bluuebunny/crossref_metadata_2025_split huggingface dataset:
Disclosure of developmental disability: A study of parent satisfaction and the determinants of satisfaction
Authors: Hasnat MJ , Graves P 
Published: March 2003

Objective: To investigate the level of parent satisfaction with the first communication of a diagnosis of developmental disability in their child (‘disclosure’) and the determinants of this satisfaction. Methodology: Interviews with parents of children with developmental disabilities regarding their experiences at the time of disclosure and their level of satisfaction with the process were carried out. Results: Parent satisfaction with disclosure overall was found to be high (82.6%). Parents were more likely to be satisfied if they received a large amount of information. Parent satisfaction was found to be higher when the disclosing professional communicates well with the parents, has an understanding of parental concerns, and is direct in manner. Having both parents, the child or support people present were not found to have any significant relationship to parent satisfaction. Conclusions: The high level of satisfaction with disclosure in this study supports the claim made by earlier researchers that parental dissatisfaction with the disclosure process is not inevitable. The major determinants of parental satisfaction with disclosure are directness, understanding of parental concerns and good communication on the part of the disclosing professional, and receiving a large amount of information.
Non‐accidental fractures in infants: Risk of further abuse
Authors: Skellern C Y , Wood D O , Murphy A , Crawford M 
Published: March 2003

Objectives: To look for features of non‐accidental fractures in infants aged under 1 year and assess the risk of subsequent morbidity and mortality. Methodology: A retrospective analysis of 99 children aged under 1 year who presented to the Mater Children’s Hospital, Brisbane, between January 1990 and December 1993, and were found to have a fracture. The 99 infants were divided into non‐accidental and accidental groups. Comparison was made between the two groups for age, sex and type of fracture. Deaths, subsequent injuries and child protection notifications until March 1997 were compared between groups. Results: Of the 99 infants with fracture (64 males, 35 female), the skull and femur were the most prevalent sites of fracture. Twenty‐six infants had fractures assessed as non‐accidental. This group was younger but did not differ significantly in gender or site of fracture. Infants aged under 4 months had a significantly greater risk of their fracture being non‐ accidental (P = 0.0007). Subsequent substantiated child protection notifications occurred in nine of the non‐accidental group and in one of the accidental group (P = 0.000001). There was no significant difference in the rate of subsequent notifications between those infants with abuse who were removed from their carers and those not removed. Subsequent injuries presenting to hospital occurred in 17 of the accidental group and three of the non‐accidental group (P = 0.20). There were no deaths. Conclusion: Infants aged under 1 year with fractures have a high prevalence of abuse. The risk of abuse as cause for the fracture is greater in those aged under 4 months. Infants with non‐accidental fractures have a high risk of further abuse even with intervention.
Continuous intrathecal baclofen infusion for children with cerebral palsy: A pilot study
Authors: Scheinberg AM , O'Flaherty S , Chaseling R , Dexter M 
Published: March 2003

Objectives: To determine whether continuous intrathecal baclofen infusion (CIBI) would decrease spasticity and improve function in children with spastic cerebral palsy. Design: Prospective study with measurement of changes from baseline assessed at regular intervals for 6 months following the intervention. Patients: Two subjects aged 8 and 9 years with cerebral palsy. Inclusion criteria included severe spasticity and age greater than 4 years. Study centre: Department of Rehabilitation, The Children's Hospital at Westmead, Westmead, New South Wales, Australia. Results: Both subjects had clinically significant reductions in lower limb spasticity from a single intrathecal dose of baclofen (screening procedure), and had intrathecal pumps implanted. An intensive physical therapy programme was provided for both subjects in the 1–3‐month period after commencing CIBI, in order to maximize functional gains. Modified Ashworth Scale scores remained reduced during the 6‐month study period. There was a clinically significant increase in upper limb function for Subject 1. Gross Motor Function Measure scores decreased from 22% to 19% for Subject 1, and increased from 6% to 10% for Subject 2 over the study period. Paediatric Evaluation of Disability Inventory scores for Subject 1 showed a reduction in the level of caregiver assistance required, while Subject 2 showed significant improvement in the functional mobility domain. The major changes noted in the parent questionnaires were reduction in tone, increased range of motion and reduced time taken helping with activities of daily living such as toilet and dressing. No significant side‐effect was seen after the screening procedure or after continuous intrathecal infusion. Both subjects’ parents felt their child was improved following the intervention. Conclusions: Children with spastic cerebral palsy can have their spasticity effectively reduced with CIBI. In this study of two children, the clinical improvements were encouraging, and it is proposed that CIBI may be of benefit to those patients whose level of spasticity severely interferes with function. Further studies using multidimensional assessment approaches, with larger numbers of children, are warranted.
Is the practice of paediatric inpatient medicine evidence‐based?
Authors: Moyer VA , Gist AK , Elliott EJ 
Published: March 2003

