckelbaum Richard J. , Tracy Russell P. , Starc Thomas J. , Berglund Lars , Shea Steven 
Published: August 2004

Objective. To examine the association of physical fitness with C-reactive protein (CRP) level in children and young adults.
Methods. Subjects (N = 205) aged 6 to 24 years were enrolled in the Columbia University BioMarkers Study (1994–1998). Physical fitness was assessed using a non-effort-dependent treadmill testing protocol (physical work capacity at heart rate of 170 beats per minute). CRP level was measured using a high-sensitivity assay.
Results. Subjects were 54% female and 65% of Hispanic origin. Mean fitness level was higher in boys than in girls, but CRP levels did not differ by gender. Fitness level was inversely correlated with CRP (r = −0.22). This relationship was significant in boys (r = −0.32) but not in girls (r = −0.15). After multivariate regression adjustment for age, race/ethnicity, body mass index, and family history of early-onset ischemic heart disease, physical fitness remained inversely associated with CRP level in boys (β = −0.02; standard error = 0.01).
Conclusions. These findings indicate that physical fitness is inversely related to CRP level in children and that this relationship is more pronounced in boys than in girls.
Early Versus Late Diagnosis: Psychological Impact on Parents of Children With Cystic Fibrosis
Authors: Mérelle Maria E. , Huisman Jaap , Alderden-van der Vecht Angélika , Taat Froukje , Bezemer Dick , Griffioen Rupino W. , Brinkhorst Govert , Dankert-Roelse Jeannette E. 
Published: August 2004

Objectives. To explore the relationship between the period preceding diagnosis and the way parents of children with cystic fibrosis (CF) experience and handle their child’s disease.
Design. A retrospective study.
Setting. CF Center “Noordwest Nederland,” the Netherlands.
Participants. Participants were the parents of children &lt;13 years old with CF who were treated at the CF Center “Noordwest Nederland.” The participants were divided into 2 groups according to the duration of prediagnostic period: &lt;3 months (defined as early diagnosis) and ≥3 months (defined as late diagnosis).
Main Outcome Measures. Experience of the prediagnostic period, contact with the medical profession, coping, future perspective, and attitudes toward neonatal screening for CF.
Results. Parents of 55 children were eligible for study participation; 45 were enrolled. Retrospectively, the period preceding an early diagnosis was less negatively experienced by parents than the period preceding a late diagnosis. Parents of children with an early diagnosis had retrospectively more confidence in the medical profession before confirmation of diagnosis. In general, parents in this study used adaptive coping styles. Duration of prediagnostic period was not significantly related to future perspective. Hopelessness seemed to be mainly determined by a severe course of disease as experienced by the parents. Ninety-eight percent of all parents were in favor of neonatal screening for CF.
Conclusions. A short prediagnostic period is associated with less negative feelings and increased confidence in the medical profession among parents of children with CF. Neonatal screening for CF may be of benefit to parents by removing the stress of a delayed diagnosis.
Amplitude-Integrated Electroencephalography Coupled With an Early Neurologic Examination Enhances Prediction of Term Infants at Risk for Persistent Encephalopathy
Authors: Shalak Lina F. , Laptook Abbot R. , Velaphi Sithembiso C. , Perlman Jeffrey M. 
Published: August 2004

