bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing the quality of preschool child health surveillance in primary care: a pilot study in one health district
Authors: Hampshire A. J. , Blair M. E. , Crown N. S. , Avery A. J. , Williams E. I. 
Published: March 2003

AbstractObjective To develop a framework for measuring the quality of preschool child health surveillance acceptable to primary health care teams and measurable at individual primary health care team level.Design Published research evidence was identified and criteria developed by a local multidisciplinary expert group. The criteria were discussed with primary health care teams. How well they were achieved was assessed.Setting Twenty‐eight general practices in one health authority area.Methods Data collection included observation of baby clinics, interviews with health visitors and general practitioners (GPs), questionnaires to parents, collation of child health surveillance reviews recorded in personal child health records and immunization rates.Results The criteria for assessing preschool child health surveillance were thought to
be acceptable and achievable by primary health care teams. Fifteen of the 22 criteria
used to assess baby clinics were met by over 90% of practices. Almost all
practices completed child health surveillance reviews within a standard time and
achieved 90% coverage for primary immunizations. At many practices, less
than 90% of parents felt welcome at the baby clinic, usually had enough time
to talk to their health visitor or had the purpose or results of the 6 to 8 week
child health surveillance review explained to them. GPs were less likely than health
visitors to discuss health promotion at child health surveillance reviews (χ2
11.52, P = 0.0007). Few practices had a call‐up and recall system for all reviews.Conclusion The framework that we developed for assessing preschool child health surveillance was acceptable and achievable by primary health care teams.
Surveying and screening preschool language development in community‐focused intervention programmes: a review of instruments
Authors: Pickstone C. , Hannon P. , Fox L. 
Published: March 2003

AbstractPreschool language intervention has come increasingly to the fore with the development of community‐focused interventions including Sure Start in the UK. Successful intervention methods may well be incorporated into mainstream service delivery, especially in areas of disadvantage. The question of whether such interventions will work and of their impact on children’s language development has focused attention on measures of language. This paper distinguishes two reasons for measuring language development: (1) surveying language; and (2) screening language. It goes on to suggest a set of criteria for selecting instruments for these applications. The review includes a wide range of language assessment instruments for preschool children and examines those most likely to be suitable. It suggests a role for paraprofessionals in survey and screening and argues that this may be advantageous in terms of reaching families and thereby achieving high levels of coverage of a population group. Finally, there is a discussion of the implications of such measures in community‐focused preschool interventions.
How do mothers’ childrearing histories, stress and parenting affect children's behavioural outcomes?
Authors: Assel M. A. , Landry S. H. , Swank P. R. , Steelman L. , Miller‐Loncar C. , Smith K. E. 
Published: March 2003

AbstractBackgroundInformation is needed to understand the role of low to moderate levels of mothers’ emotional stress and child characteristics (i.e. prematurity) on parenting behaviours and their impact on children's behaviour that might be deemed ‘challenging’ but not ‘disordered’.MethodsThe direct and indirect relations of maternal childrearing history and emotional stress, and observed parenting practices when children were 3 years of age on 4‐year child behavioural outcomes was examined in a sample of low‐income families with a term (n = 112) or preterm (n = 180) child. Parenting practices included displays of warmth and restrictiveness when interacting with their children. Child outcomes at 4 years included observation of social initiations with their mothers and maternal report of social and attentional problems.ResultsA Structural Equation Model building approach guided by specific hypotheses indicated that preterm as compared to full‐term children had more maternal reported social and attentional problems but did not differ in observed social initiating skills. Greater negative maternal childrearing history indirectly influenced social initiating skills through its direct influence on maternal emotional stress. Greater maternal emotional stress directly influenced mothers’ parenting that, in turn, directly influenced social initiating. Prematurity and a more negative childrearing history had a direct negative influence on the maternal report of social and attentional behavioural outcomes.ConclusionsThese findings delineate the effects of prematurity and maternal parenting on the behaviour of 4‐year‐old‐children and extend current knowledge of the influence of parental emotional stress on parenting. Even milder levels can negatively influence parenting, and in turn, contribute to children's less well developed social skills. The issues raised in this study could help with the identification and prioritization of medical and psychological services.
The meaning of parental illness to children: the case of inflammatory bowel disease
Authors: Mukherjee Suzanne , Sloper Patricia , Lewin Robert 
Published: March 2003

