bluuebunny/crossref_metadata_2025_split huggingface dataset:
Longitudinal study of behaviour disorders in low birthweight infants.
Authors: Sidebotham Peter 
Published: March 2003

A cohort study of a geographically defined population of survivors of < 1500 g birthweight born in 1980 and 1981 and age‐, sex‐, and school‐matched controls. The aim was to compare the prevalence of childhood and adolescent behavioural problems. Rutter and Conners questionnaires, completed by parents and teachers at age 8 and 14 years were assessed.From an initial 40 321 births, there were 399 of birthweight < 1500 g, of whom 219 survived to age 8 years. Forty‐two were excluded because of clinical disability. 167 cases were compared with matched controls. At age 14, both parent and teacher questionnaires showed an increased prevalence of behavioural problems in cases compared with controls. Pervasive behavioural problems (parents’ and teachers’ responses concordant) were present in 9% of cases and 3% of controls.
Effectiveness of child health surveillance in lowering age of referral and surgery for undescended testis
Authors: Studnik Stefan , Lewis Helen , John Anthony 
Published: March 2003

ABSTRACTObjective To ascertain the effectiveness of the child health Surveillance (CHS) in terms of referral age and time of surgery for undescended testis (UDT).Design, Setting and Participants Retrospective study of 106 children aged 1–15 years from Trafford, Greater Manchester (UK) who underwent orchidopexy between 1 December 1993 and 31 December 1998. Cases identified from a NW Regional Database and from hospital information departments.Main variables studied Age at referral and surgery, source of referral, pattern of referral to six different hospitals, time span between referral and surgery.Main outcome measures Referral to appropriate surgeon at key ages of 12 and 24 months of age (standards 90 and 95%, respectively). Orchidopexy performed by 24 months and 60 months of age (standards 75 and 95%, respectively).Results Overall, 20% were referred by the age of 12 months and 35% by the age of 24 months. Subsequently, 20% underwent surgery by the age of 24 months and 66% by 60 months.Conclusions Neither of the achievement standards was fulfilled. Although referral for UDT has improved, the timing of referrals and surgery is still unacceptably delayed.Implications for practice Active measures are recommended to improve the education and awareness of the health visitors, GPs and the parents that early referral and surgery for children with UDT is essential.
‘Epipen’ training: a survey of the provision for parents and teachers in West Lothian
Authors: Clegg Sarah K , Ritchie Joan M 
Published: March 2003

ABSTRACTObjectives To examine the training given to parents and teachers caring for children in West Lothian with an EpiPen®.Design Questionnaires relating to training in EpiPen® use and provision for an anaphylactic emergency were sent to the children’s parents and another questionnaire to the head teachers of the school they were attending.Subjects All 44 children of school age in West Lothian identified as having been prescribed an EpiPen® were included in the study. Eighty percent of parents and 84% of head teachers responded.Results Of the parents who responded, 23% had received no training in the use of EpiPen®. Of those parents who had received training, only 11% had been offered a training review. Forty‐two percent of the schools surveyed had no named person responsible for the care of the child with the EpiPen®. Only 62% of schools had a member of staff who had received EpiPen® training, and only 35% of schools had a health care plan for the allergic pupil. Both parents and head teachers expressed concerns about the lack of information received.Conclusions Parents and school staff caring for children in West Lothian with an EpiPen® do not receive adequate training in how to use the device in an emergency. The authors suggest changes to clinical practice aimed at improving the training provided and make specific recommendations relevant to West Lothian.
Children with chronic health conditions in the Nordic countries in 1996 – influence of socio‐economic factors
Authors: Grøholt Else‐Karin , Stigum Hein , Nordhagen Rannveig , Köhler Lennart 
Published: March 2003

