bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Prospective Study of the Role of Depression in the Development and Persistence of Adolescent Obesity
Authors: Goodman Elizabeth , Whitaker Robert C. 
Published: August 2004

Background. Adolescent obesity is a strong predictor of adult obesity, and adult obesity has been associated with depression, especially in women. Studies have also suggested an association between depression in adolescence and higher body mass index (BMI) in adulthood. Whether depression leads to obesity or obesity causes depression is unclear.
Objective. To determine in longitudinal analyses whether depressed mood predicts the development and persistence of obesity in adolescents.
Methods. A prospective cohort study of 9374 adolescents in grades 7 through 12 who completed in-home interviews for the National Longitudinal Study of Adolescent Health. Assessments were made at baseline (1995) and at follow-up 1 year later. Depressed mood was assessed with the Center for Epidemiologic Studies Depression Scale. BMI (kg/m2) was calculated from self-reported height and weight. BMI percentiles and z scores were computed using the 2000 Centers for Disease Control and Prevention growth charts. Obesity was defined as BMI ≥95th percentile, overweight as BMI ≥85th percentile and &lt;95th percentile, and normal weight as BMI &lt;85th percentile. A parental respondent gave information on household income, parental education, and parental obesity.
Results. At baseline, 12.9% were overweight, 9.7% were obese, and 8.8% had depressed mood. Baseline depression was not significantly correlated with baseline obesity. Among the 9.7% who were obese at follow-up, 79.6% were obese at baseline, 18.6% were overweight at baseline, and 1.8% were normal weight at baseline. Having depressed mood at baseline independently predicted obesity at follow-up (odds ratio: 2.05; 95% confidence interval: 1.18, 3.56) after controlling for BMI z score at baseline, age, race, gender, parental obesity, number of parents in the home, and family socioeconomic status. This finding persisted after controlling further for the adolescents’ report of smoking, self-esteem, delinquent behavior (conduct disorder), and physical activity. After controlling for all these same factors, depressed mood at baseline also predicted obesity at follow-up among those not obese at baseline (odds ratio: 2.05; 95% confidence interval: 1.04, 4.06) and follow-up BMI z score among those obese at baseline (β = 0.11; standard error β = 0.05). In contrast, baseline obesity did not predict follow-up depression.
Conclusions. Depressed adolescents are at increased risk for the development and persistence of obesity during adolescence. Understanding the shared biological and social determinants linking depressed mood and obesity may inform the prevention and treatment of both disorders.
Television Viewing and Initiation of Smoking Among Youth
Authors: Gidwani Pradeep P. , Sobol Arthur , DeJong William , Perrin James M. , Gortmaker Steven L. 
Published: August 2004

Background. Smoking is the leading preventable cause of death in the United States, and the risk of disease increases the earlier in life smoking begins. The prevalence of smoking among US adolescents has increased since 1991. Despite bans on television tobacco advertising, smoking on television remains widespread.
Objective. To determine whether youth with greater exposure to television viewing exhibit higher rates of smoking initiation.
Methods. We used the National Longitudinal Survey of Youth, Child Cohort to examine longitudinally the association of television viewing in 1990 among youth ages 10 to 15 years with smoking initiation from 1990–1992. Television viewing was based on the average of youth and parent reports. We used multiple logistic regression, taking into account sampling weights, and controlled for ethnicity; maternal education, IQ, and work; household structure; number of children; household poverty; child gender; and child aptitude test scores.
Results. Among these youth, smoking increased from 4.8% in 1990 to 12.3% in 1992. Controlling for baseline characteristics, youth who watched 5 or more hours of TV per day were 5.99 times more likely to initiate smoking behaviors (95% confidence interval: 1.39–25.71) than those youth who watched &lt;2 hours. Similarly, youth who watched &gt;4 to 5 hours per day were 5.24 times more likely to initiate smoking than youth who watched &lt;2 hours (95% confidence interval: 1.19–23.10).
Conclusions. Television viewing is associated in a dose-response relationship with the initiation of youth smoking. Television viewing should be included in adolescent risk behavior research. Interventions to reduce television viewing may also reduce youth smoking initiation.
Early Introduction of Oral Feeding in Preterm Infants
Authors: Simpson Chanda , Schanler Richard J. , Lau Chantal 
Published: August 2004

