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Objectives: The quality of securement directly impacts the functionality, duration of patency and likelihood of a complication for a given peripheral intravenous catheter. The objective of the study was to determine which method of peripheral intravenous catheter securement, StatLock or Tegabear dressing was more effective by comparing duration of catheter patency and complication rates. Study Design & Method: A quasi-experimental study using the Model for Improvement was conducted in a neonatal intensive care unit of a tertiary care hospital. Infants requiring insertion of a peripheral intravenous catheter for parenteral nutrition or administration of medications were eligible to participate. The study was conducted over a 4-month period and was divided into two phases, with each phase lasting two months. Results: A total of 363 peripheral intravenous catheters were inserted in 175 infants. There were 211 catheters secured with StatLock and 108 secured with Tegabear dressing. There were 42 catheters which were unable to use StatLock or Tegabear dressing and were secured with a combination of transparent dressing/ tape. There were two peripheral intravenous catheters inserted where the method of securement was not indicated. The groups were similar with regards to all demographic variables except postmenstrual age, where the Tegabear group consisted of a larger proportion of older infants (p=<0.001). There was no significant difference in the mean duration of catheter patency between the StatLock and Tegabear group (46.04 hours versus 45.33 hours respectively), p=0.84. Complication rates and reasons for catheter removal did not significantly differ between the two groups (p=0.78 and p=0.93 respectively). The proportion of catheters that used an arm board was significantly greater with the Tegabear dressing (23.8%) compared to 10.5% with StatLock (p=0.002). Twenty one percent (n=23/108) of the catheters secured with the Tegabear dressing required reinforcement with tape or transparent dressing whereas no catheters in the StatLock group needed to be reinforced (p<0.001). Conclusion: Catheter dwell time and complication rates did not differ significantly between StatLock and Tegabear dressing. However, when evaluating a new product, it is important to consider that there is often a learning curve that must be overcome. A larger study with a more rigorous design such as a randomized controlled trial is needed to validate or dispute the study findings. In the meantime, nurses must exercise individual and independent judgment when selecting a securement method most appropriate for their patient. / Thesis / Master of Science in Nursing (MSN)

Lateral biases are evident in a number of behaviors across many organisms. The present work was concerned with the particular lateral phenomenon known as handedness. Previous research has suggested that handedness is not a one-dimensional trait. This study evaluated handedness using two factors: hand preference and hand performance. Hand preference refers to the hand chosen to carry out a given action whereas hand performance refers to each hand’s ability, or skill, at carrying out that action. The relationship between hand preference and hand performance has been studied extensively in adults, but the larger body of work with human infants has only assessed hand preference. The goals of this study were to develop a methodology to measure infant hand performance and to begin to examine the relationship between hand preference and hand performance in development. To this end, thirty-six 11-month-old infants were videotaped completing three tasks. The first task assessed hand preference and consisted of a free-play period during which infants were presented with a series of toys that afforded different types of manipulation. The second and third tasks were novel measures of infant hand performance. The second task assessed the infant’s gross motor skills and involved fitting a ball into the top aperture of a toy. The third task assessed the infant’s fine motor skills by requiring infants to retrieve a Cheerio from a stationary plastic cup. Overall, the majority of infants were found to be right-preferent. This was in agreement with previous studies of hand preference in 11-month-olds as well as the pattern of hand preference seen in adults. There was no group-level asymmetry on either measure of hand performance. Hand preference was regressed on hand performance in an overall model of handedness. The right hand’s performance on each task significantly predicted hand preference scores. This was the first study to demonstrate that hand preference can be predicted by hand performance in infants. Future work will examine infant hand proficiency in greater detail as well as the relationship between hand preference and hand performance in nonhuman primate infants.