ABSTRACTObjective To give estimates of the prevalence of various chronic health conditions among children in the Nordic countries in 1996, and to describe socio‐demographic correlates of the chronic conditions.Design Analyses of the 1996 Nordic study on health and well‐being of children.Setting Nationally representative sample of non‐institutionalized children in the Nordic countries.Sample A total of approximately 10 000 children aged 2–17 years selected from population registries in Sweden, Iceland, Norway, Finland and Denmark.Interventions None.Results The total prevalence of chronic health conditions among children in the Nordic countries was 14.5%. Asthma, allergic rhinitis and eczema were most frequent among the listed diagnostic categories, accounting for about half of the cases. With the exception of asthma, the prevalence of all the selected conditions varied across the Nordic countries. All the diagnostic categories showed a social gradient in prevalence. Thus, the prevalence was for all the diagnostic categories higher among children from low‐educated, worker or low‐income families when compared with families of higher social classes. The prevalence of asthma was, for instance, higher among children from low‐educated compared to high‐educated families [odds ratio (OR) = 1.67, 95% confidence interval (CI) = 1.08–2.57], whereas the prevalence of eczema was higher in children from worker compared to white‐collar families (OR = 1.62, CI = 1.26–2.07).Conclusion The data presented in this article show that there is an association between low socio‐economic status and the prevalence of various selected chronic health conditions among children in the Nordic countries.
Infant and pre‐school child health promotion: what do health visitors and general practitioners think is important and what do they record?
Authors: Hampshire Amanda J , Blair Mitch E , Crown Nicola S , Avery Anthony J , Williams Idris 
Published: March 2003

ABSTRACTObjective To identify health visitors' and general practitioners' views on pre‐school child health promotion and to describe the health promotion content of child health surveillance reviews during the first year of life.Setting and sample One health visitor and general practitioner from 28 general practices in Nottingham, UK. Personal child health records of 2001 infants registered with the 28 practices.Methods Each health visitor and general practitioner were interviewed using a semi‐structured interview schedule. Copies of child health surveillance reviews recorded in personal child health records of infants during their first year of life were collected and analysed.Results Injury prevention and healthy eating were identified by health visitors and general practitioners as the most important health promotion topics to discuss with parents of pre‐school children. The health visitor was the member of the primary care team most frequently said to have a role in discussing health promotion. Health visitors were more likely than general practitioners to say they discussed health promotion at child health surveillance reviews (p = 0.0004). Few general practitioners said they discussed injury prevention at child health surveillance reviews. Health promotion issues were poorly recorded in personal child health records.Conclusions Although health visitors and general practitioners say they discuss health promotion at pre‐school child health surveillance reviews, it is not well recorded during the first year of life. Redesigning the child health surveillance review pages in personal child health records could encourage health visitors and general practitioners to discuss and record health promotion during child health surveillance reviews.
Temperament of pre‐term infants at 9 months of age
Authors: Langkamp Diane L , Pascoe John M 
Published: March 2003

ABSTRACTObjective To compare temperament of pre‐term infants without severe neurologic problems born at 34 weeks gestation or earlier with that of healthy, term infants at 9 months of age by maternal ratings and perceptions. We also compared temperament ratings at 9 months of age with ratings performed at 4 months of age to examine stability of temperament from 4 to 9 months of age.Sample When their infants were 9 months old, mothers of 34 pre‐term and 40 term infants completed the Infant Temperament Questionnaire (ITQ).Methods The ITQ assesses temperament by maternal ratings of specific infant behavior and by mothers' more subjective perceptions of temperament.Results Mothers rated pre‐term infants as having more negative mood (p = 0.003), being less adaptable (p = 0.01), more intense (p = 0.04) and as having a lower sensory threshold (p = 0.04). By maternal perceptions, 73% of term infants, compared with only 38% of pre‐term infants, were described as ‘easier than average’ (p = 0.006). By comparing the ITQ ratings at 9 months with temperament ratings of the same children at 4 months of age, we found significant stability in all dimensions of temperament among term infants, but not among pre‐term infants.Conclusions Pre‐term infants without severe neurologic problems have a more difficult temperament at 9 months of age than term infants.Implications for practice Health care providers need to be aware that many pre‐term children have difficult temperament, so that they may counsel parents about behavior issues more effectively.
Immunisation status amongst children attending special schools
Authors: Tuffrey Catherine , Finlay Fiona 
Published: March 2003