Objective. To determine whether transition from tube to all oral feeding can be accelerated by the early introduction of oral feeding in preterm infants. It is hypothesized that this shortened transition time will lead to earlier attainment of all oral feeding.Design. Twenty-nine infants (&lt;30 weeks’ gestation) were randomized to an intervention or control group. The intervention group (n = 13) was initiated to oral feeding 48 hours after achieving full tube feeding (120 kcal/kg/d), and the feeding progression followed a structured protocol. The oral feeding management of the control infants (n = 16) was left to the discretion of their attending physicians. Oral feeding progress was monitored for achievement of selected feeding milestones: achievement of first and all successful oral feedings. Feeding performance was assessed by overall transfer (percent volume transferred during a feeding/total volume offered) and rate of milk transfer (mL/min), which were measured from introduction of oral feeding to first successful oral feeding.Results. Infants in the experimental group, when compared with their control counterparts, were introduced to oral feeding significantly earlier (31.1 ± 1.3 vs 33.7 ± 0.9 weeks’ postmenstrual age, respectively) and attained all oral feeding significantly earlier as well (34.5 ± 1.6 vs 36.0 ± 1.5 weeks’ postmenstrual age, respectively). The transition time from full tube feeding to all oral feeding was 26.8 ± 12.3 days for the experimental group and 38.4 ± 14.0 days for the control group. Both groups of infants demonstrated similar increase in overall transfer and rate of milk transfer from introduction of oral feeding until achievement of first successful oral feeding.Conclusions. Early introduction of oral feeding accelerates the transition time from tube to all oral feeding. This not only allows earlier attainment of all oral feeding, but it also provides practice opportunities that enhance the oral motor skills necessary for safe and successful feeding.
Routine Sucrose Analgesia During the First Week of Life in Neonates Younger Than 31 Weeks’ Postconceptional Age
Authors: Johnston C. Celeste , Filion Francoise , Snider Laurie , Majnemer Annette , Limperopoulos Catherine , Walker Claire-Dominique , Veilleux Annie , Pelausa Ermelinda , Cake Heather , Stone Sharon , Sherrard Adam , Boyer Kristina 
Published: August 2004

Objective. To determine the efficacy of sucrose analgesia for procedural pain during the first week of life in preterm neonates in neonatal intensive care units on enhancing later clinical outcomes.
Methods. A total of 107 preterm neonates who were born at &lt;31 weeks’ postconceptional age (PCA) entered this double-blind, randomized, controlled trial within 48 hours of birth at 3 level III university-affiliated neonatal intensive care units in Canada, and 103 completed the study. Sucrose (0.1 mL of 24%) or sterile water was administered orally up to 3 times, 2 minutes apart, for every invasive procedure during a 7-day period. Motor development and vigor, and alertness and orientation components of the Neurobehavioral Assessment of the Preterm Infant were measured at 32, 36, and 40 weeks’ PCA; Score for Neonatal Acute Physiology was measured on the last day of intervention; and Neuro-Biological Risk Score (NBRS) was measured at 2 weeks of age and at discharge. Primary analyses of covariance were applied for each outcome to compare group differences followed by secondary analyses using standard linear regression within each group to determine predictors of outcomes.
Results. Although there were no differences between the groups on any outcomes, there were significant dose-related effects within each group. In the sucrose group only, higher number of doses of sucrose predicted lower scores on motor development and vigor, and alertness and orientation at 36 weeks’, lower motor development and vigor at 40 weeks’, and higher NBRS at 2 weeks’ postnatal age. Higher number of invasive procedures was predictive of higher NBRS both times in the water group.
Conclusions. Repeated use of sucrose analgesia in infants &lt;31 weeks’ PCA may put infants at risk for poorer neurobehavioral development and physiologic outcomes. Additional study is needed to determine the most appropriate age and duration of sucrose analgesia in preterm infants.
Effects of Volume-Guaranteed Synchronized Intermittent Mandatory Ventilation in Preterm Infants Recovering From Respiratory Failure
Authors: Herrera Carmen M. , Gerhardt Tilo , Claure Nelson , Everett Ruth , Musante Gabriel , Thomas Carlos , Bancalari Eduardo 
Published: August 2004

