Thesis (M.S.)--Florida State University, 2004. / Advisor: Dr. Deborah Frank, Florida State University, School of Nursing. Title and description from dissertation home page (viewed June 17, 2004). Includes bibliographical references.

Thesis (Ph. D.)--University of Washington, 2003. / Vita. Includes bibliographical references (leaves 112-139).

Thesis (M.S.)--Eastern Illinois University, 2003. / Includes bibliographical references (leaves 39-41).

Thesis (Ph. D.)--University of California, San Diego, 2003. / Vita. Includes bibliographical references (leaves 171-178).

published_or_final_version / Paediatrics / Doctoral / Doctor of Philosophy

published_or_final_version / Nursing Studies / Master / Master of Nursing in Advanced Practice

published_or_final_version / Public Health / Master / Master of Public Health

Using the Autism Spectrum Disorder (ASD) database of the Department of Paediatric and Adolescent Medicine of The University of Hong Kong, a retrospective cohort study was carried out exploring the relationship between prematurity and symptom severity by using Childhood Autism Rating Scale (CARS). The premature group was found to have no significant difference in total CARS score as compared to the full term group, and no significant correlation was found between CARS score and gestational age [GA] (for children diagnosed or with suspected ASDs). Significantly higher numbers of the premature group (GA 37 weeks, N = 130) had multiple births, family history of ASDs or related disorders, pre/perinatal complications, as well as a significantly lower mean birth weight as compared to the full term group (GA > 37 weeks, N = 683). Mean total CARS score of very premature cases (M = 32.20, SD = 6.29) was found to be 2 points lower than mean total CARS score of those that were full term (GA > 37 weeks [M = 34.08, SD = 6.53]). However, the result was not statistically significant by unpaired t-test analysis. Therefore, results in this cohort show no relationship between prematurity and CARS score of children with ASDs, however further studies should be carried out in order to better validate existing findings. / published_or_final_version / Paediatrics and Adolescent Medicine / Master / Master of Medical Sciences

Background Vitamin D deficiency is prevalent in many places across the world. Breastfeeding has been suggested to be a significant predictor of vitamin D deficiency during infancy, which is preventable through proper supplementation. However, whether Hong Kong should adopt the international recommendation for supplementation of exclusive breastfed infants is still not yet answered. Objective: To review the available evidence regarding the association between breastfeeding and vitamin D deficiency during infancy, as well as the effectiveness of vitamin D supplementation of breastfed infants as an intervention measure. Methods A total of 5112 potentially relevant articles were searched and identified from MEDLINE (OVID, Pubmed), Science Citation Index Expanded (ISI Web of Science), Cochrane Central Register of Controlled Trials, EMBASE, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Chinese database (CNKI) without restriction from inception to July-06-2012. 5065 articles were excluded after the initial scanning of title and abstracts. 36 were subsequently excluded due to methodological issues. A total of 11 studies were included and reviewed by two independent reviewers. Results This review pooled together a total of 1126 exclusively breast-fed infants for less than one year old from 11 studies. The pooled average prevalence of vitamin D deficiency was 54.2%. The association between breastfeeding and vitamin D deficiency during infancy has been reported consistently, and it was found to be one of the strongest predictors of vitamin D deficiency for infants less than one year old. Sunlight exposure, season, and skin pigmentation were also found to be important affecting factors. Supplementation to breastfed infants with the dosages as recommended by American Academy of Pediatrics (AAP) seem to be effective in lifting up the vitamin D levels. Conclusions The Hong Kong Government and relevant health sectors should conduct local epidemiological study to investigate the problem of concern among our breast-fed infants, and seriously consider or evaluate the AAP recommendation of supplementation. / published_or_final_version / Public Health / Master / Master of Public Health

Sound levels in the neonatal intensive care unit often exceed the recommended level of 45 dBA. Various sounds contribute to the extraneous noise that envelops this fragile environment. Increase in noise and high levels of sound can be detrimental to the health of premature infants, which can cause both short and long-term developmental delays and negative physiologic responses. Music therapy interventions in the NICU have addressed numerous needs of this population, with a positive effect on development, physiologic responses, and hospital stay. The purpose of this study was to investigate the effect of music therapy on decreasing the sound levels in the NICU. Two different pods in a 66-bed NICU were used to measure sound levels for four consecutive days, alternating between days of baseline and music therapy intervention. A dosimeter was used to collect data, which was later analyzed to determine Lmin, and Lmax, and Leq. Results indicated an overall decrease in the sound levels average when music therapy intervention was present. Future studies should use multiple settings and collect data for an extended amount of time to further examine the sound levels of the NICU environment and any additional effects music therapy can have.