This project encompasses program evaluations of infant massage intervention and its impact in the overall development of infants and children born with disabilities or babies born at risk for developmental delays.

MPH / Department of Public Health / See the attached abstract below

Thesis (M.S.)--Massachusetts Institute of Technology, Dept. of Nutrition and Food Science, 1981. / MICROFICHE COPY AVAILABLE IN ARCHIVES AND SCIENCE. / Bibliography: leaves 85-89. / by Patricia Ann Haggerty. / M.S.

Thesis (MA)--Stellenbosch University, 2004. / ENGLISH ABSTRACT: his review examines the literature on the psychological impact of Kangaroo Mother Care (KMC) on the mother, infant, support personnel and other caretakers. The paper summarizes the findings of the KMC research and considers the implications of it in light of high numbers of premature and low birth weight infants in South Africa. The review briefly considers theories of bonding and attachment adopted in the research and theories on why KMC is effective. The psychological impact of one component of KMC, Skin-to-Skin Care (SSC), used primarily in developed countries to supplement traditional care, has been extensively researched. In contrast, much less research has explored the psychological impact of full KMC programmes in developing countries. Our understanding of the psychological impact of KMC therefore relies predominantly on research from a very different context to the one in which KMC is used. As SSC has been utilised very differently to KMC and in first world settings, it cannot offer mothers or their family reliable information on the psychological demands and benefits ofKMC. Findings: Although KMC appears to offer invaluable physiological benefits and assists in 'humanising' neonatal care in important ways, there is currently very little published research on the short or long-term psychological impact of KMC on the mother, infant, support personnel and other caretakers. On the whole, research findings on the psychological impact of KMC were not conclusive but indicate some positive outcomes for increased maternal sensitivity and confidence, developmental benefits for the infant and an improvement in the clarity of infants' cues and communication with caregiver. Findings on the psychological impact of KMC for support personnel and other caretakers such as the family of the infant are also not conclusive and indicate that more research is necessary. Further research is required regarding cross-cultural experiences of KMC; maternal experiences of depression, anxiety and ambivalence; long-term developmental and attachment outcomes for the infant and the possible preventative value of KMC for maternal and infant mental health. / AFRIKAANSE OPSOMMING: Hierdie hersiening ondersoek die literatuur aangaande die sielkundige uitwerking van Kangaroo Mother Care (KMC) op die ma, suigeling, ondersteunende personeel en ander opsigters. Die artikel is 'n opsomming van die uitspraak van KMC navorsing en oorweeg die gevolgtrekkings daarvan ten opsigte van die hoe getal vroeggebore en lae ligaamsgewig van suigelinge wat in Suid-Afrika gebore is. Die hersiening kyk kortliks na die teorie verbonde aan die binding en gehegtheid van die navorsing en teorie oor hoekom KMC doeltreffend is. Die sielkundige uitwerking van een onderdeel van KMC, Skin-to-Skin Care (SSC), wat meestal in gevorderde lande gebruik word om tradisionele versorg te verryk, is deeglik ondersoek. Inteendeel is ver minder navorsing op die sielkundige uitwerking van volle KMC programme in ontwikellende lande gedoen. Dus is ons begrip van die sielkundige uitwerking van KMC afhanklik op navorsing vanuit 'n ander konteks as die een waarin die eintlik gebruik is. SSC word baie anders benut as KMC, en in eerstewereldkontekste kan dit dus nie veel betroubare inligting op die sielkundige vereistes en voordele van KMC verskaf nie. Bevindings: Al kom dit voor dat KMC waardevolle sielkundige voordele verskaf en help in geboorte nasorg op belangrike maniere, is daar huidiglik baie min navorsing op druk oor die kort- of die langtermyn sielkundige uitwerking van KMC op die ma, suigeling, ondersteunende personeel en ander oppassers. In die algemeen, is die bevindings van navorsing oor die sielkundige uitwerking van KMC nie volkome nie, maar dui positiewe uitslae aan op verhoogde moederlike gevoelens en selfvertroue. Navorsing dui ook ontwikkelingsvoordele vir die suigeling, asook die bevordering van die duidelikheid van sy kommunikasie met die oppasser. Bevindings op die sielkundige uitwerking van KMC op die ondersteunende personeel en ander oppassers, byvoorbeeld familielede van die suigeling, is ook nie volkome nie, en dui die nodigheid van verdere navorsing aan. Verdere navorsing oor die kruiskulturele ervaring van KMC, moederlike ondervinding van moedeloosheid, angs en dubbelsinnigheid is benodig. Langtermyn ontwikkeling en gehegtigheidsake vir die suigeling en die moontlike voorkomende waarde van KMC vir moederlike en suigeling se geestelike gesondheid is ook wel benodig.