Objective. Volume guarantee (synchronized intermittent mandatory ventilation [SIMV]+VG) is a novel mode of SIMV for automatic adjustment of the peak inspiratory pressure to ensure a minimum set mechanical tidal volume (VT mech). The objective of this study was to compare the effects of SIMV+VG with conventional SIMV on ventilation and gas exchange in a group of very low birth weight infants recovering from acute respiratory failure.
Methods. Nine infants were initially studied during 2 consecutive 60-minute ventilatory modalities of conventional SIMV (ventilator settings by clinical team) and SIMV+VG 4.5 (VT mech set at 4.5 mL/kg) in random order. Eight additional infants were studied during the same ventilatory modalities plus 1 additional epoch consisting of SIMV+VG 3.0 (VT mech set at 3.0 mL/kg).
Results. Peak inspiratory pressure was significantly lower during SIMV+VG 3.0. Mean airway pressure, VT mech, number of large VT mech (&gt;7 mL/kg), and mechanical minute ventilation (V′E) were reduced during SIMV+VG 4.5 compared with SIMV and were further reduced during SIMV+VG 3.0. Spontaneous V′E increased during SIMV+VG 4.5 and was even higher during SIMV+VG 3.0. The resulting total V′E was higher during both SIMV+VG modes compared with SIMV. Arterial oxygen saturation by pulse oximetry, transcutaneous carbon dioxide tension, and fraction of inspired oxygen did not differ significantly, although transcutaneous carbon dioxide tension increased slightly during SIMV+VG 3.0.
Conclusions. The short-term use of SIMV+VG resulted in automatic weaning of the mechanical support and enhancement of the spontaneous respiratory effort while maintaining gas exchange relatively unchanged in comparison to conventional SIMV.
Retinopathy of Prematurity Outcome in Infants With Prethreshold Retinopathy of Prematurity and Oxygen Saturation &gt;94% in Room Air: The High Oxygen Percentage in Retinopathy of Prematurity Study
Authors: McGregor Mary Lou , Bremer Don L. , Cole Cynthia , McClead Richard E. , Phelps Dale L. , Fellows Rae R. , Oden Neal ,   on behalf of the HOPE-ROP Multicenter Group
Published: August 2004

Objectives. To determine the rate of progression from prethreshold to threshold retinopathy of prematurity (ROP) in infants excluded from Supplemental Therapeutic Oxygen for Prethreshold Retinopathy of Prematurity (STOP-ROP) because their median arterial oxygen saturation by pulse oximetry (Spo2) values were &gt;94% in room air at the time of prethreshold diagnosis and to compare them with infants who were enrolled in STOP-ROP and had median Spo2 ≤94% in room air.Methods. Fifteen of the 30 centers that participated in STOP-ROP elected to participate in the High Oxygen Percentage in Retinopathy of Prematurity study (HOPE-ROP) from January 1996 to March 1999. Infants were followed prospectively from the time prethreshold ROP was diagnosed until ROP either progressed to threshold in at least 1 study eye (adverse outcome) or resolved (favorable outcome).Results. A total of 136 HOPE-ROP infants were compared with 229 STOP-ROP infants enrolled during the same time period from the same 15 hospitals. HOPE-ROP infants were of greater gestational age at birth (26.2 ± 1.8 vs 25.2 ± 1.4 weeks) and greater postmenstrual age at the time of prethreshold ROP diagnosis (36.7 ± 2.5 vs 35.4 ± 2.5 weeks). HOPE-ROP infants progressed to threshold ROP 25% of the time compared with 46% of STOP-ROP infants. After gestational age, race, postmenstrual age at prethreshold diagnosis, zone 1 disease, and plus disease at prethreshold diagnosis were controlled for, logistic regression analysis showed that HOPE-ROP infants progressed from prethreshold to threshold ROP less often than STOP-ROP infants (odds ratio: 0.607; 95% confidence interval: 0.359–1.026).Conclusions. The mechanisms that result in better ROP outcome for HOPE-ROP versus STOP-ROP are not fully understood. It seems that an infant’s Spo2 value at the time of prethreshold diagnosis is a prognostic indicator for which infants may progress to severe ROP. When other known prognostic indicators are factored in, the Spo2 is of borderline significance.
Sex Differences in Iron Status During Infancy
Authors: Domellöf Magnus , Lönnerdal Bo , Dewey Kathryn G. , Cohen Roberta J. , Rivera L. Landa , Hernell Olle 
Published: August 2004

