Compared to term infants, it is known that preterm infants have relatively poor regulation and are less able to handle stimulation, which only allows limited time of alertness favorable for productive social interaction. Parents that are less knowledgeable in this would often feel distressed when they try to interact with their babies. Also, non-optimal parent-infant interaction may further stress the preterm infants. So, intervention that seeks to handle this problem is needed. Mother-infant intervention is a strategy that teaches mothers or parents to respond appropriately to infants’ cues and when to stop handling. This intervention helps to achieve optimal parent-infant interaction. Evidence in the current literature has suggested that early mother-infant intervention in Neonatal Intensive Care Unit is effective in promoting maternal mental health after preterm delivery. Therefore, the proposed innovation attempts to use mother-infant intervention to reduce depressive symptoms and parenting stress of these mothers. The implementation potential of the mother-infant intervention was explored. It was found that the intervention is highly transferable and feasible to be applied in the hospital settings of Hong Kong with Chinese women. The benefits of implementing the proposed innovation also far outweigh the cost. An evidence-based practice guideline was then developed. Thorough communication plan, implementation plan and pilot study plan will be launched. The whole program will last for 24 months including stages from obtaining approval, planning, carrying out pilot study, launching the actual implementation, to conducting data collection and program evaluation. / published_or_final_version / Nursing Studies / Master / Master of Nursing

Previous research indicates that for adults and children the perception of speech can be significantly influenced by watching a speaker's mouth movements. For example, hearing the syllable /bi/ while watching a speaker mouth the syllable /vi/ results in reports of a 'heard' /vi/. Some evidence suggests young infants also may be able to integrate heard and seen speech. One theory suggests that an innate link between perception and production (Liberman & Mattingly, 1985) accounts for this phenomenon while another theory suggests that experience (e.g., producing speech sounds) may be necessary into order to develop fully the underlying representation of visible speech (Desjardins, Rogers & Werker, in press; Meltzoff & Kuhl, 1994). My dissertation addresses the above controversy by examining whether the integration of heard and seen speech is obligatory for young infants as it is for adults. In Experiment 1, 4-month-old female infants habituated to audiovisual /bi/ showed renewed visual interest to an auditory /bi/-visual NM suggesting that they may have perceived the auditory /bi/-visual /vi/ as /vi/, as do adults. In Experiment 2, neither male nor female infants showed renewed visual interest to a dishabituation stimulus which represents only a change in mouth movements. In Experiment 3, male infants looked longer to an audiovisual /bi/ than to an audiovisual /vi/ following habituation to an audio /bi/-visual /vi/, while female infants tended to look only slightly longer to an audiovisual /vi/ than to an audiovisual /bi/. Taken together these experiments suggest that at least some infants are able to integrate heard and seen speech, but that they do not do so consistently. Although an innate mechanism may be responsible for integration, a role for experience is suggested as integration does not appear to be obligatory for young infants as it is for adults.

The purpose of this research was to explore the potential application of lytic phages to control Cronobacter spp. in infant formula. More than two hundred and fifty phages were isolated from various environmental samples against different strains of Cronobacter spp. Selected phages were characterized by morphology, host range, and cross infectivity. The genomes of five novel Cronobacter phages [vB_CsaM_GAP31 (GAP31), vB_CsaM_GAP32 (GAP32), vB_CsaP_GAP52 (GAP52), vB_CsaM_GAP161 (GAP161), vB_CsaP_GAP227 (GAP227)] were sequenced. Phage GAP32 possess the second largest phage genome sequenced to date, and it is proposed that GAP32 belongs to a new genus of “Gap32likeviruses”. Phages GAP52 and GAP227 are the first C. sakazakii podoviruses whose genomes have been sequenced. None of the sequenced genomes showed homology to virulent or lysogenic genes. In addition, in vivo administration of phage GAP161 in the hemolymph of Galleria mellonella larvae showed no negative effects on the wellbeing of the larvae and could effectively prevent Cronobacter infection in the larvae. A cocktail of five phages was highly effective for biocontrol of three Cronobacter sakazakii strains present as a mixed culture in both broth media and contaminated reconstituted infant formula. This phage cocktail could be potentially used to control C. sakazakii during preparation of infant formula but would first have to be clinically evaluated in mammalian models. / NSERC & DFO

