bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hepatitis in children hospitalized with measles: The experience acquired after a Greek epidemic
Authors: Papadopoulou AL , Theodoridou M , Syriopoulou V , Mostrou G , Kattamis CH 
Published: March 2003

Objective: In childhood, hepatitis is an uncommon and ill‐defined complication of measles. We studied prospectively the prevalence of hepatitis in 189 children with measles, admitted to hospital during a measles epidemic in Greece. Methodology: Diagnosis of measles was based on clinical features and a fourfold rise of the haemagglutination inhibiting antibody titre, while liver impairment was based on a twofold or greater increase in liver enzymes. Results: Nine children (4.8%) had increased liver enzymes. Hepatitis was not related to the duration and severity of fever or the coexistence of other complications, and in all children but one, was subclinical and resolved rapidly. One child with mental retardation who was being treated with anti‐epileptic therapy and had normal liver enzymes prior to measles, developed hepatic coma from which he recovered 1 month later. Conclusions: Liver involvement in childhood measles is rare and transient but it may be severe in children receiving hepatotoxic drugs.
Paediatric melioidosis in the Northern Territory of Australia: An expanding clinical spectrum
Authors: Edmond KM , Bauert P , Currie BJ 
Published: March 2003

Objective: The objective of this study was to present the laboratory and clinical features of the six cases of paediatric melioidosis diagnosed from 1997–;2000. Methodology: All cases of melioidosis confirmed by the pathology department of Royal Darwin Hospital were prospectively identified by culture and/or serology. Results: Four children were Aboriginal and all six cases presented during the rainy season (November–;April) in rural areas in the tropical Top End of the Northern Territory. Delay in diagnosis ranged from 5 and 11 days. Two cases had localized melioidosis, two cases had underlying disease and were likely to be colonized with Burkholderia pseudomallei (B. pseudomallei). Two cases had neurological melioidosis with major residual disability. No deaths occurred. Conclusions: Melioidosis remains an unusual disease in children in the tropical Northern Territory. The average annual incidence since 1997 is 5.48 per 100 000. This series demonstrates that children in Australia can have serious neurological complications from B. pseudomallei infection. All children living in or visiting tropical Australia are at risk, especially those residing in rural areas in the rainy season. Melioidosis remains a difficult disease to manage, and expert opinion should be sought if B. pseudomallei is cultured from any site.
Glycopeptide prescribing in an Australian tertiary paediatric hospital
Authors: Jones DA , Pulver L , Tai B , Nourse C 
Published: March 2003

Objective: To assess the extent and appropriateness of glycopeptide use in a tertiary Australian Paediatric hospital. Methodology: A retrospective analysis of prescriptions during a six‐month period between July 1999 and January 2000. Medical records were examined and prescribing practices compared with the recommendations of the Hospital Infectious Control Practices Advisory Committee (HICPAC) and the Infectious Diseases Society of America (IDSA). Results: Fifty‐one patients were identified who received a total of 98 glycopeptide prescriptions. The Haematology/ Oncology unit prescribed 71/98 (72.4%). 68/98 (69.4%) patients received vancomycin, 9/98 (9.2%) received teicoplanin and 21/98 (21.4%) a combination of both. 81/98 (82.7%) had central venous catheters and 69/98 (70.4%) were immunocompromised. 48/98 (49%) prescriptions were for empiric treatment with 38/98 (38.8%) for prophylaxis and 11/98 (12.2%) therapeutic. 19/98 (19.4%) prescriptions were deemed appropriate, 6 (6.1%) by HICPAC criteria, and a further 13 (13.3%) by IDSA or other criteria. Of 19 prescriptions started appropriately, only 7/17 (41.1%) were continued appropriately beyond 48 h. Appropriate cultures were taken before prescription in 93.3% of cases. Dose was appropriate in 91/98 (92.9%) and frequency appropriate in all cases. The cost of inappropriate prescribing was approximately $9500. Discussion: A high rate of inappropriate glycopeptide prescribing was evident in this paediatric population. Inappropriate prescribing existed across all subspecialties. Use was primarily for empiric therapy and prophylaxis in young children with an oncology diagnosis. A number of situations existed where glycopeptide prescription was felt appropriate despite not being included in HICPAC/IDSA guidelines. Areas with high rates of inappropriate prescribing were identified and will be targeted for education and intervention. Audit of practice continues.
Growth of infants during the first 18 months of life in urban and rural areas of southern China
Authors: He M , Mei J , Jiang Z , Chen Q , Ma J , Dai J , Li M , Su Y , Lui SSH , Yeung DL , Anderson GH 
Published: March 2003