Background. It is commonly assumed that there is no difference in iron status between male and female infants, despite a lack of studies addressing this question.Objective. To study sex differences in different measures of iron status in infants.Methods. At 4 months of age, 263 term, breastfed infants (121 Swedish and 142 Honduran) were randomized to receive iron supplements or placebo until 9 months of age. Blood samples at 4, 6, and 9 months of age were analyzed for hemoglobin (Hb), mean cell volume (MCV), zinc protoporphyrin (ZPP), plasma ferritin, and transferrin receptors (TfR).Results. At 4, 6, and 9 months, boys had significantly lower Hb, MCV, and ferritin and higher ZPP and TfR than girls. At 9 months, boys had a 10-fold higher risk of being classified as having iron deficiency anemia. The differences at 9 months in MCV (71.6 vs 75.1 fL) and ZPP (59 vs 49 μmol/mol heme) remained significant after controlling for iron supplementation, site, growth variables, and other possible confounders. For ferritin, there was a remaining sex difference at 9 months among Swedish (29 vs 53 μg/L) but not Honduran infants. For Hb and TfR, sex differences at 9 months were larger in unsupplemented infants, especially in those with a birth weight of &lt;3500 g.Conclusions. There are substantial sex differences in Hb and other indicators of iron status during infancy. Some of these may be genetically determined, whereas others seem to reflect an increased incidence of true iron deficiency in boys.
Prevalence of Retinal Hemorrhages and Child Abuse in Children Who Present With an Apparent Life-Threatening Event
Authors: Pitetti Raymond D. , Maffei Frank , Chang Kenneth , Hickey Robert , Berger Rachel , Pierce Mary Clyde 
Published: August 2004

Objective. Child abuse (CA) can present with a spectrum of signs and symptoms. Apparent life-threatening events (ALTEs) may be a subtle presentation of CA. Retinal hemorrhages (RHs) are a well-described finding in some patients with CA. We hypothesized that screening children who present with a chief complaint of an ALTE for RH would detect an otherwise occult presentation of CA.Methods. Children who were younger than 24 months of age and presented to the emergency department between March 1, 1997, and February 28, 1999, with signs and symptoms consistent with the National Institutes of Health’s definition of an ALTE were studied prospectively. Children were excluded when it was readily apparent on presentation that the child was a victim of CA. Demographic data, a complete blood count with differential, venous blood gas, carboxyhemoglobin level, and urine toxicological screen were collected. A pediatric ophthalmologist performed a dilated funduscopic examination; patients who were found to have RH underwent a noncontrast computerized tomographic scan of the head and skeletal survey to evaluate for occult injury. Evaluations by social services or Children, Youth and Families, the results of all diagnostic tests obtained, and the final discharge diagnosis were recorded. Medical records of all patients were reviewed at 1 year; subsequent visits, hospitalizations, and evaluations by social services or Children, Youth and Families were recorded.Results. A total of 128 patients presented to the emergency department with an ALTE during the study period. No patients were excluded. Mean age was 2.1 months (median: 1.27; range: 0.07–16.0; standard deviation: 2.1). Fifty-seven (44.5%) were boys; 86 (67.2%) were white, and 36 (27.9%) were black. A total of 26 (20.3%) of 128 patients had a history of an ALTE, 4 (3.4%) of 117 had a family history of an ALTE, and 15 (12.8%) of 117 had a family history of sudden infant death syndrome. Dilated funduscopic examination was performed on 73 (57.0%) of 128 patients; RH was detected in 1 patient (1.4%). Four children, including the patient with RH, underwent an evaluation for suspected abuse; 3 (2.3%) of 128 were determined to have been abused.Conclusions. RH was detected in 1 (1.4%) of 73 patients in our population of infants with ALTEs and 1 of 3 patients who were victims of CA and presented with an ALTE. CA was detected in 2.3% of patients who presented with an ALTE. The diagnosis of CA should be seriously considered in patients who present with an ALTE. The evaluation of ALTEs should include funduscopic examination as ALTEs and RHs are associated with CA.
Assessment of Adrenal Function in the Initial Phase of Meningococcal Disease
Authors: Bone Mark , Diver Michael , Selby Andrew , Sharples Andrew , Addison Michael , Clayton Peter 
Published: August 2004