Objective: To examine differences in the antenatal detection rate of small for gestational age (SGA) infants among several race-ethnicity groups and determine whether perinatal outcomes differ in antenatally detected versus undetected SGA infants according to race-ethnicity. Methods: A retrospective cohort study was conducted at a single tertiary care center that evaluated all deliveries of SGA infants >23 weeks gestation between January 2016-January 2020. Race and ethnicity were self-reported and categorized as non-Hispanic White, non-Hispanic Black, Hispanic, or Asian. The medical charts of those eligible were reviewed and the primary study outcomes were analyzed using multivariable logistic regression analyses with accompanying point estimates and 95% confidence intervals. Results: A total of 526 childbearing persons satisfied our predefined inclusion criteria. The predominant race-ethnicity group was non-Hispanic White who comprised 50% of the study population. Antenatal detection rate of SGA was found to be 38%. The detection rate, while not statistically different, ranged from 28-40% according to race-ethnicity with Asians having the lowest detection rates. Higher rates of preterm birth, labor induction, and lower median birthweights were observed in antenatally detected versus undetected SGA pregnancies. However, no significant differences were observed with regards to perinatal outcomes when antenatally detected versus undetected SGA was compared according to race-ethnicity. Conclusions: Antenatal detection may not be the primary solution to improving racial and ethnic disparities among SGA infants. Additional investigation to identify, address, and improve disparities in other areas of perinatal medicine is necessary to provide more equitable care. Further work to investigate the barriers to antenatal detection of SGA is warranted as an avenue for improving perinatal outcomes.

Background: Breastfeeding amongst HIV-infected and HIV-exposed mother-infant dyads is a wide-ranging and persistent field in which more investigation is needed. The literature widely recognizes the multifactorial and syndemic nature of HIV and infant feeding, specifically pertaining to maternal and other breastfeeding-associated risks. Findings differed regarding breastfeeding and general developmental outcomes amongst HIV-exposed and HIV-infected infants when compared with HIV-unexposed infants. Evidence, however, suggests slight neurodevelopmental differences in HIV-exposed infants when compared with HIV-unexposed infants, suggesting possible feeding differences. Recent literature also indicated a lack of knowledge among allied health care staff regarding evidence-based counselling content to be provided to mothers concerning single option feeding, breastfeeding outcomes and risks in HIV-affected mother-infant dyads in South Africa. Owing to these varied findings related to HIV-affected mother-infant dyads, synthesising of knowledge regarding HIV, infant breastfeeding outcomes and associated risk factors is warranted. Objective: To critically appraise recent literature regarding breastfeeding outcomes and associated risks in HIV-infected and HIV-exposed infants using the PRISMA-P statement guidelines. Method: Five electronic databases were systematically searched to obtain English publications from the last ten years pertaining to breastfeeding outcomes and associated risks of HIV-infected and HIV-exposed infants and children. Grey literature sources were also included. Data were extracted according to various data items and were synthesised using thematic synthesis. Results: Of the initial 7151 sources identified, 42 articles were deemed eligible for final inclusion. The final selection included 19 cohort studies and two expert committee reports, classified as grey literature. The remaining 21 studies compromised of case-control, cross-sectional, and randomized controlled trial studies. The following themes were identified from the review objectives: breastfeeding outcomes, breastfeeding risk factors, infant growth and developmental outcomes and barriers and facilitators to feeding decisions. Most studies focused on HIV-exposed infants’ growth and developmental outcomes. Exclusive breastfeeding was confirmed to have the best outcomes for all infants, regardless of their HIV status, which in turn supports national and international policies. The most prevalent factors that made it difficult for mothers to breastfeeding were maternal factors affecting decision-making for breastfeeding, followed by biological risk factors. Conclusion: Knowledge regarding breastfeeding outcomes in HIV-exposed and HIV-infected infants remains lacking and further research is necessary. This review emphasised that the majority of HIV-affected mother-infant dyads reside in sub-Saharan Africa, illustrating that health professionals, especially those in sub-Saharan Africa (SSA), have to look beyond their traditional assessment and management focuses to include the factors that can impact successful exclusive breastfeeding. Addressing both infants’ needs and maternal HIV-related needs and risks on macro, meso, and microsystem levels is necessary. / Dissertation (MA (Speech-Language Pathology))--University of Pretoria, 2021. / Speech-Language Pathology and Audiology / MA (Speech-Language Pathology) / Unrestricted

Indiana University-Purdue University Indianapolis (IUPUI) / Twice as many African American infants die each year when compared to white infants. While infant mortality rates have declined for all ethnic groups in the United States over the past fifty years, the racial gap has remained persistent, and is not fully understood despite numerous quantitative studies. The purpose of this study was to understand the lived experiences of African American women in relationship to the black gap in infant mortality. Thirteen African American women participated in either a focus group or in–depth interviews. Women were asked to use their life experiences to identify factors that would increase the understanding of African American infant mortality. Several themes emerged indicating that the experience of stress and racism are constant factors in African American women’s lives and are inseparable from their pregnancy experience.

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