bluuebunny/crossref_metadata_2025_split huggingface dataset:
A ‘chronic disorder’ health‐care model for children with complex developmental disorders
Authors: McDowell M , Klepper K 
Published: March 2003

Objectives: To conceptualize, develop and evaluate a ‘chronic disorder’ clinical model of health services for children with ‘low‐severity’ developmental disorders assessed and treated within a public Child Development Unit. Methodology: Concepts of family empowerment, child resiliency and the management of clinical complexity were explicitly incorporated into the service model and the clinical strategies in order to address long‐term goals of prevention and health promotion. To explore the efficacy of this model, a telephone audit survey was conducted of parents of 42 children seen sequentially through this modified service. Results: Parent data indicate a high level of satisfaction with the integrated, individualized assessment processes and effective transmission of information through both written reports and dedicated discussion visits. A treatment methodology based on parent chosen treatment goals for short and long time‐frames was experienced as achievable and successful. Conclusions: These data suggest that the service goals of an integrated team process, parent empowerment and effective clinical collaborations may be achievable from a health care setting. A change in emphasis from remedial treatment to adaptation, health promotion and tertiary prevention is integral to these strategies. The concepts, clinical model and evaluation are presented to stimulate discussion around the question of what child health services are attempting to achieve for children with complex developmental disorders.
Ascertainment of birth defects: The effect on completeness of adding a new source of data
Authors: Bower C , Silva D , Henderson T R , Ryan A , Rudy E 
Published: March 2003

Background: The Western Australian (WA) Birth Defects Registry aims for complete ascertainment of birth defects in WA, but the proportions of birth defects in rural areas and in Aboriginal children are lower than in metropolitan and non‐Aboriginal children. The effect on ascertainment of adding data from the Rural Paediatric Service (RPS) was investigated. Method: A file of all cases of birth defects for children born 1980–1997 and recorded on the RPS database was linked to the Registry. Results: The addition of this new data source had little effect on the overall prevalence of birth defects (an increase from 5.38 to 5.41%). There was a slightly greater effect on the prevalence of birth defects in rural residents (4.67%–4.76%) and Aboriginal children (4.55–4.78%), although the prevalence for each of these groups is still less than for metropolitan residents and non‐Aboriginal infants, respectively. All major categories of birth defects were represented in the new cases and, in general, their addition made little difference to the prevalence of each category. The exception was fetal alcohol syndrome, which increased from 0.13 per 1000 to 0.18 per 1000 once the 21 new cases from the RPS were added. Conclusion: Complete ascertainment of birth defects is important in developing and evaluating preventive programs, and in investigating clusters of birth defects.
Sudden infant death syndrome (SIDS) in South Australia 1968–97. Part 2: The epidemiology of non‐prone and non‐covered SIDS infants
Authors: Beal S M , Baghurst P , Antoniou G 
Published: March 2003

Objective: To identify the risk factors for infants who die suddenly and unexpectedly, but whose deaths are not related to prone position, or having the head covered. Methodology: A case‐control study was designed in which the cases were infants who had died of sudden infant death syndrome (SIDS) in South Australia between January 1974 and December 1997, who were found not prone, not bed sharing and with the head not covered. The controls were two infants for each case, born in the same year and found in the prone position (again not bed sharing and with the head not covered). Results: Sudden unexpected death in infancy is rare in non‐prone infants with the head not covered, occurring on average twice a year in South Australia, where there are 18 000–21 000 births per year. In this group there was a higher percentage of infants with features associated with low socio‐economic groups (teenage pregnancies and maternal smoking), sibling SIDS, suspicion of non‐accidental injury and the presence of minor congenital anomalies, especially cardiac anomalies. Conclusions: The majority of unexpected deaths in infancy can be prevented by not allowing infants to be unobserved in prone position, and by preventing them from getting their faces covered. For the few infants not found in these positions, a careful investigation should be made for malformations or non‐accidental injury.
A parent‐completed developmental questionnaire: Follow up of ex‐premature infants
Authors: Skellern CY , Rogers Y , O'Callaghan MJ 
Published: March 2003