Objective. To determine the status of the hypothalamic-pituitary-adrenal axis in children who had meningococcal disease and were admitted to 2 regional pediatric intensive care units.
Methods. Sixty-five children (34 boys; median age: 2.5 years; range: 0.2–15 years) had cortisol and adrenocorticotropic hormone (ACTH) levels measured on admission, then at 8 am and 8 pm during the next 48 hours. At 48 hours, a low-dose short Synacthen test (LDST) (500 ng of 1–24 corticotropin/m2) was performed in 42 patients (19 boys). Normal ranges for 8 am cortisol and ACTH levels in unstressed children were 140 to 500 nmol/L and 2 to 11.3 pmol/L, respectively. Adrenal insufficiency (AI) was defined as a peak cortisol &lt;500 nmol/L on the LDST or an 8 am cortisol value &lt;140 nmol/L.
Results. Five (7.7%) of the 65 children died, including 1 with primary AI. Cortisol levels were elevated on admission (median: 1122 mmol/L; range: 65–2110 nmol/L) with 81% of values more than the 8 am normal range. The median ACTH level on admission was within the 8 am normal range, but 40% of values were more than the 8 am normal range. However, 7% and 8% of cortisol and ACTH values, respectively, were less than the normal range. Both cortisol and ACTH levels fell thereafter and showed no diurnal variation during the 48-hour profile. Six (14%) of the 42 failed the LDST. These patients had significantly lower mean 8 am cortisol values than those with a normal peak value on the LDST. Five additional patients who did not have the LDST had 8 am cortisol values &lt;140 nmol/L. In the diagnosis of AI, the sensitivity of the 8 am mean cortisol value at a cutoff of 400 nmol/L, judged against the LDST, was 83%; the specificity was 81%.
Conclusions. During the initial phase of meningococcal disease, raised cortisol and ACTH levels indicate an appropriate stress response within the hypothalamic-pituitary-adrenal axis. However, a substantial subpopulation (11 [16.9%] of 65) has evidence of adrenal dysfunction during this period. Morning cortisol values in the initial phase of meningococcal disease could be used as a potential early index of AI.
National Practices Regarding Payment to Research Subjects for Participating in Pediatric Research
Authors: Weise Kathryn L. , Smith Martin L. , Maschke Karen J. , Copeland H. Liesel 
Published: August 2004

Objective. Payment to subjects for participation in research is reportedly common, but no published data documents the nature of this practice. Institutional review boards (IRBs) are responsible for ensuring both the safety and voluntary participation of research subjects, yet guidance from federal and expert pediatric sources regarding appropriate payment approaches is conflicting. Ethical issues of payment for participation of adult versus pediatric research subjects may differ. This empirical study sought to examine current payment practices for participation in pediatric research as reported by IRBs.
Design. An 18-question survey regarding payment practices for participation in pediatric research was sent to IRB chairs at member institutions of the National Association of Children’s Hospitals and Related Institutions, and to a systematic random sample of IRB chairs listed with the Office for Protection From Research Risks. Descriptive, nonparametric, and qualitative analyses were used to describe institution types, payment practices, and correlations among responses.
Results. Data from 128 institutions that conduct pediatric research revealed that payment for participation in pediatric research was allowed by 66% of responding institutions, and practices varied widely among institutions. Most responding IRBs that allowed payment required disclosure of payment before enrollment (during the consent process), following federal guidelines more closely than American Academy of Pediatrics guidelines. An IRB’s perception of potential benefits or harms of a study correlated with the amount of payment approved.
Conclusions. IRBs must balance the need to recruit pediatric research subjects against the risk of undue influence during the recruitment process. Federal guidelines and expert pediatric opinion differ in recommendations regarding payment; responding IRBs appeared to follow federal guidelines more closely than guidelines proposed by the American Academy of Pediatrics.