Objective: Observe the growth pattern of infants from birth to 18 months. Methodology: A prospective study was conducted from 1994 to 1996 in urban and township–rural areas of Guangdong Province, southern China, recruiting 568 and 257 newborn infants, respectively. Anthropometric data was collected at birth, 1.5, 4, 5, 6, 8, 10, 12, 15, and 18 months. Results: The urban infants at birth had Z‐scores of weight for age (WAZ), height for age (HAZ) and weight for height (WHZ) below the National Center for Health Statistics (NCHS) median (P < 0.01). However, from 1.5 to 4 months, the WAZ and WHZ scores were above (P < 0.01), but by 7 months fell and remained at – 0.7 to – 0.8 SD below the NCHS median (P < 0.01). HAZ scores improved after birth, were at the NCHS median to 8 months (P = NS), and then decreased to 0.2–0.4 SD below the NCHS median (P < 0.01). Compared with the urban infants, the township–rural infants were lighter and shorter throughout the first 18 months of life, and from 8 months of age, were – 1 SD or more below the NCHS median. Conclusions: Growth retardation was found in this sample of Chinese infants. The magnitude of growth retardation was greater for infants in the township–rural area compared with those in the urban area.
Inspired gas humidity during mechanical ventilation: Effects of humidification chamber, airway temperature probe position and environmental conditions
Authors: Todd DA , Boyd J , Lloyd J , John E 
Published: March 2003

Objectives: To determine the inspired gas humidity during mechanical ventilation with: (i) four different humidification chambers; (ii) two airway temperature probe (ATP) positions; (iii) five different humidicrib temperatures; and (iv) insulating the inspiratory limb with bubble wrap. Methodology: An observational study in the Neonatal Laboratory and Neonatal Intensive Care Unit, Westmead Hospital. The humidity of the inspired gas was measured at the proximal end of the endotracheal tube (ETT) during mechanical ventilation. Inspired humidity measurements were made with four different humidification chambers (Fisher & Paykel (F&P Healthcare Pty Ltd, Auckland, New Zealand) auto refill MR290, F&P manual refill MR310, Suruga (Suruga Inc. Humidifiers, Vincent Medical, Dongguan, China) manual refill MI‐20 and MI‐10F) with the humidity control (relative humidity setting) set at – 2. Measurements were made with the ATP positioned either; (A) at the distal end of the inspiratory tube inside the humidicrib or (B) outside the humidicrib 50 cm proximal to the ETT. The inspired gas temperatures were set at 36.5°C and at 39.0°C, respectively. For each of the different humidification chambers and ATP positions, inspired humidity measurements were made with the humidicrib temperature set at 30.8, 32.9, 35.2, 36.2, or 37.2°C. Two further sets of measurements were made, one with the inspiratory limb insulated with bubble wrap and the second set without bubble wrap. Results: There were significant differences in inspired humidity with the four humidification chambers at both ATP positions at all humidicrib temperatures. Both Suruga humidification chambers produced significantly higher inspired gas humidities under most conditions. Positioning the ATP outside the humidicrib produced significantly higher inspired gas humidities than with the ATP inside the humidicrib. Insulating the inspiratory tubing with bubble wrap also significantly improved the inspired gas humidity. Conclusions: Significant differences in inspired gas humidity were found with the humidification chambers tested. The position of the ATP and the set temperature had a significant impact on the absolute humidity of the inspired gas. In general, higher inspired gas humidities were obtained with the ATP outside the humidicrib. However, condensation of water close to the ETT appeared at low humidicrib temperatures (< 36.2°C) with the ATP outside the humidicrib and extreme care should be taken that particulate water does not enter the lungs under these conditions.
The most difficult clinical situations: A survey of Victorian general paediatricians
Authors: Cooper CP , Hewson PH 
Published: March 2003