ABSTRACTObjective To determine whether children with disabilities attending special schools have the same immunisation uptake rate as the local general child population.Design Cross‐sectional survey of computer database of immunisation records for the area.Setting Community population of Bath clinical area, south‐west England.SampleThe 136 children attending three special schools in the area and 272 randomly selected age and sex matched controls.MeasurementUptake rates of all vaccines covered by the routine immunisation schedule in the UK.ResultsImmunisation rates for the children in the special schools were significantly lower (59%) than those of control children attending normal schools (83%). The immunisations which children in special schools were less likely to have received were pertussis, measles and rubella.ConclusionsChildren with severe learning and physical disabilities who attend special schools in the area studied are less likely to be fully immunised than their peers attending mainstream schools. These children have the right to receive the appropriate protection against infectious disease and may in fact be particularly vulnerable to these diseases. Steps should be taken to determine why they are not fully immunised and plans made to improve the uptake rate.
How do child care center personnel define fever?
Authors: Juhn Young J , Sauver Jennifer St. , Shapiro Eugene D , McCarthy Paul L 
Published: March 2003

ABSTRACTBackground Children with ‘fever’ are routinely excluded from child care centers, resulting in disruption of parental work schedules. Little is known about how child care centers define fever in states that do not provide guidelines.Objective To determine the frequency of temperature thresholds for the definition of fever used by child care centers that are either lower or higher than thresholds commonly used and to identify factors associated with their use.Methods We interviewed a random sample of 1632 child care program directors in Connecticut. Child care centers were classified into three groups based on their temperature threshold for definitions of fever by oral temperature: (1) group with lower fever threshold (<99.5°F); (2) group with mid‐range fever threshold (99.5–100°F); or (3) group with higher fever threshold (>100°F).Results Of the 115 directors randomly selected and then contacted, 100 (87%) agreed to be interviewed. Of the 100, one center did not have a numerical definition of fever. Eight centers used a lower temperature threshold, 60 centers used a standard or mid‐range temperature threshold, and 31 centers used a higher temperature threshold. The multinomial logistic regression model indicated that directors without a college degree were more likely to use higher or lower temperature threshold for the definition of fever compared to those with a degree (p < 0.05).Conclusions There is substantial variation in the definition of fever used by child care centers. Directors without a college degree may be target groups for continuing education of what constitutes fever in child care settings. In addition, implementation of state‐wide standards for definition of fever in child care programs should be advocated.
Persistent early feeding difficulties and subsequent growth and developmental outcomes
Authors: Motion Sara , Northstone Kate , Emond Alan , Team The ALSPAC Study 
Published: March 2003