Objectives. The objectives of this study were to determine, first, whether an early neurologic examination could predict a persistent abnormal neonatal neurologic state comparable to the amplitude-integrated electroencephalography (a-EEG) and, second, whether a combination of the 2 methods would further enhance early identification of high-risk infants.Methods. Fifty term infants were enrolled prospectively when they had evidence of intrapartum distress, Apgar score ≤5 at 5 minutes, or cord arterial pH ≤7.00 and were admitted to intensive care. Each enrolled infant underwent an early neurologic examination using a modified Sarnat staging system (stages 2 and 3 were regarded as abnormal) and a blinded simultaneous a-EEG measurement. Predictive values were calculated for a short-term abnormal outcome defined as persistent moderate to severe encephalopathy beyond 5 days.Results. An abnormal short-term outcome was present in 14 (28%) of 50 infants. The neurologic examination was performed at 5 ± 3 hours after delivery. A short-term abnormal outcome occurred in 9 (53%) of 17 infants with initial stage 2 and in both infants with initial stage 3 encephalopathy. In addition, 13 infants manifested features of both stage 1s and 2 and post hoc were classified (S1–2). Three of the latter infants (23%) developed an abnormal short-term outcome. The a-EEG was abnormal in 15 (30%) infants, 11 (73%) of whom developed an abnormal outcome. An abnormal a-EEG was more specific (89% vs 78%), had a greater positive predictive value (73% vs 58%), and had similar sensitivity (79% vs 78%) and negative predictive value (90% vs 91%) when compared with an abnormal early neurologic examination. A combination of abnormalities had the highest specificity (94%) and positive predictive value (85%).Conclusion. The combination of the a-EEG and the neurologic examination shortly after birth enhances the ability to identify high-risk infants and limits the number of infants who would be falsely identified compared with either evaluation alone.
Vascular Endothelial Growth Factor in the Cerebrospinal Fluid of Infants Who Died of Sudden Infant Death Syndrome: Evidence for Antecedent Hypoxia
Authors: Jones Kimberly L. , Krous Henry F. , Nadeau Julie , Blackbourne Brian , Zielke H. Ronald , Gozal David 
Published: August 2004

Objectives. Recurrent hypoxemia has been proposed as an important pathophysiological mechanism underlying sudden infant death syndrome (SIDS). However, conflicting results emerged when xanthines were used as markers for hypoxia. The vascular endothelial growth factor (VEGF) gene is highly sensitive to changes in tissue partial oxygen tension, and changes in genomic and protein expression occur even after changes in oxygenation within the physiologic range.Methods. For determining whether hypoxia precedes SIDS, VEGF levels were measured using an enzyme-linked immunosorbent assay in the cerebrospinal fluid (CSF) of 51 SIDS infants and in 33 additional control infants who died of an identifiable cause. In addition, 6 rats that had a chronically implanted catheter in the lateral ventricle were exposed to a short hypoxic challenge, and VEGF concentrations were measured in CSF at various time points for 24 hours. Another set of 6 rats were killed with a pentobarbital overdose, and VEGF CSF levels were obtained at different time points after death.Results. Mean VEGF concentrations in CSF were 308.2 ± 299.1 pg/dL in the SIDS group and 85.1 ± 82.9 pg/dL in those who died of known causes. Mean postmortem delay averaged 22 hours for both groups. In rat experiments, hypoxic exposures induced time-dependent increases in VEGF, peaking at 12 hours and returning to baseline at 24 hours. Postmortem duration in the animals was associated with gradual increases in VEGF that reached significance only at 36 hours.Conclusions. We conclude that VEGF CSF concentrations are significantly higher in infants who die of SIDS. We postulate that hypoxia is a frequent event that precedes the sudden and unexpected death of these infants.
Newborn Early Discharge Revisited: Are California Newborns Receiving Recommended Postnatal Services?
Authors: Galbraith Alison A. , Egerter Susan A. , Marchi Kristen S. , Chavez Gilberto , Braveman Paula A. 
Published: August 2004