Objective:  To determine whether management provided to paediatric inpatients in general units was supported by high‐level evidence.Methods:  A retrospective review was carried out of all patients (n = 142) admitted during one calendar month to two general paediatric units in the USA and Australia. For each patient, the primary diagnosis and primary treatment were determined. A literature review was performed to determine whether the therapy used was evidence‐based. The main outcome measure was the level of evidence supporting the primary intervention for the primary diagnosis of each patient.Results:  Level I evidence (at least one randomized trial) supported the primary intervention used in 31% of paediatric admissions and level II evidence (convincing non‐experimental evidence) supported the primary intervention in 44% of admissions. Primary interventions were not supported by evidence (level III) in only two patients. The remaining 24% of patients were admitted for observation or evaluation only, and received no primary medical or surgical intervention. Most patients whose interventions were supported by randomized trials were admitted with either asthma or appendicitis.Conclusions:  Most primary interventions (75%) in paediatric inpatients were supported by high‐level published evidence (level I or II). A large number of patients were admitted for evaluation or observation only, and received no therapeutic intervention. Evidence to support this action is not available.
Comparative immunogenicity of hepatitis B vaccine administered into the ventrogluteal area and anterolateral thigh in infants
Authors: Cook IF , Murtagh J 
Published: March 2003

Objective:  To compare the immunological response of hepatitis B vaccine given by intramuscular injection into the anterolateral thigh and ventrogluteal site of infants up to 10 months old at initiation of vaccination.Methods:  An open, randomized study of 200 healthy infants recruited from a single practice in a small regional town in New South Wales was carried out. Infants were vaccinated with hepatitis B vaccine (Engerix‐B 10 µg) using a 0 months, 1 month, 6 months regimen, with venous blood being collected from children 4−6 weeks after the last dose of vaccine for quantitative determination of hepatitis B surface antibody (anti‐HBs) titre. Infants with anti‐HBs titre ≥ 100mIU/mL were considered to be ‘good’ responders and were unlikely to acquire clinically significant hepatitis B infection. Infants with anti‐HBs titre < 100mIU/mL were considered to be ‘poor’ responders and were given a booster dose of Engerix‐B 20 µg; serology was repeated for anti‐HBs titre 2−3 months after this injection.Results:  Quantitative anti‐HBs titre was obtained from 177 infants: 171 4−6 weeks after the last dose of vaccine; 87 at the ventrogluteal site (46 boys, 41 girls); and 84 at the anterolateral thigh site (38 boys, 46 girls). Good antibody response (anti‐HBs titre ≥ 100mIU/mL) was not significantly different for the two sites (ventrogluteal 96.6%, anterolateral thigh 93.2%), and antibody geometric mean titres (GMT) for anti‐HBs were comparable for the two sites (ventrogluteal 2071.2 ± 5.8mIU/mL, anterolateral thigh 2073.2 ± 5.2mIU/mL).Conclusion:  The ventrogluteal and anterolateral thigh vaccination sites in infants are immunologically comparable for hepatitis B vaccine. Presumably the variance of this study with studies of adults reflected the uniform injection of vaccine antigen into muscle tissue in infants.
Anti‐oxidant vitamins and steroid responsive nephrotic syndrome in Indian children
Authors: Mathew JL , Kabi BC , Rath B 
Published: March 2003