ABSTRACTAim To investigate the prevalence of feeding difficulties in infancy, and to determine whether feeding difficulties in the first 15 months can be predictive of poor growth or developmental impairments in the pre‐school years.Methods Data on infant feeding behaviour and developmental milestones were collected prospectively, using self‐completion questionnaires, from the parents of the 14 138 live births in the Avon Longitudinal Study of Parents and Children.Results Weak sucking (18%), and choking with feeding (55%) were common at 4 weeks of age, and 3.3% of parents described great difficulties with feeding their children at 15 months. Children who had persistent feeding problems at 1, 6, and 15 months had a prevalence of 2.6/1000. This study group had a higher prevalence of delayed motor milestones, with delayed walking at 18 months (p < 0.0001) and inability to run at 30 months (p < 0.0001); delayed language development at 18 months (p = 0.041), and impairment of articulation of speech at 38 months (p = 0.012). They also demonstrated difficult behaviours, with more frequent episodes of temper tantrums (p = 0.004) and meal refusal (p < 0.0001) at 18 months. There were reductions in the mean scores for motor skills (p = 0.001), communication (p = 0.01) and total development (p < 0.0001) at 18 months. At 30 months, 22% of the parents reported concern regarding their child's weight (p = 0.0001), and the mean weight Z scores at 9 and 18 months for this group were lower than the remaining population, although the differences did not reach statistical significance.Conclusions Feeding difficulties were widely reported by parents of infants at 4 weeks of age, and thus did not have a predictive value in identifying children who were subsequently noted to have developmental impairments. The children with persistently difficult feeding throughout their first 15 months had significant impairments in their motor, language and behavioural development, and may benefit from early referral for assessment.
Catch‐up vaccination – the case of hepatitis B: identifying barriers and facilitating factors
Authors: Pesach Shvartzman , Sasson Nakar , Aya Peleg , Friger Michael , Amnon Lahad , Hava Tabenkin 
Published: March 2003

ABSTRACTBackground Hepatitis B vaccine was introduced into the regular immunization schedule in Israel in 1992. At the time, a need for a catch‐up vaccination for those aged 4–18 years, became apparent.Study objective To evaluate the vaccination rate for hepatitis B among children aged 4–18 years.Subjects The study population consisted of a national sample of 1500 children aged 4–18 years, registered at large family practices and pediatric centres, belonging to Clalit Health Services (Health Maintenance Organization).Design and setting A total of 817 telephone interviews were conducted with parents of the sampled children regarding hepatitis vaccination status and facilitating factors or barriers for vaccination.Results The overall percentage of the children vaccinated was 19%, with 14.8% receiving the full immunization course. The variables found to be significantly associated with being vaccinated were (p < 0.05): families with one to three children; first born; higher education level of parents; number of parents’ visits to the physician in the last 3 months, higher parents’ immunization status; and younger parents. The main reason for vaccination noted was a recommendation. Of those not immunized, 50% noted that the main reason was a lack of recommendation.Conclusions and Implications forpractice The outlined factors found to be associated with vaccination might benefit others facing vaccination catch‐up programs and the central role the primary care physician has as a recommending factor. Careful planning is clearly needed in developing an effective catch‐up program.
Use of volunteers to help launch a pediatric residency program in Laos
Authors: Olness Karen , Torjesen Hakon 
Published: March 2003

ABSTRACTWhen five Lao physicians began their training in a 3‐year pediatric residency program in Laos in late 1997 it launched the first full‐time postgraduate medical education in the history of the country. For a poor country with 5 million people, half of them children, and only seven fully trained pediatricians, the prospect of soon adding five new pediatricians per year has substantial implications for child health.This residency grew out of 10 years of collaboration between the Lao Faculty of Medical Sciences and a wide‐ranging group of volunteer faculty members recruited from Case Western Reserve University and many other academic centres in the United States, Canada and Thailand, with the help of an all‐volunteer organization, Health Frontiers. The collaboration grew slowly, first with a pediatric curriculum for medical students, then a series of intensive short courses in pediatrics, and finally a government‐approved residency program, based on local health needs and consistent with international standards.This article reviews some of the academic, cultural, political, organizational and financial factors involved in the project. It suggests that the low‐cost, in‐country, volunteer‐assisted residency program being developed in Laos may emerge as an effective and affordable model for introducing postgraduate medical education in other less developed countries.
The seroepidemiology of measles in Western Europe.
Authors: Jacobson Robert M 
Published: March 2003