Infants are perceptually sensitive to rising pitch over falling pitch (Sullivan & Horowitz, 1983) and this is reflected in their ability to discriminate between questions and declaratives in maternal speech (Soderstrom, Ko, & Nevzorova, 2011). Questions are proposed to play a fundamental role in the acquisition process by soliciting vocalization on the part of the infant (Snow, 1977). In the current study, we explored whether infant vocal responses to questions were distinct from those to declaratives; in particular, whether the use of questions by mothers encouraged greater vocalization by infants. Contrary to our hypothesis, infant vocalizations were no more likely to occur in response to questions. Infants responded more to questions when they were defined by rising pitch contours rather than falling ones. Infants did not respond more to declaratives with rising pitch contours. Questions, in combination with rising pitch contour, may provide especially salient response cues for infants. We propose that infants rely on these perceptual cues to learn when to respond during vocal exchanges with their mothers.

WIC food packages are undergoing major revisions to accommodate the unique requirements of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in the twenty-first century. This dissertation is an evaluation of the impact of the revised WIC food packages through national-level surveys obtaining data before and after food package changes. In addition, a community-level metabolic/dietary study of obese women consuming either the original or revised food packages was performed. Since WIC has never revamped its entire program before, this is an opportunity to learn more about the impact of the revisions on WIC participants across the country, including Native Americans from Indian Tribal Organizations (ITOs). The National Food and Nutrition food frequency questionnaire (NATFAN) evaluates food and consumption practices of WIC participants, including Native Americans, for both the original and revised WIC food packages. The baseline surveys (NATFAN') were administered before the 2009 rollout of the revised WIC food packages (dates varied by state program). The post-rollout surveys (NATFAN'') were administered spring through winter of 2010-2011, and at least six months after the implementation of the revised WIC food packages. Hierarchical linear modeling, with restricted maximum likelihood approximation, was used to evaluate 100% juice, fruit, and vegetable frequency of consumption based upon NATFAN' and NATFAN'', including samples from states, territories, and ITOs. This research is important because it was national in scope and analyzed nutritional behaviors of a Native American subpopulation of WIC that is seldom documented in national nutrition research. For the metabolic/diet study, obese women 185% of the poverty level were given the original or revised WIC food packages (n=3). Three venous blood serum collections (0, 6, 12 weeks) were biomarker tested (cholesterol, glucose, C-reactive protein, etc.) in lipid and metabolic panels. Three, seventy-two hour dietary recalls were also assessed to determine fruit and vegetable consumption changes over the course of the study. This phase was important because it focused on the individual's actual consumption behaviors of specific WIC foods dispensed in the WIC food packages and assessed how such consumption affected the health of the individual.

The purpose of this study was to determine if teaching low income prenatal women about infant feeding cues instead or in addition to the standard WIC education about the benefits of breastfeeding would serve to increase breastfeeding duration. One hundred ninety seven prenatal women who qualified for the federal Women Infants and Children Special Supplemental Feeding Program were divided into an experimental (E, n=51) or a control (C, n=139) group. The C group was given the WIC standard education of the benefits of breastfeeding by a nutritionist or nurse (CPA), the E group was given information about hunger cues that an infant exhibits by a lactation consultant during their WIC nutrition appointments. Data were analyzed by means of survival analyses, Kaplan Meier and Cox Regression. Data for 52 weeks indicate no statistically significant difference between the groups (chi square= 1.548, df=l, p=0.213). However data for 26 weeks indicated a stronger probability of continuing breastfeeding. Breastfeeding duration for C and E groups was 14.3±17.4 weeks and 18.5±17.1 weeks respectively (chi square=2.907,df=l,p=0.088), representing a 28% better duration. Findings suggest that prenatal women need information about infant behavior to help determine if they are adequately feeding their babies in order to maintain breastfeeding for longer duration. / Department of Family and Consumer Sciences