Objective:  In recent years, it has been proposed that nephrotic syndrome is a consequence of an imbalance between oxidant and anti‐oxidant activity. In the present study, the levels of micronutrient anti‐oxidant vitamins (vitamin E, vitamin C, carotene and riboflavin) in Indian children with steroid responsive nephrotic syndrome were investigated. Their levels were measured during the acute proteinuric phase of the disease, as well as during clinical recovery (remission), in order to understand the possible role of nutritionally modifiable anti‐oxidants in the aetiopathogenesis of the disease.Methods:  The study was a hospital based, prospective cohort study. Serum and erythrocyte vitamin E, leucocyte vitamin C, serum carotene, erythrocyte riboflavin activity and serum malonyldialdehyde (MDA) levels were measured in 30 consecutive cases of children with nephrotic syndrome (International Study of Kidney Diseases in Children (ISKDC) criteria) during the proteinuric phase of the disease and at 4 weeks after remission was induced by steroid therapy. The same biochemical parameters were measured in healthy siblings (controls) of the 30 patients.Results:  Mean vitamin E (serum and erythrocyte), vitamin C and carotene were significantly lower during the proteinuric phase of the disease, and there was decreased erythrocyte riboflavin activity. There was significant elevation in the serum level of MDA during this phase. In addition, all these parameters tended to improve during remission, although complete normalization did not occur.Conclusion:  These vitamins were active in performing their anti‐oxidant function, as indicated by significant depression in their levels during the acute (proteinuric) phase, followed by partial recovery during remission. It may be concluded that steroid responsive nephrotic syndrome in children is associated with oxidative stress.
Professional telephone advice to parents with sick children: Time for quality control!
Authors: Andrews JK , Armstrong KL , Fraser JA 
Published: March 2003

Objective: To assess the quality of professional telephone advice given to parents with sick children. Methods: All hospitals with an emergency department and a paediatric ward and a designated child health telephone advice line in the greater Brisbane region were invited to participate in the study. Case scenarios involving a febrile baby, a 14‐month‐old with gastroenteritis and an 18‐month‐old with a head injury were used three times with each institution. Each of the cases should have elicited a response indicating the need for urgent medical attention. A research assistant presented the symptoms in accordance with the questions of the telephone advice‐giver. Aspects of the call were recorded, including time between call made and access to advice‐giver, profession of advice‐giver, identifying details sought by advice‐giver, questions asked about the case presented, length of call, and advice‐given. Results: Of the 10 hospitals asked, six agreed to participate. Included in the study were two paediatric hospitals, two general public hospitals, one private hospital, and a Statewide‐designated child health telephone advice line. Calls were generally attended to promptly. Only 37 (68.5%) of the advisers recognized the urgency of the case scenarios, with the febrile infant having the least likelihood of eliciting the correct advice (39%). Doctors gave more reliable advice than nurses in the fever scenario, but not in the other cases. Conclusions: Telephone advice to parents with sick children is easily accessible, but is often dangerously inappropriate. There is a need for tighter quality control and/or for a centralised telephone advice line to prevent inappropriate advice being given to parents.
Eating behaviour of children 1.5–3.5 years born preterm: Parents’ perceptions
Authors: Cerro N , Zeunert S , Simmer KN , Daniels LA 
Published: March 2003

