bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of pacifier use on breastfeeding: A prospective cohort study
Authors: Vogel AM , Hutchison BL , Mitchell EA 
Published: March 2003

Objectives: To determine the predictors of pacifier use during the first year of life and to assess the influence of pacifier use on the duration of breastfeeding. Methodology: A prospective cohort study was conducted. Three hundred and fifty mother–infant pairs were followed to 1 year of age to determine the impact of the use of a pacifier on the duration of breastfeeding. Results: A cohort of 441 mothers were enrolled and 79% participated. Ninety four per cent were followed up to 1 year. Daily pacifier use was associated with early cessation of breastfeeding (risk ratio (RR) 1.71; 95% confidence interval (95%CI) 1.29, 2.28) and a reduced duration of full breastfeeding (adjusted (adj.) RR 1.35; 95%CI 1.05, 1.74). Finger sucking was not associated with a reduced duration of breastfeeding (RR 1.05; 95%CI 0.81, 1.37). Pacifier use less than daily was not associated with a change in duration of breastfeeding (RR 1.02; 95%CI 0.75, 1.39). Most mothers commenced the use of a pacifier within the first month. Multiple logistic regression analysis found that the use of a pacifier was associated with male gender (adj. RR 1.97; 95%CI 1.23, 3.13), maternal smoking in pregnancy (adj. RR 2.23; 95%CI 1.01, 4.95), and low maternal confidence with breastfeeding (adj. RR 2.70; 95%CI 1.48, 4.93). Conclusions: Daily pacifier use is associated with a reduced duration of breastfeeding. Less frequent pacifier use does not reduce the duration of breastfeeding.
Factors associated with breastfeeding at discharge and duration of breastfeeding
Authors: Scott JA , Landers MCG , Hughes RM , Binns CW 
Published: March 2003

Objective: To identify determinants of the initiation and duration of breastfeeding amongst Australian women. Methods: A prospective cohort study of 556 women in Perth, Western Australia and 503 women from the Darling Downs area, Queensland, Australia. Results: Breastfeeding at discharge was most strongly associated with perceived paternal support of breastfeeding with an adjusted odds ratio of 9.13 (95% CI 4.83–17.26), using multivariate logistic regression analysis. Duration of breastfeeding was most strongly associated with the length of time a mother intended to breastfeed with an adjusted relative risk of 4.18 (95% CI 2.81–6.22) for ≥ 4 months relative to < 4 months. Conclusions: Interventions which aim to increase the length of time a woman intends to breastfeed, and which highlight the role of the father in successful breastfeeding, are recommended to help achieve recommended targets for breastfeeding initiation and duration.
Growth and nutrition of Chinese vegetarian children in Hong Kong
Authors: Leung SSF , Lee RHY , Sung RYT , Luo HY , Kam CW , Yuen MP , Hjelm M , Lee SH 
Published: March 2003

Objective: The study investigated the nutritional status of Chinese lacto‐ovo‐vegetarian children aged 4–14 years. Methodology: Dietary intake over 7 days was assessed using a computer program, previously used for a local population‐based dietary survey. Anthropometric measurements were made and fasting venous blood was examined for serum lipids, haematological data, iron, vitamin B12 and folate status. Bone mineral density (BMD) of the spine (L2 – L4) was measured as a reflection of calcium status. Results: Fifty‐one lacto‐ovo‐vegetarians aged 4–14 years were investigated. The mean ± standard deviation (SD) daily energy intake was 1600 ± 425 kcal. The mean (± SD) daily protein intake was 1.6 ± 0.6 g/kg bodyweight which met the United States recommended dietary allowance. Compared to that of the local omnivore diet, the vegetarian diet was closer to the recommended healthy diet with lower fat (20–23%), more fibre (5.8–8.7 g/day) and better polyunsaturated to saturated fatty acid ratio (1.0–1.1). Growth and BMD of the vegetarian children were comparable to the general omnivore population. Two children had iron deficiency and two children had anaemia. The calcium status, as reflected by the BMD, was not impaired. Serum folate and vitamin B12 were within the normal range. Six (25%) boys and four (15%) girls were obese. Three boys had hyperlipidaemia. Conclusions: A Hong Kong Chinese vegetarian diet appears healthy, providing adequate iron and vitamin B12 nutrition, but the prevalence of obesity was high.
Coordinated outpatient care of the narcotic‐dependent infant
Authors: Oei J , Feller JM , Lui K 
Published: March 2003