Objective: To identify which clinical situations are the most difficult to manage for general paediatricians in Victoria, Australia.Methods: Self‐administered questionnaires were sent to general paediatricians in Victoria. They were asked their opinions regarding what were the most difficult and the most dangerous clinical situations with which they deal.Results: The response rate was 64% (63 out of 98 questionnaires sent). The general paediatricians surveyed believed that behavioural, developmental and psychosocial conditions were the most difficult to deal with; conduct disorder was the most nominated clinical category (26% of respondents). The ‘dangerous’ cases nominated were predominately traditional medical cases. The most commonly nominated category was sepsis and shock (21% of respondents). The most difficult and dangerous clinical situations overall for general paediatricians in Victoria appear to be in the areas of sepsis, child protection, paediatric and neonatal resuscitation, depression and suicide, raised intracranial pressure, intravenous fluid management, and communication with parents and adolescents.Conclusions: The present survey provides useful information to help with training‐programme design and it gives trainee paediatricians an idea of what experienced paediatricians find difficult. Severe behavioural, family and social difficulties, as well as neonatal and childhood resuscitation, severe sepsis, raised intracranial pressure, and intravenous fluid management were the clinical situations most frequently described as difficult.
Health‐service use by children with asthma over a 6‐month period
Authors: Spurrier NJ , Staugas R , Sawyer MG , Wakefield MA , Ruffin RE , Jureidini J , Arney F , Baghurst P 
Published: March 2003

Objectives:  The present study aims to describe the use of health services by children with asthma, and examine disease‐specific, parental and sociodemographic variables associated with different levels of health‐service utilization.Methods:  Parents of 135 children attending an emergency room (ER) completed questionnaires measuring the children's asthma symptoms, and sociodemographic and psychological variables. Parents were contacted monthly for 6 months to document the number of planned and unplanned visits to hospital and community health‐care services for asthma.Results:  At least one further unplanned visit to the ER was made by 37% of children, while 62% made at least one unplanned visit to a general practitioner (GP). Fifty‐five per cent made planned review visits to a GP, 30% to paediatricians and 5% to hospital clinics. After controlling for the level of asthma symptoms, parental anxiety and parental perceptions of children's vulnerability were associated with unplanned GP visits (P = 0.05 and P = 0.01, respectively); a planned review visit and the child being admitted to hospital for the index attack were associated with unplanned ER visits (P = 0.05 and P = 0.004, respectively).Conclusions:  Children with asthma more frequently attend GP services than hospital services for both planned and unplanned asthma management. Different variables predict the unplanned use of GP and ER services. Understanding these differences is imperative if children and families are to make the most effective use of health services.
Modelling the reciprocal water exchange between a river (Havel) and a lake (Tegeler See) during spring and autumn overturns
Authors: Lindenschmidt Karl‐Erich , Fröhlich Martin 
Published: March 2003

AbstractA finite volume computer model (current flow and transport) was used to simulate the reciprocal water exchange between a river (Havel) and a lake (Tegeler See) appendaged to the river in Berlin, Germany. The discretization of the model control volume is 2‐D along the plane of the water surface, which restricts the modelling to time periods of complete overturn. The finite volume method does, however, allow a depth to be given for each volume cell. A k‐ε turbulence submodel was integrated into the model to calculate the distinct dispersion coefficients for each volume cell. As current flow measurements were unavailable, the model was verified indirectly by the transport simulation of dissolved chloride, a conservative substance. The results show that the Havel contributes up to 30% of the total inflow to Tegeler See when it is overturned. As the Havel is more heavily polluted with respect to phosphorus loading, this has negative implications to the water quality of Tegeler See. Suggestions are given for controlling the Havel inflow amount by increasing the output of the phosphate elimination facility, the second main inflow to Tegeler See. Its output has very low phosphorus concentrations and serves as a flushing function.
Identification of processes regulating the colour and colour change in an oligotrophic, hardwater, groundwater‐fed lake, Blue Lake, Mount Gambier, South Australia
Authors: Telfer Andrew L. 
Published: March 2003

