A paper submitted to The University of Arizona College of Medicine - Phoenix, History of Medicine course.

This work was car'red out in the Neonatal Intensive Care Unit at Groote Schuur Hospital, Cape Town, from July, 1972, to December, 1973, under the guidance of Dr. A.F. Malan. This was a newly opened Unit for Coloured and African Neonates requiring special care, well-equipped with trained staff and good monitoring apparatus. For the first time it was possible to provide facilities for patient care in line with those available abroad. The problem of feeding preterm infants has interested many authors (Abramowicz, 1966; Babson, 1971; Gamsu, 1972). The ideal quantity, content of nutrients, calorific value and mode of administration of feeds remains, at best, approximate. With the advent of Total Parenteral Nutrition (TPN) and the availability of relatively safe solutions of fats and amino-acids for intravenous use, interest has been stimulated in the optimal nutrient and caloric requirements of the growing infant.

dissertation submitted to the Faculty of Health Sciences for the degree of Masters in Medicine in the University of the Witwatersrand, Johannesburg. August ,2013 / South Africa is one of the countries in which neonatal mortality has either remained the same or decreased marginally over the past 20 years (1). Resource constraints result in early discharge of well newborns and curtailment of follow up home visits by nurses. This potentially high-risk group of infants may contribute to these neonatal deaths post hospital discharge. In addition, once a neonate has been home, they are no longer admitted to the neonatal unit but to the general paediatric wards that may lack specialized neonatal care. Numerous programs, algorithms, education drives and protocols have been devised in an attempt to improve the quality of healthcare offered to the newborn. These have led to a perceptible decline in the neonatal mortality and morbidity rates respectively. The neonatal mortality and morbidity rates remain unacceptably high however, particularly in resource poor settings. Aim: The aim was to determine the profile and outcome of neonates admitted to the general paediatric wards at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH). Methodology: Audit of all newborns (<28days) admitted to the general wards from 1 January 2011 to 30 April 2011. Patients transferred from other tertiary hospitals were excluded. Patients with incomplete records were also excluded Results: There were a total of 73 neonates admitted with a mean weight of 3.2kg (SD 0.65). The median age for 0-7 days was 4 days and for 8-28 days was 17 days. The majority of neonates 41/73 (56.2%) were male and 21/73 (28.8%) were HIV exposed. In the HIV exposed group only 16/21 (76%) were on HIV prophylaxis. Although antenatal care (ANC) was received by 76.7% of mothers, this is lower than ANC received by the general population. Lack of ANC could possibly be a risk factor for admission of neonates. Possible risk factors for serious illness included 8 (11%) were ex premature infants and 11 (15.1%) had a low birth weight (<2.5 kg). Individual indicators for severity of illness by World Health Organization (WHO) Integrated Management of Childhood and Neonate Illness (IMCNI) were used. The most frequent indicators were tachypnoea (RR>60) 34 (46.6%), jaundice 30 (41.1%) and only 1 (1%) presented with convulsions. Respiratory distress was very sensitive (100%) and relatively specific (76%) for detecting bronchopneumonia (BRPN) with a LR of 3.98. The other clinical indicators were neither specific nor sensitive in detecting serious illness. Most 45 (61%) were referred from the local clinic. The commonest diagnoses were bronchopneumonia (BRPN) 20 (27.4%), neonatal sepsis (NNS) 22 (30.1%) and jaundice 22 (30.1%). Two patients died (2.7%). Their diagnoses were NNS and BRPN Conclusions: There are a significant number of newborns admitted to the general paediatric wards, although the mortality rate in this group was low. IMCNI guidelines remain the most sensitive indicator of the need for admission, and “routine” blood investigations are often non-contributory Community based care and education programmes as well as targeted neonatal care in hospitals for this group is warranted.

Thesis (M.S.)--University of Wisconsin-Madison, 1988. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 102-106).

No description available.

published_or_final_version / Comparative Asian Studies / Master / Master of Arts

Thesis (M.S.)--University of Michigan, 2001. / Includes bibliographical references.

Thesis (M.S.)--University of Michigan, 2001. / Includes bibliographical references.

This research project is about infant-observation, that is looking at, observing, and studying parent-infant interactions and relationships within the first year of life. The principle intention of the study is to illustrate and shed light upon human infant development and how the newborn becomes a fully functioning member within the family. The study provides a context in which to consider parent-infant interaction beginning in utero, expanding to the birthing process, and continuing through the infant's first year. It focuses on specific themes of parent-infant interaction. The following situations are explored: the role of the mother; the mother as a container; the infant's experience of containment; the internalisation of experience; the symbolic meaning of food; dealing with distress and the development of concrete communication; the growth of a sense of ego; and, the infant's internal world. The study concludes by addressing various implications for further psychotherapy and compares the therapist-client relationship to the mother-infant relationship. The research outlines one particular psychoanalytic theoretical orientation of mental and emotional development. It is a model derived predominantly from The Developmental School Theorists and Object Relations Theorists, namely, Bowlby, Klein, Mahler and Winnicott. This model looks at the infant's earliest relationships and the processes these set up within the infant's developing mind. Infant observation, asa research method proposed by Bick and Sidoli, links method and theory, and serves as the methodological approach utilised in the present study. A video, based on the parent-infant interaction of three families, provides observational data and may be viewed in conjunction with this research. / KMBT_363 / Adobe Acrobat 9.54 Paper Capture Plug-in

Clinicians use growth curves to assess infant health. Most children are measured on growth curves that contain percentiles for height, weight, and head circumference by sex. Preterm infants have their own growth curves. Infants who present with measurements below the 10th percentile are considered small-for-gestational age (SGA), and infants who present with measurements above the 90th percentile are considered large-for-gestational age (LGA). Growth curves and centiles can be generated using 3 and 4 parameter distribution models. To date, no studies have been published to investigate whether growth curves generated using a 3- or 4-parameter model differ significantly. Additionally, researchers have found mixed results when exploring the association between race and pregnancy/delivery. Black mothers may have greater risks and babies with lower weights than babies born to White mothers (Borrell, Rodriguez-Alvarez, Savitz, & Baquero, 2016), and growth curves that do not consider race may misclassify non-White babies (Buck-Louis et al., 2015). In this study, I had two specific aims: (1) to compare the preterm infant growth curves and centiles generated using 3 and 4 parameter methods (Lamba Mu Sigma [LMS] and Box-Cox Power Exponential [BCPE], respectively) and assess each model for adequate fit, and (2) to use percentile cut points from race-specific and non-race-specific LMS curves to classify babies in a validation dataset as SGA or LGA. Regarding the differences in curves generated from the LMS and BCPE distributions, the curves produced using the BCPE distribution had a lower GAIC in some cases but model fit criteria for the LMS curves were adequate. The simpler models generated by the LMS method were retained for birth length, head circumference, and weight by sex with an explanatory variable of gestational age. For aim 2, results indicated that race-specific curves classified babies within expected ranges. Non-race-specific curves overidentified Black babies as SGA and underidentified them as LGA. More research is required to test if this relationship persists for babies delivered at full term.