Background The World Health Organization has targeted measles for elimination from Europe in 2007. Whether this can be achieved through routine immunization strategies now in place remains to be seen.Methods As part of the European Seroepidemiology Network, seven Western European countries conducted age‐ and sex‐stratified serological surveys of measles antibody from 1994 to 1998. The countries included the Denmark, Finland, France, Germany, Italy, Netherlands, and the United KingdomResults Overall, susceptibility levels among 2‐ to 4‐year‐olds ranged from 2.9 to 29.8%, in 5‐ to 9‐year‐olds from 2.5 to 25% and 10‐ to 19‐year‐olds from 2.1 to 13.9%. Susceptibility‐profiles were categorized as low, intermediate, and high. A country's susceptibility profile was highly associated with vaccine coverage for the first dose. First‐dose coverage ranged from 91 to 97.5% for four low‐susceptibility countries, 75–85% for two intermediate‐susceptibility countries and 55% for the one high‐susceptibility country. The low‐susceptibility countries had achieved or are very close to measles elimination. In moderate susceptibility countries endemic transmission still exists as does the risk of outbreaks as pools of susceptible individuals accumulate. Only the high‐susceptibility country still reported epidemics of measles regularly occurring in 4‐year cycles.Conclusion For the low‐susceptibility countries, the priority should be to maintain uniformly high MMR vaccine coverage for both vaccine doses. For the moderate‐susceptibility countries catch‐up campaigns may close the gap between the highly vaccinated infants and the older children who missed the new programs of infant vaccination. In the high susceptibility country the priority should be to increase infant vaccine coverage and reduce regional variation in coverage levels.
The surveys from these seven Western European countries using comparable designs provides a special opportunity to compare serological impact of measles vaccination with the epidemiology of disease. These data provide an assessment of the progress being made toward measles control in Western Europe as well as an understanding for countries around the world of the sort of coverage we will need to attain.
The UK accelerated immunization programme and sudden unexpected death in infancy: case–control study.
Authors: Reading Richard 
Published: March 2003

Objectives To investigate whether the accelerated immunization programme in the United Kingdom is associated, after adjustment for potential confounding, with the sudden infant death syndrome.Design Population‐based case–control study, February 1993 to March 1996. Parental interviews were conducted for each death and for four controls matched for age, locality and time of sleep. Immunization status was taken from records held by the parents.Setting Five regions in England with a combined population of over 17 million.Subjects Immunization details were available for 93% (303/325) of infants whose deaths were attributed to the sudden infant death syndrome (SIDS); 90% (65/72) of infants with explained sudden deaths; and 95% (1515/1588) of controls.Results After all potential confounding factors were controlled for, immunization uptake was strongly associated with a lower risk of SIDS [odds ratio 0.45 (95% confidence interval 0.24–0.85)]. This difference became non‐significant [0.67 (0.31–1.43)] after further adjustment for other factors specific to the infant's sleeping environment. Similar proportions of SIDS deaths and reference sleeps (corresponding to the time of day during which the index baby had died) among the controls occurred within 48 hours of the last vaccination [5% (7/149) versus 5% (41/822)] and within 2 weeks [21% (31/149) versus 27% (224/822)]. No longer term temporal association with immunization was found (p = 0.78). Of the SIDS infants who died within 2 weeks of vaccination, 16% (5/31) had signs and symptoms of illness that suggested that medical contact was required, compared with 26% (16/61) of the non‐immunized SIDS infants of similar age. The findings for the infants who died suddenly and unexpectedly but of explained causes mirrored those for SIDS infants.Conclusions Immunization does not lead to sudden unexpected death in infancy, and the direction of the relation is towards protection rather than risk.
More reassuring information about the safety of the accelerated course of immunization. This paper should help us reassure the public that young babies' immune systems are not too immature to handle multiple vaccines. In fact there is no logic to this view at all: Babies' immune systems are set up to be able to respond to multiple challenges, and there is mounting evidence that the lack of such challenges has its own deleterious effects on the subsequent development of the immune system.This paper also addresses some of the research into babies’ temperature control, which suggested that the response to immunization at this age might precipitate an abnormal response in some babies. Epidemiologically, there seems to be no risk of death. The authors postulate a possible protective effect, but I think that residual confounding may account for this, despite their best efforts to avoid it.