AbstractBlue Lake, located in Mount Gambier, South Australia, is the only known global example of a lake that annually changes colour in the blue end of the spectrum. A series of experiments, including Secchi depth readings, in situ spectroradiometric analysis and spectrophotometric analysis of water samples, were designed to identify the factors affecting the colour of Blue Lake and the processes that regulate these factors. Based on the results of these experiments, the processes controlling the colour and colour change in Blue Lake are described and quantified. Blue Lake colour was observed to change between AS 2700 Aqua during winter (April through to October) and Blue Bell during summer (December through to February). The colour change in Blue Lake is measurable and reflects primarily the regulation of the concentration of humic substances in the upper part of the lake by calcite precipitation. The calcite precipitation is driven by degassing of carbon dioxide from the epilimnion of the stratified lake in summer. The humic substances co‐precipitate with the calcite. Photodegradation of the humic substances may also occur.
Quantitative analysis of IgA1 binding protein in human serum by hypoglycosylated IgA1/Sepharose chromatography
Authors: Nakamura I , Iwase H , Hiki Y , Kobayashi Y 
Published: March 2003

IgA nephropathy (IgAN) is a common disease characterized by predominant IgA deposits in the renal mesangium. It is well‐known that IgA1 among two subclasses, IgA1 and IgA2, is the dominant deposit in the glomeruli during IgAN. The most prominent structural difference between the IgA1 and IgA2 subclasses was the duplicated proline‐rich hinge portion and the characteristic O‐linked oligosaccharide chains on the IgA1 hinge portion. There are many reports on the presence of an incompletely glycosylated O‐linked oligosaccharide (s) on the IgA1 hinge region in some of the IgAN patients. It was also reported that the artificially deglycosylated IgA1 acquired binding ability for fibronectin, type IV collagen and laminin.In this experiment, preparation and analysis of binding protein (IgA1‐BP) to the hypoglycosylated IgA1/Sepharose column were carried out. In order to examine the presence of the specific binding protein to the hypoglycosylated IgA1 in human serum, IgA1, asialo‐IgA1 and asialo‐agalacto‐IgA1/Sepharose column chromatography of normal human serum was carried out. A portion of the serum protein was bound to those columns and eluted with the buffer containing 1.0 M NaCl. About four times the amount of protein was eluted from the hypoglycosylated IgA1/Sepharose column than that from IgA1/Sepharose. Most of the eluted protein was IgG, and the IgG1 and IgG3 subclasses but neither IgG2 nor IgG4 was dominant (Fig. 1). The Protein A passed‐fraction (PAP fraction) of the IgA1‐BP seemed to contain proteins other than IgG, a detailed analysis of the PAP fraction was carried out. The PAP fraction was composed of a relatively large amount of IgA, IgM and complement C3 besides IgG. The relative content of IgG : IgA : IgM : C3 : C4 was 25 : 10 : 41 : 22 : 2 in the PAP fraction. Meanwhile, the Protein A bound‐fraction of IgA1‐BP was essentially composed of IgG (78%) and IgM (19%) (Fig. 2). Since the deposited IgA1 in IgA nephropathy patient was reported as hypoglycosylated IgA1, the obtained results might explain well the high frequency of copresence of IgM and C3 with the deposited IgA1 in IgAN patients. With respect to the IgA content in the IgA1‐BP from IgAN patients, it was significantly higher than that from other nephropathy patients (Fig. 3). Both of the samples contained a few microgram of abberant IgA per millilitre of serum.IgG subclass ratio in normal serum and IgA‐BP.imageRelative content of IgG, IgA, IgM, C3 and C4 in the PAP and PAB fractions of IgA1‐BP.imageTotal amount of IgA1‐BP and content of IgA in IgA1‐BP prepared from nephropathy patients.imageThus, the obtained results indicated hypoglycosylated IgA‐BP were IgG1, IgG3, IgA, IgM, C3.
In the name of Husserl: nursing in pursuit of the things‐in‐themselves
Authors: Yegdich Tania 
Published: March 2003

In the name of Husserl: nursing in pursuit of the things‐in‐themselves A perceived contradiction between the tenets of humanism and positivism secures phenomenology’s endorsement in nursing as an alternative methodology to the natural sciences. Nursing’s humanistic doctrine of valuing the individual is aligned with phenomenology in the belief that both projects investigate the subjective experiences of others. However, the belief that phenomenology opposes objectifying methods does not account for the different understandings of subjectivity that underpin various philosophic positions, such as humanism, phenomenology, hermeneutics and positivism. What is not recognised in nursing inquiry is that the same characteristics which belong to humanism and are subsequently attributed as belonging to phenomenology are grounded, philosophically, in a view that separates the person from her world. But rather than examining the premises on which phenomenology and humanism are based, nurse‐phenomenologists have simply yoked them together in a mutual alliance against a common enemy — Cartesian dualism. This paper focuses on Husserl and argues that the conceptual link between nursing as a humanistic discipline and Husserlian phenomenology cannot be sustained on philosophic and methodologic grounds. Far from being mutual allies, the philosophic underpinnings of humanism and Husserlian phenomenology offer two incommensurable views on the nature of subjectivity.
Nursing as normative praxis
Authors: Holmes Colin , Warelow Philip 
Published: March 2003