Objective: Concern regarding parental capacity to manage their infant's drug withdrawal traditionally leads to prolonged hospitalization for both mother and infant. This study examines the impact of a multidisciplinary follow‐up clinic for infants discharged home on morphine. Methodology: Records of full‐term infants born to mothers with narcotic dependency were reviewed retrospectively. Two periods were compared: 1995–1997 (period A) and 1998 to September 1999 with clinic established (period B). Results: Twenty‐five and 26 mothers were identified in periods A and B, respectively. Almost half had fewer than four antenatal clinic visits and most were on methadone with other substance usage. Despite higher maternal methadone doses (mean 48.5 vs 89.5 mg/day, P = 0.009) and withdrawal rates, the mean length of stay was significantly shorter for period B mothers (7.8 ± 4.8 vs 5.4 ± 3.3 days, P = 0.01) and babies (14.8 ± 9.7 vs 8.7 ± 7.2, P = 0.01). Median duration of morphine treatment was significantly shorter in period A (17 vs 60 days, P = 0.0001) when only four babies were discharged on morphine. In contrast, 18 treated period B babies were discharged on morphine. No families were lost to follow up. Compliance with clinic attendance was 92%. Conclusions: Hospital stay was reduced with establishment of the clinic. The shorter treatment duration before establishment of the clinic could have been related to a lesser abstinence severity or a perceived need of a more rapid weaning prior to discharge. Further studies are needed to assess the impact of this model of care on the health outcome of the narcotic‐dependent mother and infant unit.
Determinants of linear growth in Malaysian children with cerebral palsy
Authors: Zainah SH , Ong LC , Sofiah A , Poh BK , Hussain IHMI 
Published: March 2003

Objective: To compare the linear growth and nutritional parameters of a group of Malaysian children with cerebral palsy (CP) against a group of controls, and to determine the nutritional, medical and sociodemographic factors associated with poor growth in children with CP. Methodology: The linear growth of 101 children with CP and of their healthy controls matched for age, sex and ethnicity was measured using upper‐arm length (UAL). Nutritional parameters of weight, triceps skin‐fold thickness and mid‐arm circumference were also measured. Total caloric intake was assessed using a 24‐h recall of a 3‐day food intake and calculated as a percentage of the Recommended Daily Allowance. Multiple regression analysis was used to determine nutritional, medical and sociodemographic factors associated with poor growth (using z‐scores of UAL) in children with CP. Results: Compared with the controls, children with CP had significantly lower mean UAL measurements (difference between means –;1.1, 95% confidence interval –;1.65 to –; 0.59), weight (difference between means –;6.0, 95% CI –;7.66 to –;4.34), mid‐arm circumference (difference between means –;1.3, 95% CI –;2.06 to –;0.56) and triceps skin‐fold thickness (difference between means –;2.5, 95% CI –;3.5 to –;1.43). Factors associated with low z‐scores of UAL were a lower percentage of median weight (P < 0.001), tube feeding (P < 0.001) and increasing age (P < 0.001). Conclusion: A large proportion of Malaysian children with CP have poor nutritional status and linear growth. Nutritional assessment and management at an early age might help this group of children achieve adequate growth.
Seroprevalence of hepatitis B, hepatitis C and human immunodeficiency virus antibodies among multitransfused thalassaemic children in Shiraz, Iran
Authors: Karimi M , Ghavanini AA 
Published: March 2003