AbstractBackground Research on the impact of parental illness on children is sparse, and it remains unclear what kind of support, if any, families would value. This paper presents findings from the first investigation to explore the experiences of young people who have a parent with inflammatory bowel disease (IBD).Design and methods This qualitative study involved interviews with 23 young people, aged between six and 20 years, who have a parent with IBD. A range of non‐verbal techniques was used to facilitate interviews with young children. Data were analysed using the framework approach.Results Participants varied in their understanding and perception of their parent's condition and the extent to which they discussed it with family and friends. Some reported being unaffected by their parent's illness. The main negative effects on everyday life were restrictions on social activities, parents being unable to do housework, children having to be well‐behaved and parents becoming withdrawn or irritable. Experiences could lead to feelings of sadness, worry, anger and guilt. The few who reported positive effects described spending time with the parent while ill, being allowed to be more independent and being close as a family. Relatives, friends, neighbours, service providers and young people all played a role in helping to manage the situation, and most participants felt that their family did not need additional support. However, some young people would value advice and information regarding the condition and opportunities to meet others in a similar situation.Conclusion IBD is a highly variable condition, with substantial differences in the extent to which it impinges on the lives of family members. In addition to supporting patients, health professionals have an important role to play in offering advice and information to others affected by the illness, including children.
Use of physiotherapy and alternatives by children with cerebral palsy: a population study
Authors: Parkes J. , Donnelly M. , Dolk H. , Hill N. 
Published: March 2003

Abstract Objectives To describe the use of physiotherapy services and alternative therapies by a population of children with moderate to severe cerebral palsy (CP). Design Descriptive cross‐sectional survey. Subjects A total of 212 parents of children aged 4–14 years with moderate to severe CP were identified from the Northern Ireland Cerebral Palsy Register (NICPR) and a random subsample of their paediatric physiotherapists. Main measures A standardized description of motor impairment or assessment form; a postal questionnaire to parents and paediatric physiotherapists (to validate parents’ reports of service use). Response rates In total, 85% of parent questionnaires were returned and 100% of paediatric physiotherapists responded. Results Service use among families was high; on average the families had contact with approximately seven services in a 6‐month time interval. The overwhelming majority of children (96%) received physiotherapy during the school term and most (59%) received treatment at least twice a week for 30 min; 43% of children had their physiotherapy discontinued over the summer holidays. Over one‐quarter (28%) of families had opted out of the NHS and bought alternatives like conductive education (21%) or private forms of conventional physiotherapy (16%). Children with more severe forms of CP, in special education, particularly at schools for physical disability, were high‐intensity users of the physiotherapy service. Despite this, 74% of parents wanted more physiotherapy for their child. Conclusions and implications The demand for physiotherapy services is likely to continue given the relatively stable prevalence rate of CP, the proportion of children with disabling CP and the level of parent interest in the service. A number of quality aspects and gaps in the service have been identified.
The value of the PedsQLTM in assessing quality of life in survivors of childhood cancer
Authors: Eiser C. , Vance Y. H. , Horne B. , Glaser A. , Galvin H. 
Published: March 2003

AbstractAims  To determine differences in ratings of quality of life (QOL) depending on respondent (mother or child) and implications for the validity of measures of QOL, and interpretation of scores.Method  Forty‐five survivors of acute lymphoblastic leukaemia (ALL) and 23 survivors of central nervous system (CNS) tumours and their mothers completed a generic measure of QOL: the Pediatric Quality of Life Inventory TM Version 4.0 (PedsQLTM4.0; Varni et al., 2001).Results  Although correlations between mother and survivor ratings were largely moderate to good, further analyses showed that mothers reported QOL to be worse than survivors. Both mothers and survivors rated physical health worse than psychological health, and survivors of a CNS tumour had poorer QOL than survivors of ALL. Although survivors of ALL reported reasonably good physical health, their psychosocial health was more adversely affected.Conclusions  Implications for further use of the PedsQLTM 4.0 in the clinical or research context are discussed. Incidental findings highlight some limitations of the PedsQLTM4.0 for work with this population.
A 6‐year follow‐up study of chronic constipation and soiling in a specialist paediatric service
Authors: Procter E. , Loader P. 
Published: March 2003

AbstractObjective  Constipation and soiling is a relatively common condition in childhood and its course is often chronic. This study investigated long‐term outcome of children with chronic constipation and soiling by following up a cohort of children 6 years after their presentation to a specialist paediatric gastroenterology clinic with chronic constipation and soiling.Design  Retrospective postal survey.Setting/sample  All children referred in 1991 to a specialist paediatric gastroenterology clinic accepting both secondary and tertiary referrals.Measures  A semi‐structured postal questionnaire was sent to all families, and the Strengths and Difficulties Questionnaire (SDQ) was sent to a random sample.Results  The response rate (of those who could be traced) was 89%. Of these, over a third (36%) still had a problem with constipation and soiling and 17% were using regular laxatives. Three people still having problems with constipation and soiling in the sample were aged over 18 years. No significant difference was found with regard to age, sex or age at referral between the group that improved and the group that did not. Both groups felt they had suffered a high degree of distress because of the problem, with parents highlighting their powerlessness to help their child and the child identifying the embarrassment caused by the problem.Conclusions  A significant number of children presenting to a specialist paediatric clinic continue to have problems for several years. Further research is needed to identify these cases and to identify which factors promote resolution of the problem.
Multimedia versus written information for nocturnal enuresis education: a cluster randomized controlled trial
Authors: Redsell S. A. , Collier J. , Garrud P. , Evans J. H. C. , Cawood C. 
Published: March 2003