Objective: Premature infants are at increased risk of developmental disability. Early identification of problems allows intervention to ameliorate or attenuate problems. A reliable screening tool allows triage of children in this high‐risk population by identifying those unlikely to need full developmental assessment. To explore the test characteristics of an established parent‐completed developmental assessment questionnaire ‘Ages and Stages Questionnaire’ (ASQ) in follow up of an Australian population of premature infants. Methodology: One hundred and sixty‐seven children born prematurely with corrected ages 12‐ to 48‐months attending the Growth and Development Clinic at the Mater Children’s Hospital in Brisbane, Queensland, Australia; 136 questionnaires ‘ASQ’ were returned completed (81%) and were compared to formal psychometric assessment (Griffith Mental Development Scales for 12‐ and 24‐months, Bayley Mental Development Intelligence Scale for 18‐months, McCarthy General Cognitive Intelligence Scale for 48‐months). Developmental delay was considered to be present if any of the above psychometric assessments fell below 1.0 standard deviations (SD). The ASQ cut‐off used was 2.0 SD (US data derived means and SD). Results: Aggregate results for all age groups comparing ASQ to psychometric assessments as ‘gold standards’ found the ASQ to have the following test characteristics: sensitivity (90%); specificity (77%); positive predictive value (40%); negative predictive value (98%); % over‐referred (20%); % under‐referred (1%); % agreement (79%). Likelihood ratio for children failing the ASQ was 3.8 and for passing the ASQ was 0.13. Twenty‐one children with known disabilities were included in the study and in 14 of these, the ASQ overall score agreed with the psychometric assessment (67%). Conclusion: The high negative predictive value of the ASQ supports its use as a screening tool for cognitive and motor delays in the follow up of ex‐premature infants. This would need to be combined with other strategies as part of a comprehensive follow up program for ex‐premature infants.
Childhood poisoning in Queensland: An analysis of presentation and admission rates
Authors: Reith DM , Pitt WR , Hockey R 
Published: March 2003

Objective: To determine the presentation rates for paediatric poisoning by ingestion and the determinants of hospital admission. Methodology: Cross‐sectional survey using an injury surveillance database from emergency departments in South Brisbane, Mackay and Mt Isa, Queensland, from January 1998 to December 1999. There were 1516 children aged 0–14 years who presented following ingestional poisoning. Results: The presentation rates for poisoning were 690, 40 and 67 per 100 000 population aged 0–4, 5–9 and 10–14 years, respectively. The admission rates to hospital for poisoning were 144, 14 and 22 per 100 000 population aged 0–4, 5–9 and 10–14 years, respectively. Although presentation rates for poisoning were higher in the rural centres the admission rates were disproportionately high for the 0–4 years age group. The agents most frequently ingested were paracetamol, Dimetapp®, rodenticides and essential oils. Conclusion: There is a need to design and implement interventions aimed at reducing poison exposures and unnecessary hospital admissions in the 0–4 years age group.
The Sleep and Settle Questionnaire for parents of infants: Psychometric properties
Authors: Matthey S 
Published: March 2003

Objective: To determine the psychometric properties of a parent‐report questionnaire (Sleep and Settle Questionnaire (SSQ)) assessing: (i) the infant’s sleep and settling behaviour, and (ii) the parent’s level of concern with such behaviours. Methodology: Test‐retest reliability was determined by administering the SSQ to 20 mothers on two occasions, 7–14 days apart. Validity was determined by comparing SSQ responses between mothers with 6‐week‐old infants who, on a semistructured questionnaire, reported no sleep or settling difficulties (n = 56–60) with those who reported they were experiencing difficulties (n = 133). Further comparison was made with a sample of mothers (n = 34–36) attending a community class on sleep and settling difficulties with infants. Sensitivity to change was determined by comparing mothers’ SSQ responses at 6‐weeks and 6‐months postpartum. Results: The SSQ was found to have low test–retest reliability on items referring to the infants’ sleep and settling behaviour, but moderate reliability for the extent that such behaviour bothered the parent. Comparison across the different samples showed good discriminant and concurrent validity. Conclusions: Parental reports on the SSQ indicates that over a short period (1–2 weeks) the infants’ sleep and settling behaviour can change considerably, but that the extent to which such behaviour bothers the parent is more stable. Good validity demonstrates the SSQ is sensitive to differing infant behaviour. It is recommended as both a clinical and research instrument, and could be used to complement assessments focusing on the parent’s psychosocial adjustment in the early postpartum period.
Couple distress after sudden infant or perinatal death: A 30‐month follow up
Authors: Vance JC , Boyle FM , Najman JM , Thearle MJ 
Published: March 2003