Objective: To evaluate the rate of seropositivity to hepatitis B and C and human immunodeficiency virus (HIV) infections among children with β‐thalassaemia major receiving multiple transfusions in Shiraz, Iran, compared with healthy controls. Methodology: The study was performed during 1999–2000 on multitransfused children with β‐thalassaemia major registered by the Shiraz Thalassaemia Society. Hepatitis B surface antigen (HBsAg), anti‐hepatitis C virus (HCV) antibodies (Ab) and HIV Ab were checked using a second‐generation enzyme‐linked immunosorbent assay (ELISA). Positive tests were confirmed by western blots. Healthy blood donors were used for the control group. Results: Hepatitis B surface antigen, anti‐HCV Ab and HIV Ab were positive in four of 755 (0.53%, 95% confidence interval (CI) = 0.17–1.3), 73 of 466 (15.7%; 95% CI = 12.6–19.2) and none of 466 patients tested, respectively. Positive sera for HBsAg, anti‐HCV Ab and HIV Ab were found in 85 (1.07%), 47 (0.59%) and 27 (0.34%) of 7879 control children, respectively. The rate of anti‐HCV Ab was significantly higher in patients than in the control group (P < 0.0001). In patients, the rate of positive anti‐HCV Ab was significantly higher than the rate for positive HBsAg (P < 0.0001). Conclusion: It is concluded that HCV is the current major problem in multitransfused children with thalassaemia major and more careful pretransfusion screening of blood for anti‐HCV must be introduced in our blood banks.
Acute flaccid paralysis in Australian children
Authors: Morris AMS , Elliott EJ , D’Souza RM , Antony J , Kennett M , Longbottom H 
Published: March 2003

Objectives:  To describe the epidemiology and causes of acute flaccid paralysis (AFP) in Australian children, and the clinical features of the two most common causes of AFP, Guillain−Barré syndrome and transverse myelitis.Methods:  Monthly active surveillance for AFP was carried out through the Australian Paediatric Surveillance Unit, with AFP defined as ‘acute onset of flaccid paralysis in one or more limbs or of bulbar paralysis in any child less than 15 years of age’.Results:  Between March 1995 and December 1999, 143 cases of AFP were reported (approximately 0.8 per 100 000 children < 15 years of age per annum). The age range was 2 months−14 years and 59% were boys. Out of these children, 137 (96%) were hospitalized and 47 required intensive care. No case of wild or vaccine‐associated poliomyelitis was identified. The most common causes of AFP were Guillain−Barré syndrome in 67 (47%) and transverse myelitis in 27 (19%). Other diagnoses included acute disseminated encephalomyelitis, trauma, tick‐bite paralysis and infantile botulism.Conclusion:  The participation of paediatricians in AFP surveillance contributed to the accreditation of Australia (along with the other 36 countries of the western Pacific region) as ‘polio free’ by the World Health Organization in October 2000. The surveillance also provided data on the frequency of AFP and identified Guillain−Barré syndrome and transverse myelitis as the most common diagnoses. In this large national series, many other conditions that may present as non‐polio AFP were identified.
Basis for the protection and management of tropical lakes
Authors: Lewis William M. 
Published: March 2003

AbstractManagement of lakes for the protection of water quality, aquatic life and other uses must be approached somewhat differently in the tropics from how it is approached at temperate latitudes. More than half of all tropical lakes are accounted for by natural river lakes or reservoirs. Therefore, degradation of water quality in rivers will have direct negative effects on the majority of lakes in the tropics. Also, regulation of rivers, which is one result of river impoundment, is a potential cause of damage to river lakes. Tropical lakes are more sensitive than temperate lakes to increases in nutrient supply and show higher proportionate changes in water quality and biotic communities in response to eutrophication. Tropical lakes are especially prone to loss of deep‐water oxygen, and in order to maintain ecological stasis therefore require more stringent regulation of organic and nutrient loading than temperate lakes. Nutrient containment must be more strongly oriented toward nitrogen, the most probable limiting nutrient in tropical lakes, than has been the case at temperate latitudes. However, phosphorus control is also important. Nitrogen management may be more feasible in the tropics because of high temperature, which is one of the critical conditions for efficient denitrification. Planktonic and benthic communities of the tropics bear a close resemblance, both in composition and diversity, to those of temperate latitudes; there is no parallel to the latitudinal gradient in biodiversity that is characteristic of terrestrial ecosystems. Foci of biodiversity, which require special attention, include the endemic species of ancient lakes and the diverse fish communities of very large rivers. The latter are an especially valuable untapped economic resource, but face severe impairment due to hydrological regulation and pollution of rivers. Effective management programs for tropical lakes will focus on interception of nutrients, protection of aquatic habitats from invasive species, and minimization of hydrological changes in rivers to which lakes are connected. In the absence of protective management, tropical lakes will decline greatly in their utility for water supply, production of commercially useful species, and recreation.
Influence of sewage from different water treatment plants in the Cracow Region (Poland) on early developmental stages of water snails
Authors: Wagner Aleksandra 
Published: March 2003