Infants are perceptually sensitive to rising pitch over falling pitch (Sullivan & Horowitz, 1983) and this is reflected in their ability to discriminate between questions and declaratives in maternal speech (Soderstrom, Ko, & Nevzorova, 2011). Questions are proposed to play a fundamental role in the acquisition process by soliciting vocalization on the part of the infant (Snow, 1977). In the current study, we explored whether infant vocal responses to questions were distinct from those to declaratives; in particular, whether the use of questions by mothers encouraged greater vocalization by infants. Contrary to our hypothesis, infant vocalizations were no more likely to occur in response to questions. Infants responded more to questions when they were defined by rising pitch contours rather than falling ones. Infants did not respond more to declaratives with rising pitch contours. Questions, in combination with rising pitch contour, may provide especially salient response cues for infants. We propose that infants rely on these perceptual cues to learn when to respond during vocal exchanges with their mothers.

The focus of the study is on the effect of massage on an infant's stress level, development and the emotional bond between the infant and the mother. Eight mother-infants dyads were recruited and the infants were between the ages of 3 to 9 months. The dyads were paired to ensure similarity of the groups and divided into an experimental and control group. The research made use of a multi-method, pre and post-test design. The measures used during the pre and post-testing included a biographical questionnaire, the Griffiths Mental Development Scales, the Parenting Stress Index and the Mother-to-lnfant Bonding Scale. Personal interviews were conducted with each mother as part of the post-test procedures. Saliva samples from every mother and infant were retrieved on three separate occasions to determine cortisol levels before, during and after the intervention. The experimental group's mothers received training to perform infant massage and were requested to massage their infants at least four times a week for the duration of four months. The data was processed by the Statistical Consultation Service of the Northwest University at Potchefstroom. The non-parametric test, Mann-Whitney U Test, was used to determine any statistical and/or practical significant differences between the experimental and control group before and after implementation of the intervention. The non-parametric test, Wilcoxon Matched-Pairs Signed Rank T-Test, was used to determine the differences within both the experimental and control group. Friedman's ANOVA was used to determine the changes within the groups regarding cortisol levels. As the sample size for this study is small and the possibility of determining statistical significance was slight, the effect sizes were considered for this study. The study had six aims. The first aim focused on the effect of infant massage on the infants' stress levels as measured through cortisol. No statistical significance could be found and the results revealed that the experimental group's infants' stress levels did not decrease. The second aim investigated the effect of infant massage on the mothers' stress levels as measured on the Parenting Stress Index and cortisol levels. No statistical significance could be determined but practical significant differences on the Parenting Stress Index indicated decreased maternal stress levels in the experimental group. These results differ from the cortisol levels that revealed the experimental group's mothers to experience higher levels of stress. The third aim focused on the effect of infant massage on the bond between mother and infant and found that the bond improved due to the intervention. The fourth aim investigated the effect of massage on the infants' development and although no statistical significance could be determined, practical significance could be found, indicating improvements on the motor scales for the experimental group. The fifth aim explored the mothers' subjective experience of infant massage as reported through qualitative measures. The sixth aim compared the mothers as participants' experience of infant massage as reported through quantitative measures and through qualitative measures. Strengths of the study included making use of a multi-method design and following a multi-disciplinary approach. Limitations of the study included a small sample size, the participants' restricted background and difficulty to ensure that the participants comply with the instructions for sampling saliva. Based on the results from the study, it can be concluded that infant massage have an effect on the mother-infant relationship, the mothers' subjective view of their stress levels and specified areas of the infants' development. According to the results from this study infant massage did not have an effect on the infants and mothers' stress levels as measured through cortisol. / Thesis (M.Sc. (Psychology))--North-West University, Potchefstroom Campus, 2009.