AbstractObjective  This study evaluated the impact of child‐focused information provision using a multimedia software package ‘All About Nocturnal Enuresis’ and written leaflets containing the same information for bedwetting children.Design  A stratified cluster randomized controlled trial with data on 270 children collected longitudinally.Setting  Fifteen school nurse‐led community enuresis clinics in Leicestershire, UK.Main outcome measures  The outcome measures were becoming and remaining dry and time to dry, non‐attendance and dropout rates. The psychological measures completed by children were the impact of bedwetting and Coopersmith self‐esteem scales. Parents completed the maternal tolerance scale.Results  No significant intervention effect was found for any of the outcome measures recorded during treatment, at discharge or six‐months post discharge.Conclusions  Multimedia educational programs and written leaflets are widely used to enable children to learn more about their health‐related conditions. However, our result suggests that multimedia is no more effective than traditional materials at effecting health‐related behavioural change.
Expression of cyclo‐oxygenases 1 and 2 proteins in upper respiratory mucosa
Authors: Demoly  , Crampette  , Lebel  , Campbell  , Mondain  , Bousquet  
Published: March 2003

BackgroundCyclo‐oxygenases 1 (Cox‐1) and 2 (Cox‐2) catalyse the conversion of arachidonic acid to prostaglandin endoperoxides, leading to the formation of prostaglandin and thromboxane mediators of inflammation. The involvement of these enzymes in inflammatory disorders such as sinusitis and nasal polyps is unknown although this may be relevant to their pathophysiology.MethodsWe studied Cox‐1 and Cox‐2 immunoreactivities in nasal polyp, maxillary sinus, and turbinate biopsies obtained from eight patients with chronic allergic rhinitis and sinusitis and/or nasal polyps, 15 patients with chronic non‐allergic rhinitis and sinusitis and/or nasal polyps and five control subjects (patients requiring nose surgery not related to sinusitis or nasal polyps).ResultsBoth Cox‐1 and Cox‐2 were mainly expressed in the epithelium (basal, ciliated) and were found in 16/28 and 25/28 subjects for Cox‐1 and Cox‐2 respectively. We did not find any differences between the patient populations. There were no correlations between any of the clinical parameters studied nor the pathological patterns and the presence and characteristics of the Cox immunoreactivities.ConclusionBoth cyclo‐oxygenase enzymes are expressed in normal human upper respiratory epithelium and are not upregulated in chronic sinusitis nor in nasal polyposis, possibly suggesting that Cox products do not have an important role as mediators of the chronic upper airway inflammation.
Serum eosinophil cationic protein as a marker of eosinophilic inflammation in asthma
Authors: Niimi A. , Amitani R. , Suzuki K. , Tanaka E. , Murayama T. , Kuze F. 
Published: March 2003

BackgroundThe serum level of eosinophil cationic protein (ECP) has been used as a clinical marker in asthma, on the assumption that it reflects ongoing eosinophilic inflammation of the airways. However, only a few studies have investigated this issue, using bronchial secretions but not tissue specimens.ObjectiveTo evaluate cross‐sectionally the correlation between serum ECP level or blood eosinophil count, and the degree of eosinophilia in bronchoalveolar lavage fluid (BALF) and bronchial biopsy tissue, and disease activity, in asthmatic patients.MethodsThirty‐three adults with symptomatic asthma and six healthy controls were studied. The blood eosinophil count, ECP levels in serum and BALF, percentage of eosinophils in BALF, number of eosinophils in bronchial tissue, pulmonary function, and methacholine bronchial responsiveness of these subjects were clarified. An asthma severity score and inhaled β2‐agonist requirement (puffs/day) were also assessed for the asthmatic patients.ResultsThe asthmatic patients, compared with the controls, had more obstructive (as tested by %FEV1, FEV1/FVC, and FEF25–75%) and more responsive airways, and showed a significant increase in the number of eosinophils in the blood, BALF, and tissue, and in the serum ECP levels. The ECP levels in BALF were below the detection limit for most of the subjects in both groups examined. In the asthmatic patients, serum ECP level demonstrated correlations with the number or percentage of eosinophils in BALF and tissue, whereas the blood eosinophil count correlated only with the percentage of eosinophils in BALF. Serum ECP level correlated with all indices of disease activity examined; %FEV1, FEV1/FVC, FEF25–75% bronchial responsiveness, severity score and β2‐agonist usage, whereas the blood eosinophil count correlated only with %FEV1 and bronchial responsiveness.ConclusionThe data suggest that serum ECP level reflects the intensity of eosinophilic airway inflammation, as well as the disease activity, and may be useful as an inflammatory marker in asthma.
Stability of Pityrosporum ovale allergens during storage
Authors: Lintu  , Savolainen  , Kalimo  , Terho  
Published: March 2003