Nursing as normative praxisThe purpose of this paper is twofold. First, it introduces a variety of concepts of ‘praxis’, and argues in support of those which reflect the normative dimension of the critical social perspective. This begins with the Aristotelian concept, and moves through a variety of sources, including Hannah Arendt and Paulo Freire, but focuses primarily, and uniquely in the nursing literature, upon the work of the Yugoslavian ‘praxis Marxists’. Second, specific ways of conceiving nursing as praxis are outlined, including political, aesthetic and ethical forms which have immediate import for nurses. The paper concludes with brief suggestions as to how these ways of conceiving praxis may be used by nurses to develop a more intimate and productive understanding of their own practices.
A profile analysis of personality disorders: Beyond multiple diagnoses
Authors: Nakao Kazuhisa , Takaishi Jyo , Tatsuta Kenji , Katayama Hisanori , Iwase Madoka , Yorifuji Kazuhiro , Shinosaki Kazuhiro , Takeda Masatoshi 
Published: March 2003

AbstractThe authors applied cluster analysis and multidimensional scaling to the analyses of 59 patients with personality pathology. Cluster analysis yielded eight typologies of patients: detached, anankastic, phobic, dramatic, erratic, emotional, milder emotional, and masochistic negativistic. Multidimensional scaling identified the dimensions of classifying patients: anxious rumination versus behavioural acting out, overall severity of personality pathology, and assertiveness versus withdrawal. Considering the distinction between personality disorder (dysfunctional personality) and abnormal personality (extreme personality), the following changes in current classification system are proposed: use of a hierarchy and exclusion criteria in a categorical‐type model or use of a personality profile in a dimensional‐trait model, in either case, with a dimensional rating for severity of psychopathology to define personality ‘disorder’.
Depression among caregivers of the disabled elderly in southern Japan
Authors: Washio Masakazu , Arai Yumiko 
Published: March 2003

AbstractThe present study was conducted in an attempt to investigate factors related to depression of caregivers who looked after the disabled elderly residing in a community in southern Japan. A questionnaire survey was carried out of 45 pairs of caregivers and the disabled elderly who received regular visits from a practice nurse, who was located in Onga County, Fukuoka, in southern Japan. Twenty‐four out of 45 caregivers (53.3%) scored above the conventional cut‐off of the Center for Epidemiologic Studies Depression Scale (CES‐D). The proportion of children‐in‐law caregivers was significantly smaller (0%vs 23.8%, P = 0.01) and the proportion of caregivers who had consulted a physician within 1 month prior to the study was greater in the depressed than that in the non‐depressed (79.2%vs 47.6%, P = 0.03). The elderly whose caregivers were depressed (group 1) had more behavioural disturbances than those of the non‐depressed caregivers (group 2) (1.92 ± 2.38 vs 0.52 ± 0.87, P = 0.01) A multiple logistic regression analysis revealed that only behavioural disturbance was positively related to depression (odds ratio: 4.29, 95% confidence interval: 1.28–14.37). More behavioural disturbances led the caregivers to depression or the depressed caregivers failed to take care of the elderly, which resulted in an increase in the number of the behavioural disturbances of the elderly.
Secondary personality change in psychiatric in‐patients
Authors: Tsai Shih‐Jen , Hsiao Yu‐Hua 
Published: March 2003

AbstractSecondary personality change (SPC) can be caused by various medical conditions and is rarely reported. We retrospectively investigated the prevalence, characteristics, clinical features and treatment response in psychiatric in‐patients with a primary diagnosis of SPC. Ten cases of SPC were diagnosed in a series of 5774 patients. Head trauma was the leading cause of SPC. Impulsivity, affective lability and aggression were commonly found in these SPC patients. After medication treatment, all SPC patients had mild to moderate improvement. Secondary personality change is rarely diagnosed in psychiatric in‐patients and responds poorly to medication treatment.