AbstractThe cocoons of the great pond snail, Lymnaea stagnalis (L.), and the great ramshorn, Planorbarius corneus (L.) were exposed to mechanically and biologically treated sewage from different water treatment plants in the region of Cracow (southern Poland). The control group consisted of snails from the same cocoon as the experimental snails. Mineral water and pond water from Zabierzów Bochenski (near Cracow) were used for the control groups. We found that mechanically treated sewage from the Plaszów sewage treatment plant was highly toxic (100% embryo lethality). The toxicity was reduced after mixing sewage with the control water (25% solution). However, in this group, the development of embryos was slower than in the control. No toxicity was observed in the biologically treated sewage from the same plant. The sewage from the Myslenice plant (mechanical treatment) was also very toxic (100% lethality), but this toxicity disappeared after keeping the sample at room temperature for 1 year. Water from the Vistula River was not toxic.
Zinc, lead and cadmium speciation in Dnieper water‐bodies
Authors: Linnik Peter M. 
Published: March 2003

AbstractData on the concentrations and movements of Zn, Pb and Cd in Dnieper reservoirs and the Dnieper‐Bug estuary are considered. There is a clear trend of increasing concentrations, often two‐ to fourfold, of these materials from the 1960s to the end of the 1980s. Large increases may be explained as the result of increased human impact on the water‐bodies and also because of reduced water discharge in the Dnieper River (discharge has been reduced by nearly 10 km3 in recent years). At present, the average concentrations of Zn, Pb and Cd in Dnieper water‐bodies are 35.0–50.0, 15.0–18.0 and 0.5–1.8 μg L–1, respectively. Anodic stripping voltammetry, membrane filtration, ion‐exchange and gel permeation chromatography on neutral sephadexes were methods used for analysis. The influence of adsorption and complexation processes on the mobility of Zn, Pb and Cd, and the ratio of their forms were compared. Ratios of free metal ions to ions bound in complexes with natural organic ligands were studied. The binding of metals in complexes with dissolved organic matter (DOM), or their adsorption onto suspended particles, were major processes reducing the concentration of free ions in their most toxic form. The percentage of Zn, Pb, and Cd free ions in the total balance of dissolved forms was no more than 3.6–4.8, 0.2–0.6 and 7.2–9.5%, respectively. The molecular‐weight distribution of organic metal complexes and their chemical nature, as well as the potential for complexing of DOM were investigated. Most Zn, Pb and Cd was found as complex compounds with DOM of different chemical natures and molecular weights. Humic substances, particularly fulvic acids, played a major role in the migration of the metals. These ligands bind from 40 to 80% of metals in the composition of organic complexes. Metal complex compounds of relatively low molecular weight (< 5000 Da) predominated in organic complexes of Zn (38–50%), Pb (38–52%) and Cd (22–47%). The role of inorganic ligands in complexation in surface waters was less important.
Chemical and biological features of a high altitude lake in the southern Alps (Laghetto Inferiore, Switzerland)
Authors: Barbieri Alberto , Mosello Rosario , Simona Marco 
Published: March 2003