Context. Responding to safety concerns, federal and state legislation mandated coverage of minimum postnatal stays and state legislation in California mandated coverage of follow-up after early discharge. Little is known about the postnatal services newborns are receiving.Objective. To describe rates of early discharge and of timely follow-up for early-discharged newborns.Design and Setting. Retrospective, population-based cohort study using a 1999 postpartum survey in California.Participants. A total of 2828 infants of mothers with medically low-risk singleton births.Main Outcome Measures. Rates of early discharge (≤1-night stay after vaginal delivery and ≤3-night stay after cesarean section) and untimely follow-up (no home or office visit within 2 days of early discharge).Results. Overall, 49.4% of newborns were discharged early. Of these, 67.5% had untimely follow-up. The odds of early discharge were greater with lower incomes: the adjusted odds ratios (AORs) (with 95% confidence intervals) were 2.06 (1.50–2.83) for incomes ≤100% of poverty, 2.20 (1.65–2.93) for incomes from 101%–200% of poverty, and 2.24 (1.63–3.08) for incomes from 201%–300% of poverty. Untimely follow-up was more likely for infants of women with incomes ≤100% of poverty (AOR = 1.89 [1.13–3.17]) and 201%–300% of poverty (AOR = 1.78 [1.09–2.91]), Medicaid coverage (AOR = 1.73 [1.20–2.47]), Latina ethnicity (AOR = 1.47 [1.02–2.14]), and non-English language (AOR = 1.72 [1.16–2.55]).Conclusions. Despite an apparent decline in short stays after legislation, many newborns—particularly from lower-income families—continue to be discharged early. Most newborns discharged early—particularly those with Medicaid and those from low-income, Latina, and non–English-speaking homes—do not receive recommended follow-up. The most socioeconomically vulnerable newborns are receiving fewer postnatal services.
Prescribing of Psychotropic Medications for Children by Australian Pediatricians and Child Psychiatrists
Authors: Efron Daryl , Hiscock Harriet , Sewell Jillian R. , Cranswick Noel E. , Vance Alasdair L. A. , Tyl Yvonne , Luk Ernest S. L. 
Published: August 2004

Objective. To describe the pattern of prescribing of psychotropic medications for Australian children.
Design. Australia-wide cross-sectional postal survey conducted in 2000.
Participants. All registered general pediatricians and child and adolescent psychiatrists.
Results. The survey was completed by 435 general pediatricians and 187 child and adolescent psychiatrists (response rates 72% and 70%, respectively). Stimulants and clonidine were the most frequently prescribed medications. Seventy-two percent of practitioners reported that they had prescribed a combination of medications. Frequent combinations included a stimulant and clonidine (64% of pediatricians, 51% of child psychiatrists) and a stimulant and a selective serotonin reuptake inhibitor (SSRI; 29% of pediatricians, 36% of child psychiatrists).
Pediatricians were more likely than child psychiatrists to report prescribing clonidine for sleep problems (67% vs 36%). Child psychiatrists were more likely than pediatricians to report prescribing SSRIs (93% vs 75%) and mood stabilizers (45% vs 11%) for depression, and SSRIs (74% vs 50%) and tricyclic antidepressants (37% vs 12%) for obsessive compulsive disorder.
Off-label prescribing (indication or age not included in the product information) was reported by 40%. Over 5% of practitioners in this study had prescribed clonidine, methylphenidate, dexamphetamine, and typical neuroleptics for children under 3 years of age.
Conclusions. A broad range of psychotropic medications are being prescribed for Australian children, with some medication groups being prescribed frequently. Combinations of psychotropic medications are used regularly, and there is some prescribing for very young children. The safety and efficacy of several of the agents prescribed have not been adequately researched in children. There is an urgent need for pediatric psychopharmacology research to inform current prescribing practice.
Availability of Adolescent Health Services and Confidentiality in Primary Care Practices
Authors: Akinbami Lara J. , Gandhi Hiren , Cheng Tina L. 
Published: August 2004