Objective:  To examine, using a 30‐month prospective study, patterns of anxiety, depression and alcohol use in couples following stillbirth, neonatal death or sudden infant death syndrome.Methodology:  One hundred and thirty‐eight bereaved and 156 non‐bereaved couples completed standardized interviews at 2, 8, 15 and 30 months post‐loss.Results:  At all interviews, bereaved couples were significantly more likely than non‐bereaved couples to have at least one distressed partner. Rarely were both partners distressed in either group. For bereaved couples, ‘mother only’ distress declined from 21% to 10% during the study. ‘Father only’ distress ranged from 7% to 15%, peaking at 30 months. Bereaved mothers who were distressed at 2 months reported significantly lower marital satisfaction at 30 months.Conclusions:  At the couple level, the experience of a baby's death is multifaceted. Gender differences are common and partners’ needs may change over time. Early recognition of these differences may facilitate longer‐term adjustment for both partners.
Partial liquid ventilation and nitric oxide in experimental acute lung injury
Authors: Davies MW , Stewart MJ , Chavasse R , Bayley G , Butt W 
Published: March 2003

Objective: To investigate the effects of inhaled nitric oxide (iNO) and partial liquid ventilation (PLV) on oxygenation and pulmonary haemodynamics in acute lung injury (ALI), and to assess their effects on lung function, systemic haemodynamics and lung injury.Methods: Using saline lung lavage, ALI was induced in 18 piglets. A control group was ventilated with conventional mechanical ventilation (CMV) for 2 h. An iNO‐first group received iNO for the first hour and then iNO with PLV. A PLV‐first group received PLV for the first hour and then PLV with iNO. Variables were measured at baseline, 5 min postlavage, and at 1 h and 2 h postlavage.Results: During the first hour, both treatment groups showed improvement in oxygenation index (OI). At 2 h, the dif­ferences in OI were statistically significant (P = 0.037), with a mean ± SD of 23.8 ± 20.7 in the control group, 4.4 ± 0.9 in the PLV‐first group and 6.5 ± 3.1 in the iNO‐first group. The OI was similar in both treatment groups (P = 0.178). At 2 h, the pulmonary artery pressure (PAP) was significantly different (P = 0.04) between groups, with a mean ± SD PAP of 36.3 ± 7.2 mmHg in the control group, 27.4 ± 4.0 mmHg in the PLV‐first group and 30.0 ± 4.1 mmHg in the iNO‐first group. The PAP was similar in both treatment groups (P = 0.319).Conclusion: In ALI, oxygenation and pulmonary hypertension are improved with PLV and iNO given together, regardless of the order in which they are commenced.
Randomized controlled trial of oral versus intravenous fluid supplementation on serum bilirubin level during phototherapy of term infants with severe hyperbilirubinaemia
Authors: Boo N‐Y , Lee H‐T 
Published: March 2003