AbstractSince 1980, surveys have been performed nearly every three years on approximately 50 small high altitude alpine lakes located in the Swiss part of the Lake Maggiore watershed. On the basis of this information, since 1996 Laghetto Inferiore has been included in the Mountain Lakes Research (MOLAR) project, an extensive European cooperative research project with 23 partners. Laghetto Inferiore is located at 2074 m a.s.l.; its watershed is mainly composed of crystalline silicic rocks; it has a maximum depth of 33 m, and a theoretical renewal time of 41 days. The pH of the water is approximately 5.6; the alkalinity of the surface water is approximately 30 μmol and that of the bottom water approximately 60 μmol. Chemical studies were performed on the inputs from atmospheric deposition and the main tributary streams, the lake concentration (on a monthly basis), and the outflow. The results show that the characteristics of summer deposition (rain) differ significantly from those of winter deposition (snow). By means of a budget model it was possible to distinguish between the contribution from atmospheric deposition and the contribution from weathering. Biological studies revealed a considerable variety of phytoplankton species and a scarcity of zooplankton species. The vertical distribution of the main algal species shows a marked vertical stratification, with biomass concentrations higher in the profundal. Along this profile, the species of the same taxonomic class tend to gather in a particular depth band, while the single classes tend to be distributed at different depths, according to their specific light requirements.
Management issues in the Lake Victoria watershed
Authors: Ntiba M. J. , Kudoja W. M. , Mukasa C. T. 
Published: March 2003

AbstractLake Victoria is the largest lake in Africa (68 800 km2) and is the eighth largest lake in the world by volume. The three East African countries of Tanzania, Uganda and Kenya share Lake Victoria and its resources. The total annual catch of fish from the lake ranges between 400 × 106 kg and 500 × 106 kg, bringing these riparian countries a combined annual income of approximately US$250 000–500 000 from exports alone. Approximately 30 million people live in the riparian region and the catchment, with about 2 million of these depending directly or indirectly on fishing activities. Tragically, Lake Victoria’s extremely diverse fauna was decimated in only 30 years following the introduction of non‐native Nile perch in the early 1960s. An estimated 200 endemic cichlid species became extinct. Dramatic increases in overfishing, pollution from various sources, effects of noxious water weeds and other associated problems threaten the sustainability of the lake’s resources and the economies of the riparian governments and peoples. Regulations governing Lake Victoria’s resources are different in each country. The laws concerning treatment of effluents from point sources in the three countries are not harmonized, neither are implementation or enforcement provisions. The governments of Kenya, Uganda and Tanzania have begun to put in place regional mechanisms to address the lake’s many problems including the creation of a permanent regional international institution through the establishment of the Lake Victoria Fisheries Organization (LVFO). A strategic vision document and action plans have been developed. Efforts are being made at local, national and regional levels to control the water hyacinth, including manual pulling, mechanical harvesting and introduction of weevils that weaken hyacinth root systems. To address the problem of overfishing, fishermen committees at landing beaches have been put in place. Each country has committed to take all necessary measures including legislation to implement the decisions of the LVFO governing bodies. All three countries have agreed to adopt and enforce legislation and regulations prohibiting the introduction of non‐indigenous species to the lake and to enforce existing regulations regarding fisheries. A Global Environment Facility project which provides funding to the Lake Victoria Fisheries Organization addresses land use management, catchment forestation, fisheries research and management, water hyacinth control, industrial effluent treatment and municipal waste treatment.
Optimizing sampling strategies for estimating mean water quality in lakes using geostatistical techniques with remote sensing
Authors: Hedger R. D. , Atkinson P. M. , Malthus T. J. 
Published: March 2003

AbstractIn planning a sampling regime, it is desirable that the sampling procedure should involve minimum estimation error for a given sample size or minimum sampling effort for a given accuracy. Two approaches for matching sampling effort to accuracy may be used: a classical approach, which ignores spatial dependence between observations, and uses a random scheme; and a geostatistical approach, which exploits spatial dependence, and uses a systematic scheme. Four Airborne Thematic Mapper images of two British lakes were processed to provide a chlorophyll index, reflecting variations in chlorophyll‐a concentration. Spatial structure was characterized using the variogram, and the modelled variogram was used in Kriging to plan sampling regimes for estimating the mean chlorophyll. For a given sample size, the systematic scheme incurred less error than the random scheme; and for a given error, the systematic scheme required smaller sample sizes than the random scheme. The relative advantage of the systematic approach over the random sampling approach increased with an increase in sample size and an increase in the proportion of variance in the data that was spatially dependent. This paper demonstrates that the sampling regime must be calibrated to the spatial dynamics of the lake under investigation, and suggests that remote sensing is the ideal means by which to determine such dynamics.