Objective: To investigate parents’ perceptions of the eating behaviour of toddlers born preterm. Methods: A mailed, self‐administered questionnaire was sent to parents of infants born between July 1994 and July 1996 with gestational ages less than 32 weeks who had been admitted to the Neonatal Unit at Flinders Medical Centre. Results: Responses were received for 95 subjects (response rate 70%)
with a mean ± SD gestational age of 29.2 ± 2.1 weeks, birthweight
of 1243 ± 296 g and median corrected age of 134 weeks (range 84–185
weeks) at the time of study. Seventy‐eight per cent of parents were concerned about
the quality of food intake and 45% wished to change their child’s
eating behaviour. Although only 20% of parents identified their toddlers
as being fussy eaters, food refusal was reported by 58% of respondents, and
51% and 69% used food rewards or coaxing, respectively, to encourage
intake. Parents of toddlers who had received home gavage feeding (n = 5) or
had a respiratory or neurological disability (n = 16), reported poorer feeding indicators. Conclusions: Programmes providing information on normal toddler eating behaviour and strategies to promote positive feeding practices may reassure parents and promote development of food preferences and eating behaviours consistent with long‐term healthy eating habits. Special emphasis should be placed on children with a disability or children who have received home gavage feeding.
Polyneuritis cranialis with contrast enhancement of cranial nerves on magnetic resonance imaging
Authors: Morosini A , Burke C , Emechete B 
Published: March 2003

Abstract: The disorder of multiple cranial nerve palsies without spinal cord involvement is referred to as polyneuritis cranialis (PC) and is rare. It is thought to be an acute post‐infective polyneuropathy or a variant of Guillain−Barré syndrome. Electrophysiological evidence of demyelination has been reported, but no radiological abnormalities of the affected cranial nerves have been noted. We report a case of PC where contrast enhanced magnetic resonance imaging (MRI) showed enhancement of the peripheral segments of the oculomotor and abducens nerves. This case illustrates the utility of MRI in the assessment of cranial nerve palsies.
Impact of light regimen and self‐shading by algal cells on primary productivity in the water column of a shallow tropical lake (Lake Naivasha, Kenya)
Authors: Hubble D. S. , Harper D. M. 
Published: March 2003

AbstractLight is the factor that fundamentally determines the level of primary production. Primary productivity is controlled by bottom‐up factors (nutrient levels), with secondary effects due to biological factors (zooplankton grazing). The light regimen experienced by algae is determined largely by mixing of the water column. The processes of photoinhibition and light attenuation combine with the resultant light–dark adaptation to shape the vertical productivity profile and it is important to determine their importance separately because they vary spatially and temporally. Daily variations in productivity can be as large as longer‐term changes and events causing high productivity may not be important in whole‐lake terms. At approximately 0.5 m depth, there is maximal photosynthesis causing depletion of nutrients, but there is vertical homogeneity in productivity control and horizontal similarity in productivity levels. There is zero productivity below 5 m depth due to light attenuation but, if the benthos becomes productive due to an environmental change, such as decreased turbidity, overall productivity may rise appreciably. Self‐shading was investigated by incubating serial dilutions of whole lakewater with filtered water to reduce the density of algal cells. Photosynthetic efficiency was calculated as productivity per unit of chlorophyll a. Self‐shading showed different responses for conditions of ‘low’ and ‘high’ productivity. With low productivity, there was a shading loss of 17%, while for high productivity this was 46%. Thus, self‐shading is seen to have a considerable impact on potential productivity and may affect phytoplankton–cyanobacterial community structure with implications for lake management.
Wetland use and impact on Lake Victoria, Kenya region
Authors: Kairu J. K. 
Published: March 2003

AbstractThis article reports on a study of wetland use and impact on Lake Victoria conducted in March and April 1995. A field survey and interviews were used to study wetland use and their impact on Lake Victoria. This article identifies management issues and establishes a broad vision for the future. It also addresses the need to balance the competing demands for wetland use and development with the need to conserve a healthy and functional Lake Victoria. Investment proposals are made that would minimize destruction of the wetlands and negative impacts on the lake. General recommendations for planning and management issues, as well as suggestions of specific research needs that should form the basis of action and investment initiatives, are given.
Phosphates in Lake Chapala, Mexico
Authors: De Anda J. , Shear H. , Maniak U. , Riedel G. 
Published: March 2003