Objective: To compare the rates of decrease in serum bilirubin levels in severely jaundiced healthy term infants given oral or intravenous fluid supplementation during phototherapy. Methods: A randomized controlled study was carried out in the neonatal intensive care unit (NICU) of Hospital Universiti Kebangsaan Malaysia over a 12‐month period. Fifty‐four healthy term infants with severe hyperbilirubinemia were randomized to receive either solely enteral feeds (n = 27) or both enteral and intravenous (n = 27) fluid during phototherapy. Results: There were no significant differences in the mean birthweight, mean gestational age, ethnic distribution, gender distribution, modes of delivery and types of feeding between the two groups. Similarly, there was no significant difference in the mean indirect serum bilirubin (iSB) level at the time of admission to the NICU between the enteral (359 ± 69 μmol/L [mean ± SD]) and intravenous group (372 ± 59 μmol/L; P = 0.4). The mean rates of decrease in iSB during the first 4 h of phototherapy were also not significantly different between the enteral group (10.4 ± 4.9 μmol/L per h) and intravenous group (11.2 ± 7.4 μmol/L per h; P = 0.6). There was no significant difference in the proportion of infants requiring exchange transfusion (P = 0.3) nor in the median duration of hospitalization (P = 0.7) between the two groups. No infant developed vomiting or abdominal distension during the study period. Conclusion: Severely jaundiced healthy term infants had similar rates of decrease in iSB levels during the first 4 h of intensive phototherapy, irrespective of whether they received oral or intravenous fluid supplementation. However, using the oral route avoided the need for intravenous cannulae and their attendant complications.
Alteration of the water balance of lakes
Authors: Basso Eduardo 
Published: March 2003

AbstractTwo cases of alteration of the water balance of lakes are discussed, these are: (i) alteration of the hydrological cycle due to changes in the lake basin; and (ii) alteration of the hydrological cycle due to changes in the amount of evaporation from the lake surface. In both cases, the technical aspects that result from these changes are briefly discussed, as well as the use of methods for the chemical reduction of lake evaporation.
Dominance of Cylindrospermopsis raciborskii (Nostocales, Cyanoprokaryota) in Queensland tropical and subtropical reservoirs: Implications for monitoring and management
Authors: McGregor Glenn B. , Fabbro Larelle D. 
Published: March 2003

AbstractSince October 1997, 47 reservoirs and weir pools across tropical and subtropical Queensland have been regularly monitored for the occurrence of planktic cyanoprokaryotes. Cylindrospermopsis raciborskii (Woloszynska) Seenaya & Subba Raju (Nostocales, Cyanoprokaryota) was found in 70% of the storages, with one storage displaying year‐round dominance, 50% of the reservoirs seasonally dominated and a seasonal presence in 46% of the weir pools. Maxima for the majority of storages occurred from late summer through to early autumn. The precise timing of onset of seasonal maxima varied considerably between storages and regions. Temperature and stratification patterns influenced seasonal recruitment with C. raciborskii reaching seasonal maxima in southern storages generally later than the northern storages. Overall peak seasonal abundance occurred in deep strongly stratified storages. The majority of storages experiencing concentrations > 15 000 cells mL–1 tested positive to the presence of the alkaloid cytotoxin, cylindrospermopsin. Median cylindrospermopsin concentration across the 14 reservoirs in which toxin was recorded was 3.4 μg L–1. The highest toxin concentrations were generally associated with storages in which C. raciborskii had been established for a considerable period of time, or occurred after the peak summer population maxima. Toxin concentrations of 1 μg L–1 were generally associated with cell concentrations of approximately 20 000 cells mL–1, hence this cell concentration threshold was adopted as a health trigger level at which to begin monitoring for toxicity. The morphology of this species was highly variable and included straight, coiled and sigmoid‐shaped trichomes. Populations were routinely recorded as mixtures of all three morphotypes or proceeded as transitions from one morphotype to another throughout the year. The dominance of C. raciborskii appears to be favoured by a set of environmental and hydrological factors that include long water residence time, high pH, high temperature, high incident irradiation and a thermally stratified water column. The lack of visual monitoring cues, such as scum formation, variation in colour of the water body, rapid germination of large numbers of cells, highly variable morphology, relative toxicity and persistence of this species year round in many areas, continues to make this species a primary focus of water managers.
Turbid flow through a tropical reservoir (Lake Dalrymple, Queensland, Australia): Responses to a summer storm event
Authors: Faithful John W. , Griffiths Dilwyn J. 
Published: March 2003