Background Pityrosporum ovale is a common saprophyte on the skin capable to induce IgE antibody production in atopic dermatitis. Generally IgE response to P. ovale has been established with skin‐prick test, but the stability of P. ovale skin test allergens is not known.Objective and methodsIn this study we analysed the stability of identified allergens of P. ovale in skin test solutions during storage. The stability was checked with immunoblotting and densitometry after different time periods and at various temperatures.ResultsCoomassie Brilliant blue staining clearly showed, that proteins were preserved poorly at +20 °C in 50% glycerol. Even extracts stored at +4 °C during 6 and 12 months in 50% glycerol were degraded. Only extract stored at +4 °C for 1 month in 50% glycerol was guite well preserved. According to densitometry results the 9 kDa band was the most stable main protein allergen. The 20 kDa and expecially the 96 kDa bands were far more labile. The stability of low molecular allergens was in general better than the stability of high molecular weight allergens.ConclusionsThe stability of P. ovale extracts stored for more than 1 month was poor even when kept at +4 °C temperature. Reliability of negative skin prick results should be questioned when older extracts are used. In skin test negative cases, the sensitization should be evaluated also with the measurement of specific serum IgE antibodies to P. ovale.
Validation of a screening questionnaire for atopy with serum IgE tests in a population of pregnant Dutch women
Authors: Lakwijk  , Van Strien  , Doekes  , Brunekreef  , Gerritsen  
Published: March 2003

BackgroundWe have started a large birth cohort study in which pregnant women with and without atopy are differentially included. In view of the large number of subjects to be screened (12 000), a simple questionnaire was developed for the assessment of atopy in pregnant women.ObjectiveThe objective of our study was to evaluate the efficacy of a questionnaire using serum IgE tests.MethodsDuring a antenatal visit to the midwife clinic, 175 expecting mothers completed a questionnaire and from each subject blood was obtained in which total and specific IgE against house dust mite, cat, dog, birch and grass was determined.ResultsWhen atopy was defined as the presence of a positive test for IgE against at least one allergen, seven questions from the questionnaire had a sensitivity and specificity of 55.0% and 88.7%, respectively. With the use of the questionnaire it was possible to select about 50% of the subjects with specific IgE to one or more common inhalant allergens. The positive predictive value of the screening questions was 71.7%. Taking total IgE into account did not change these results.ConclusionThe screening questionnaire is an efficient tool for differential inclusion of subjects with and without atopy in epidemiological studies.
The significance of specific IgG4 antibodies to methyltetrahydrophthalic anhydride in occupationally exposed subjects
Authors: Yokota  , Yamaguchi  , Takeshita  , Morimoto  
Published: March 2003

BackgroundA definitive role for allergen‐specific IgG4 as either an anaphylactic or a blocking antibody, or both, remains controversial.ObjectiveA population of 148 workers from two condenser plants (A and B) using epoxy resin with methyltetrahydrophthalic anhydride (MTHPA) was studied to evaluate the significance of MTHPA‐specific IgG4 antibody.MethodsThe workers were evaluated through questionnaire and serological investigations.ResultsNinety‐seven (66%) of the currently exposed workers had positive MTHPA‐specific IgE. IgE‐sensitized workers in each plant had significantly more eye and nose complaints than unsensitized workers (P < 0.03). As the result of multiple logistic analysis, specific IgE antibodies was the most important predictor of work‐related symptoms and its effect was greater than that of specific IgG4 (odds ratio 16.7 and 3.68, respectively). These indicate an IgE‐mediated mechanism in most cases of work‐related symptoms associated with MTHPA exposure. However, it cannot be denied that specific IgG4 is an anaphylactic antibody. Furthermore, IgE‐sensitized workers in these plants displayed work‐related symptoms despite the presence of specific IgG4. The frequency of positive specific IgG4 in continuously exposed workers was significantly (P < 0.02) higher in plant A than in plant B, reflecting the difference of the MTHPA levels between the two plants. In plant A, the frequency of positive specific IgG4 was significantly (P < 0.002) higher in continuously exposed workers than in intermittently exposed workers. Multiple regression analysis also confirmed that plant and exposure style contributed significantly (P < 0.01) to the determination of specific IgG4 levels.ConclusionThese results suggest that work‐related eye and nasal symptoms are likely to be IgE‐mediated, and that specific IgG4 may reflect the intensity of MTHPA exposure and may not act as a blocking antibody.