The focus of the study is on the effect of massage on an infant's stress level, development and the emotional bond between the infant and the mother. Eight mother-infants dyads were recruited and the infants were between the ages of 3 to 9 months. The dyads were paired to ensure similarity of the groups and divided into an experimental and control group. The research made use of a multi-method, pre and post-test design. The measures used during the pre and post-testing included a biographical questionnaire, the Griffiths Mental Development Scales, the Parenting Stress Index and the Mother-to-lnfant Bonding Scale. Personal interviews were conducted with each mother as part of the post-test procedures. Saliva samples from every mother and infant were retrieved on three separate occasions to determine cortisol levels before, during and after the intervention. The experimental group's mothers received training to perform infant massage and were requested to massage their infants at least four times a week for the duration of four months. The data was processed by the Statistical Consultation Service of the Northwest University at Potchefstroom. The non-parametric test, Mann-Whitney U Test, was used to determine any statistical and/or practical significant differences between the experimental and control group before and after implementation of the intervention. The non-parametric test, Wilcoxon Matched-Pairs Signed Rank T-Test, was used to determine the differences within both the experimental and control group. Friedman's ANOVA was used to determine the changes within the groups regarding cortisol levels. As the sample size for this study is small and the possibility of determining statistical significance was slight, the effect sizes were considered for this study. The study had six aims. The first aim focused on the effect of infant massage on the infants' stress levels as measured through cortisol. No statistical significance could be found and the results revealed that the experimental group's infants' stress levels did not decrease. The second aim investigated the effect of infant massage on the mothers' stress levels as measured on the Parenting Stress Index and cortisol levels. No statistical significance could be determined but practical significant differences on the Parenting Stress Index indicated decreased maternal stress levels in the experimental group. These results differ from the cortisol levels that revealed the experimental group's mothers to experience higher levels of stress. The third aim focused on the effect of infant massage on the bond between mother and infant and found that the bond improved due to the intervention. The fourth aim investigated the effect of massage on the infants' development and although no statistical significance could be determined, practical significance could be found, indicating improvements on the motor scales for the experimental group. The fifth aim explored the mothers' subjective experience of infant massage as reported through qualitative measures. The sixth aim compared the mothers as participants' experience of infant massage as reported through quantitative measures and through qualitative measures. Strengths of the study included making use of a multi-method design and following a multi-disciplinary approach. Limitations of the study included a small sample size, the participants' restricted background and difficulty to ensure that the participants comply with the instructions for sampling saliva. Based on the results from the study, it can be concluded that infant massage have an effect on the mother-infant relationship, the mothers' subjective view of their stress levels and specified areas of the infants' development. According to the results from this study infant massage did not have an effect on the infants and mothers' stress levels as measured through cortisol. / Thesis (M.Sc. (Psychology))--North-West University, Potchefstroom Campus, 2009.

This study considers the reproductive experiences of women in Sheffield between 1870 and 1939, encompassing the development of concepts of maternal and infant welfare, and debates over birth control and abortion. It focuses on the impact of state and voluntary enterprise, on the development of health professions and hospitals, and on the position of mothers. The study shows that high infant mortality was caused primarily by poor sanitation. Unlike other areas, Sheffield had low rates of both maternal employment and bottle feeding, suggesting that these were not significant factors. The decline in infant mortality was due to a combination of factors; the removal of privy middens and slum areas, and the development of welfare clinics and health visiting services. High maternal mortality was prevalent mainly in areas of skilled working class employment; not middle class areas as in other cities. There was no inverse correlation between infant and maternal mortality in Sheffield. Maternal mortality was caused by high rates of sepsis following illegal abortion. The reduction in mortality was due to a cyclical decline in the virulence of the causative bacteria, and the application of sulphonamide drugs to control it. The development of antenatal and birth control clinics had little impact. Despite early action to train midwives in Sheffield, midwifery remained a largely part time, low status occupation throughout the period. The hospitalisation of normal childbirth occurred early in Sheffield, and demand for beds outstripped supply, demonstrating that women were able to shape the development of services. Local authority and voluntary groups generally co-operated in the delivery of services, which were developed along pragmatic lines with little reference to debates about eugenics or national deterioration. The growth of welfare schemes was circumscribed by the available resources. Central government provided enabling legislation, but schemes were planned and implemented at the local level.