AbstractLake Chapala, the most important lake in Mexico, has suffered from cultural eutrophication problems for many years, manifested by the growth of aquatic vegetation and an increase in primary productivity. It was found that about 70% of the total phosphorus entering Lake Chapala is orthophosphate, thus increasing the biological availability of nutrients in the lake. In addition, the hydrologic imbalance in the lake, caused by the over‐use of water resources along the Lerma–Chapala basin, has significantly increased the hydraulic residence time of the inflow waters, thus increasing the effects of the added phosphorus, and creating conditions that increase the lake’s eutrophication status.The shallow characteristics of the lake and the action of the wind forces produce rapid changes in water quality, especially in the distribution of phosphate. The focus of this paper is on the development of a historical orthophosphate balance in Lake Chapala, quantifying the main point and non‐point sources that contribute to the enhancement of this nutrient in the lake. The estimation of the amount of phosphate in the lake can be used to determine appropriate management practices to reduce the phosphate loads on the lake.
Understanding the prattle of praxis
Authors: Penney Wendy , Warelow Philip J. 
Published: March 2003

Understanding the prattle of praxis This paper will examine and discuss some of the strengths and weaknesses of conceiving nursing as a form of praxis, encompassing within this, the idea that in order to conceive nursing as a form of praxis, reflection has to be considered a key component. It will be argued that praxis can (and should) become a practical process and that, when applied to one’s own nursing practice, changes, reshapes and allows one to discover new meanings (or, draws out the meanings which were always there). Clearly there are many different forms, understandings and applications of the term praxis and this paper will examine some of the tensions and the nexus that exist. These claims will be supported by using personal–professional journal extracts as a catalyst, showing that there is potential for closing the theory–practice gap through more in‐depth reflection, and that this examination using reflective techniques will demonstrate that nurses, by using this process develop their own implicit personal nursing theories. Using one’s colleagues as a critical resource allows what might be described as ongoing reflection to occur, where critical friends in both theoretical and practice worlds act as a dialectical catalyst for growth and change, moving toward closing the theory–practice gap.
Dance events as a caregiver intervention for persons with dementia
Authors: Palo‐Bengtsson Liisa , Ekman Sirkka‐Liisa 
Published: March 2003

Dance events as a caregiver intervention for persons with dementiaThe aim of the study was to illuminate the phenomenon of dance events as a caregiver intervention for persons with dementia in one nursing home as described by the caregivers. Seven caregivers were interviewed. The interviews were unstructured and conducted while the caregivers were watching a video of dance events arranged in the nursing home. The analysis was carried out using the phenomenological method developed by Giorgi. The results are presented in five consistent themes: (1) prerequisites for dance events; (2) creating and preparing different kinds of activities related to the dance events; (3) emotional arousal; (4) caregivers’ situational understanding; and (5) dance events and contextual consequences and synthesis into a general structure. The meaning of the dance events as a caregiver intervention was founded not only on the dancing itself but also encompassed the ontological state of ‘being together’.
Effects of zolpidem and zopiclone on cognitive and attentional function in young healthy volunteers: An event‐related potential study
Authors: Nakajima Toru , Takazawa Satoru , Hayashida Seiki , Nakagome Kazuyuki , Sasaki Tsukasa , Kanno Osamu 
Published: March 2003

AbstractThe effects of zolpidem and zopiclone, non‐benzodiazepine ultra‐short‐acting hypnotics, on cognitive function and vigilance level were investigated in the morning following nocturnal administration using event‐related potentials (ERP) and a sleep latency test (SLT). Zopiclone significantly shortened the sleep latency the following morning, whereas zolpidem did not, perhaps due to the difference in the elimination half‐lives between the compounds. No significant effect was observed for either drug on the ERP indices, including the P3, mismatch negativity and negative difference components. At a clinically prescribed dosage these sleep inducers have no remarkable effect on cognitive or attentional functions but increase sleepiness of the subjects.