AbstractThe first flood event following a prolonged dry period is described for an impoundment, Lake Dalrymple, in tropical north‐eastern Australia. The event, in January 1996, generated substantial flow in the two main inflow sources: the Burdekin River from the north and the Suttor River from the south. Flow through the Burdekin River peaked early and then subsided to a lower level, but flow through the Suttor River persisted at a moderate level for over 15 days after the initial inflow. An extensive water quality survey was conducted on 16 January 1996 (seven days after the initial dam overflow) to determine the nature of the inflows originating from the two major subcatchments feeding the reservoir as they entered and passed through the impoundment. The inflow comprising waters of high turbidity and low conductivity occupied the mid‐column region along the two major inflow channels through the impoundment to the dam wall. The suspended particulate material in the form of silt and clay sized particles remained in suspension as the flow passed through the reservoir, due in part to the low ionic strength of the inflow and the relative densities of the inflowing and receiving waters. For both river sources, more than 50% of the total nitrogen and almost all of the total phosphorus were bound to the suspended particulate matter. Much of this was exported in the flow over the spillway. The highly turbid nature of the inflow resulted in strong attenuation of down‐welling photosynthetically active radiation (up to maximum attenuation values of 12.24 m–1 in the reservoir where the euphotic depth was only 0.38 m). The irradiance reflectance and the scattering coefficient were considerably higher than any reported for other Australian inland waters. Concentrations of viable chlorophyll a in the surface waters were very low (maximum value 3.4 μg L–1) because of the highly turbid conditions and extensive dilution by the inflow. The results of this study provide an example of the significant impact a large inflow of turbid, low conductance water can have on a large reservoir in the arid tropics following a prolonged dry period. During inflow events such as the one described in this paper, the reservoir becomes riverine in nature, and large amounts of suspended particulate matter and associated nutrients are transported through the reservoir.
Optical and biological properties of Lake Ülemiste, a water reservoir of the city of Tallinn I: Water transparency and optically active substances in the water
Authors: Erm A. , Arst H. , Trei T. , Reinart A. , Hussainov M. 
Published: March 2003

AbstractOptical and biological measurements were performed in Lake Ülemiste in the summer of 1997 (four measurement days), and from May to October in 1998 (12 measurement days). This kind of data, describing the type and amount of optically active substances in the water, phytoplankton characteristics, the underwater light field, and temperature–oxygen situation in the lake are necessary when estimating the ecological state of the lake. Lake Ülemiste is the main drinking water reservoir of Tallinn, the capital of Estonia. Phytoplankton abundance and biomass, chlorophyllaand suspended matter were determined from collected Lake Ülemiste water samples in the laboratory. Spectrophotometrical processing of the filtered and unfiltered water was carried out to describe the beam attenuation coefficient spectra and optical influence of yellow substance in the water. Vertical profiles of downwelling irradiance of the PAR (400–700 m) region of the spectrum (and from these data the averaged over depth diffuse attenuation coefficient) were determined. The relative transparency of the water was estimated by using a Secchi disk. Passive optical remote measurements were episodically made from aboard a boat. Results obtained confirmed that Lake Ülemiste is turbid (almost hypertrophic), comparable with most turbid lakes in Estonia (e.g. Lake Võrtsjärv) and Finland (Lake Tuusulanjärvi). Its chlorophyllacontent varied within the range 13–121 mg m–3, phytoplankton biomass 3–107 mg L–1, phytoplankton abundance 65 000–999 000 mL–1, suspended matter 8–34 mg L–1, effective concentration of the yellow substance 6–30 mg L–1, diffuse attenuation coefficient of light in the PAR region 1.0–3.3 m–1and a Secchi disk depth of 0.5–1.75 m. The temporal variation of the spatial averages of these parameters during 1998 was analysed. Almost all characteristics showed an increase from May to midsummer with a maximum in late July or in August (correspondingly the Secchi depth values were minimal in late summer). The amount of yellow substance was an exception, which was nearly constant during the observation period. The maximum level of chlorophyllacontent in July and August 1998 markedly exceeded that in 1997, despite the fact that the summer of 1997 was sunny, but the summer of 1998 was cold and rainy. The correlative relationships between the different parameters were investigated together with the respective data for other lakes. They show that the data of Lake Ülemiste supplemented the correlation graph in the region of turbid lakes, whereby in all cases the correlation coefficient increased following the addition of Lake Ülemiste data. The highest correlation coefficient was obtained when light attenuation coefficient values were correlated with a sum of weighted concentrations of chlorophylla, yellow substance and suspended matter (multiple regression analysis).