The development of emotion regulation skills is an imperative task early in development. Respiratory sinus arrhythmia (RSA), a physiological proxy of regulation, is indicative of one’s regulatory capacity and can be predictive of behavior in later life (Graham, Ablow, & Measelle, 2010; Moore, 2010). Children begin regulating their emotions at a physiological level early in infancy. Infants who are able to properly suppress RSA have higher quality social interactions in childhood (Graziano, Keane, & Calkins, 2007). Previous work has suggested that parents play a role in predicting infant RSA (Conradt & Ablow, 2010). For example, parent marital satisfaction is known to impact infants’ physiological regulation, such that infants whose parents are less satisfied with their marriages have a decreased ability to regulate physiologically (Moore et al., 2009; Porter, Wouden-Miller, Silva, & Porter, 2003). Previous research has found that parent personality impacts parenting strategies (Cummings & Davies, 1994; Prinzie, Stams, Deković, Reijntjes, & Belsky, 2009), however work examining how parent personality interacts with marital satisfaction to predict infant RSA is lacking. Moreover, the majority of previous work assessing the parent predictors of infant RSA focused on mothers (e.g., Moore et al., 2009). There are known differences in the way mothers and fathers interact with their infants, as well as differences in the way fathers and mothers respond to marital dissatisfaction (Forbes, Cohn, Allen, & Lewinsohn, 2004; Karney & Bradbury, 1995). The present study focused on examining how marital satisfaction and parent personality predicts infant RSA with mothers and fathers. The current study involved 38 families (6-month old infants, mothers, and fathers). Parents completed questionnaires measuring marital satisfaction and personality. Mother-infant and fatherinfant dyads participated in a baseline and face-to-face play task (Still Face Paradigm; Tronick, Als, Adamson, Wise, & Brazelton, 1978), where infant physiological regulation was assessed. Results involving mothers did not yield significant findings predicting infant physiological regulation. For fathers, results indicated that parent personality and parent marital satisfaction predicted infant physiological regulation. The current study highlights the importance of examining the roles of both mothers and fathers predicting infant physiological regulation.

Music interventions have been shown to improve parent-child interactions (e.g., Lyons, 2000; Mackenzie & Hamlett, 2005; Nicholson et al., 2008; Oldfield et al., 2003) and maternal sensitivity (Nicholson et al., 2008). However, there are currently no studies of Canadian parents’ perceived motivations for, and their experiences participating in, singing classes with their infants. Therefore, more information is needed on Canadian parents’ experiences, and motivations for, participating in singing classes with their infants in order to better understand and support healthy parenting behaviours and infant development.. Specifically, the research questions guiding this preliminary inquiry, were: (1) What do parents identify as factors motivating them to participate in parent-infant singing classes? and (2) What do parents identify as the benefits of participating in parent-infant singing classes? Interviews were conducted with four mothers who were attending parent-infant singing classes. Two music instructors involved in the parent-infant singing classes were also interviewed to learn more about the content and functioning of the classes. Additionally, the Parenting Sense of Competency Scale (PSOCS) and the Key to Interactive Parenting Scale (KIPS) were administered to gain additional information related to parent participation in parent-child singing groups (i.e., parenting behaviours and parental sensitivity), and to triangulate data from parent interviews. Four themes emerged from the parents’ interview data: (1) mothers’ motivations, (2) enhanced parenting, (3) parents’ enhanced view of self, and (4) predictors of change. Parents described their development of music-based parenting tools they perceived to have helped them better regulate their infants’ emotions and behaviours, strengthen their parent-child relationship, and support their child’s language and musical development. In addition, parents described the positive development of their view of self as demonstrated by decreases in reported parenting guilt, normalization of parenting struggles, and an increased focus on success. Moreover, preliminary findings raised questions about additional variables that may enhance growth of parenting skills to foster language and musical development and parental self-efficacy, such as using repetition, routines and structure, and developing supportive relationships with classmates and instructors. Implications for practice and future research are discussed.