Background. Little is known about availability of services and confidential care for adolescents in primary care practices or how availability among pediatric practices compares to that among other primary care practices. The objective of this study was to assess self-reported availability of services for medically emancipated conditions and confidential care in primary care practices, to compare physician responses to those from office staff who answer appointment lines, and to compare availability in pediatric practices to other primary care practice types.
Methods. We conducted a telephone survey of randomly selected practices from the Washington, DC, metropolitan area in pediatrics (Peds), internal medicine (IM), and family medicine (FM). We asked staff who answer appointment lines about availability of services for medically emancipated conditions and confidential appointments for adolescents. Physicians received the same questions via a mail survey. Responses from office staff and physicians in the same practice were linked for comparison.
Results. Of 434 practices contacted by telephone, 372 (86%) responded. Of the 615 physicians surveyed from these 372 practices, 264 (43%) from 170 practices responded to the mail survey. Peds practices were less likely than FM and IM practices to offer services for medically emancipated conditions and were less likely than FM practices to offer confidential services to adolescents. Office staff and physicians from FM and IM had higher agreement compared with Peds about availability of services for medically emancipated conditions. Agreement between office staff and physicians about provision of confidential appointments to adolescents was low among all practice types. However, having a written office policy on adolescent confidentiality was significantly associated with agreement between office staff and physicians about availability of confidential services.
Conclusions. Care for medically emancipated conditions and confidential services for adolescents are limited among primary care practices, especially among pediatric practices. All primary care practice types had significant disagreement between office staff and physicians about availability of confidential services to adolescents. Adolescents who call appointment lines are likely to receive inaccurate information about confidentiality policies. Establishing written office policies on adolescent confidentiality may help to improve access to confidential care for adolescents.
Adolescent Participation in Tobacco Promotions: The Role of Psychosocial Factors
Authors: Burke Albers Alison , Biener Lois 
Published: August 2004

Objectives. To identify psychosocial factors that place adolescents at risk for participation in tobacco promotions, and to further investigate the hypothesis that psychosocial vulnerabilities have an indirect effect on smoking initiation among youth by way of involvement with tobacco promotions.
Methods. Data were from a follow-up telephone survey of youth in Massachusetts. A subset of adolescents who were not established smokers, had not smoked cigarettes in the past 30 days, and did not own a promotional item at baseline in 1993 was used for the analyses (n = 468). Bivariate analyses were used to evaluate the association between psychosocial vulnerabilities and subsequent acquisition of cigarette promotional items. Logistic regression was conducted to identify the set of factors that best predict attainment of tobacco promotional items, and to examine the mediating influence of item acquisition on the relation of between psychosocial vulnerabilities and smoking initiation.
Results. Adolescents who were academically disengaged at baseline were more likely to acquire a tobacco promotional item at follow-up. Academic disengagement was significantly associated with item acquisition, above and beyond the other psychosocial vulnerabilities. The direct effect of academic disengagement changed from marginally significant to nonsignificant when item acquisition was introduced.
Conclusions. This study provides evidence that receptivity to tobacco promotional items is greatest among youth who are disengaged from school.
Childhood Drowning: Barriers Surrounding Private Swimming Pools
Authors: Stevenson Mark R. , Rimajova Miroslava , Edgecombe Dean , Vickery Ken 
Published: August 2004

Objective. To investigate the causes of child drowning and determine the need for changes in the legislation as well as improvements to the inspection and enforcement of current legislation related to barriers surrounding private swimming pools.Methods. There were 3 stages to the study: a retrospective review of coroner’s data, an audit of swimming pool inspections, and in-depth interviews with swimming pool inspectors in Western Australia. The incidence of childhood drowning (per population) and compliance rates of swimming pools (per 1000 swimming pools) to the legislation were measured.Results. During the 12-year observational period (1988–2000) 50 children younger than 5 years drowned in private swimming pools in Western Australia with an overall incidence of drowning of 4.4 per 100 000 children per year. Sixty-eight percent of drownings occurred in pools that did not have 4-sided fencing with an almost 2-fold increased risk (incidence rate ratio: 1.78; 95% confidence interval: 1.40–1.79) of a child’s drowning in a swimming pool with 3-sided versus 4-sided fencing. The compliance rate of swimming pools (compliance to the current legislation) at first inspection was approximately 400 per 1000 swimming pools.Conclusions. Almost two thirds of the swimming pools in which children drowned had only 3-sided fencing. With a combination of a change in legislation, enhanced inspection processes, and public education, the incidence of drowning in private swimming pools in Western Australia could be reduced in the coming years.