published_or_final_version / Community Medicine / Master / Master of Public Health

The premature infant is subject to pathological alterations of the cardiovascular system leading to insufficient pulmonary blood flow and/or sudden surges of pressure to fragile cerebral blood vessels, conditions which are often associated with hypotension. Dobutamine appears to be a potentially useful agent to increase pulmonary blood flow and correct hypotension. In view of this potential, the alpha-adrenergic characteristics of dobutamine acts were studied in the isolated rabbit femoral and pulmonary arteries. Dobutamine on the post synaptic membrane of these tissues as a high affinity, low intrinsic activity alpha adrenergic agonist. No action of dobutamine to modulate stimulation evoked release of norepinephrine was found, although dobutamine did increase spontaneous release of norepinephrine. This effect was not blocked by antagonists of uptake 1 and uptake 2. To further evaluate dobutamine for use in the neonate, contractile responses of the femoral and pulmonary arteries and aorta to dobutamine and norepinephrine were studied in dogs of various ages from newborn to 6 weeks. Maximal contractile responses to norepinephrine in the pulmonary artery and aorta increased with age. Dobutamine produced small or no responses in all newborn tissues studied and also showed increasing responsiveness with age. To allow future study of the mechanism of these changes a method of radioligand binding was established for vascular smooth muscle using the ligands prazosin and rauwolscine in the dog and rabbit pulmonary artery and aorta. This binding was found to demonstrate the properties of saturability, sterospecificity and rank order of potency. Possible variables that could account for the observed changes in response during maturation were mathematically modeled to provide a theoretical basis for future studies combining measurement of contractile response and radioligand binding techniques.

In der Neonatologie ist die Verabreichung von Erythrozytenkonzentrat (EK) eine der häufigsten therapeutischen Maßnahmen. Ursachen dafür sind die Frühgeborenen-anämie und die iatrogen durch diagnostische Blutentnahmen hervorgerufene sekundäre Anämie. Obwohl ca. 80% der Frühgeborenen während des postnatalen stationären Aufenthaltes EK erhalten, gibt es noch immer keine einheitlichen Richtlinien zur Bluttransfusion bei Frühgeborenen. In der vorliegenden Studie sollte der Effekt einer EK-Gabe mit Hilfe der Messung der cerebralen und peripheren Gewebsoxygenierung (crSO2 und prSO2) erfasst werden. Und es wurde der Annahme nachgegangen, dass in der Neonatologie Subgruppen existieren, welche unterschiedlich von einer EK-Transfusion profitieren. Im Rahmen dieser Promotionsarbeit wurden Frühgeborene der neonatologischen Abteilung der Universitätsklinik und Poliklinik für Kinder- und Jugendmedizin Leipzig prospektiv analysiert. Es konnte gezeigt werden, dass bei allen untersuchten Patienten sowohl die cerebrale als auch die periphere Gewebsoxygenierung unter EK-Transfusion ansteigen und auch nach einem Intervall von 24 Stunden noch auf diesem gesteigerten Niveau konstant bleiben. Zudem konnte nachgewiesen werden, dass Kinder mit niedrigen crSO2-Ausgangswerten vor Transfusion mehr Sauerstoffsättigungsabfälle unter 80% (SaO2<80%) aufweisen. Nach Transfusion ist bei diesen Patienten zusätzlich ein stärkerer Rückgang der Anzahl der SaO2<80% zu beobachten. Somit ist die Gewebsoxygenierung möglicherweise ein sinnvoller Parameter für die Indikation zur EK-Transfusion, welcher bei der Erarbeitung neuer Transfusionsricht-linien in der Neonatologie mit einbezogen werden sollte.

Herbal and homeopathic compounds have been used to aid in childbearing and pregnancy for centuries. Much of this information is anecdotal and lacks scientific support, making it difficult to evaluate safety and efficacy. Increased public interest in alternative treatments leads to the need for a systematic review on the topic. Herbal remedies are most often used to treat the most common pregnancy-related problems like nausea, stretch marks and varicose veins. In contrast to this, concerns have also been raised about the adverse effects of these remedies. The primary objective of this research project was to conduct a systematic review to assess the maternal and neonatal outcomes of ingested herbal and homeopathic remedies using during pregnancy, birth and breastfeeding.