Decision making could be defined as the ability to make a choice or a judgement before an individual takes action. How the individual works through the process of making a decision is influenced by a number of factors. It is acknowledged decision making is a complex process that involves cognitive and affective thought processing, together with interpretation, understanding, choosing between alternatives and taking action. The steps involved in this process are varied and range from a few to many depending on whose literature one is reading at the time. This descriptive cross sectional study aimed to determine what factors influenced a woman's decision when choosing the infant feeding method for her newborn. The information was gathered by means of a survey questionnaire and follow-up telephone interview. The factors identified as being important or influencing the decision were included on the survey. These factors were highlighted in previous studies and were considered part of the Theory of Reasoned Action (TRA) the framework on which this study was based. The one hundred and sixteen women who participated in this study had delivered term babies - that is babies over thirty-seven weeks gestation, in two hospitals in metropolitan Melbourne. A number of assumptions were tested. The descriptive statistics was generated using Statistical Package for Social Sciences (SPSS) Version 7. The qualitative data was analysed using thematic analysis. Eighty-five per cent (85%) of the women in this study made the decision to breastfeed and seventy-five per cent (75%) made this decision prior to their pregnancy being confirmed. Ninety-seven (83.6%) of the women stated their own values and beliefs had a major influence (i) on their infant feeding decision with just over twenty per cent (20.2%) of the women indicating the midwife had a major influence on their decision. Results of data supported or refuted the assumptions made at the beginning of the study and previous studies. These results also identified areas in midwifery practice that require change. This in itself will be a challenge for midwives. How they respond to this challenge may have an impact of the way women make the decision regarding their choice of infant feeding

Thesis (Ph.D.)--University of Delaware, 2007. / Principal faculty advisor: Mary Dozier, Dept. of Psychology. Includes bibliographical references.

BACKGROUND. There are various methods of health care follow-up of children born very preterm (VP, ≤31 week gestation) from a neonatal intensive care unit (NICU). Whilst the gold standard is the systematic NICU based follow-up program, which provides highly specialised neurodevelopmental and medical assessment, it is not feasible at all the appropriate times for all infants because of cost and geographical constraints. In Queensland, and elsewhere, 50% of children born VP rely on primary care-general practice for their screening and health needs once discharged from hospital. Recently, randomised and interrater agreement studies have shown the feasibility of the use of a questionnaire-based collection of late health status in children born VP. A preterm-targeted childhood primary health screening and surveillance program which draws from these methods may be effective in collecting long-term disability data and meeting the screening needs of children born VP. AIM. To (1) develop and (2) assess a Preterm-Targeted Screening and Surveillance Program against the routine National Health Medical Research Council (NHMRC) program for the early detection of sensorineural based disability in children born VP by general practitioners in the primary health setting for (1) prevalence estimation and (2) as a screening tool. METHODS. A two-part approach was chosen. Part 1 was a reconstructed cross-sectional cohort of 388 of 523 (74.2%) located and consented 2, 4 and 7 year ca (corrected age) children with a birthweight ≤ 1250 grams (g) born in Queensland. Epidemiological information was collected on child health outcomes and factors relating to the feasibility of providing a standardised targeted screening and surveillance program to be used by general practitioners to detect sensorineural based disability in children born VP. The Preterm- Targeted Screening and Surveillance Program was developed using World Health Organisation (WHO) screening program criteria and NHMRC evidence based health practice criteria. Part 2 was a multicentred randomised controlled trial to test the efficacy of the newly developed program in 202 VP infants who were randomised to receive the NHMRC or Preterm-Targeted Screening and Surveillance Program. The primary outcome was correct identification of sensorineural disability (developmental quotient >-1 standard deviation (SD), cerebral palsy, bilateral blindness or deafness requiring aids) at 12-months ca by general practitioners assessed against gold standard paediatric assessments. The odds ratios (OR) calculated the disability status (agreed vs. disagreed/unsure). Kappa statistics (k) and screening test characteristics calculated interrater agreement and screening accuracy (agreed vs. disagreed). Logistic regression investigated factors that might affect agreement between general practitioners and paediatric assessment for disability. Secondary outcomes were designed to be descriptive and included post-natal depression, parental stress, health service utilisation and satisfaction. RESULTS. Part 1 demonstrated that in Queensland there is no state-based information on 25.8% of children born VP. Children assessed suffer from sensorineural impairment and a range of other health and developmental problems. In addition, there is limited specialist child health resources located outside the major metropolitan areas and families rely heavily on general practitioners for child health care. Parents and general practitioners clearly demonstrated that they would use an evidence-based targeted childhood screening and surveillance program for children born VP. The Preterm-Targeted Screening and Surveillance Program provide parents and health practitioners with an evidence based-high accuracy standardised screening for sensorineural and non-sensorineural domains. In Part 2, 195 of 202 infants randomised were assessed for the primary outcome. There was no difference in the correct identification of sensorineural disability between general practitioners in either group shown by an OR of 0.91 (95%CI 0.50, 1.65) (preterm-targeted 65.6% vs. NHMRC 67.6%). No prognostic factors independently affected this outcome. Interrater agreement was fair (preterm-targeted k =0.30, p for Ho=0.001 vs. NHMRC k =0.29, p for Ho=0.002). The preterm-targeted group had more disability identified (73% vs. 33%) with less under-referrals (27% vs. 67%) but poorer specificity (70% vs. 92%) with more over-referrals (30% vs. 8%) compared to the NHMRC group. Secondary outcomes showed that children born VP experience high rates of health services use but their families experience similar rates of depression and parental stress compared to the general paediatric population. Satisfaction results suggest that the program was well received. CONCLUSION. A comprehensive epidemiological approach to collecting a broad range of VP child health outcomes and health service data was successfully used to develop an evidence-based Preterm-Targeted Screening and Surveillance Program which proved to have excellent uptake by parents and general practitioners. Assessing the program using a randomised methodology has allowed demonstration of its efficacy as a screening tool when used by general practitioners in the primary health setting. The Preterm-Targeted Screening and Surveillance Program is superior in identifying disability at 12-month ca compared to the standard NHMRC program. Whilst the results are promising, the program will not provide totally accurate prevalence of disability data because of the overestimation of disability.

Thesis (M.S.)--University of Delaware, 2006. / Principal faculty advisor: Martha J. Buell, Dept. of Individual & Family Studies. Includes bibliographical references.

Thesis (Ph. D.)--Ohio State University, 1981. / Includes vita. Includes bibliographical references (leaves 184-194). Available online via OhioLINK's ETD Center.

Phonetic perception becomes native-like by 10 months of age. A potential mechanism of change, distributional learning, affects the perception of 6-8-month-old infants (Maye et al., 2002). However, it was anticipated that perception may be more difficult to change by 10 months of age, after native categories have developed. In fact, some evidence suggests that by this age, the presence of social interaction may be an important element in infants’ phonetic change (Kuhl et al., 2003). The current work advances the hypothesis that infants’ level of attention, which tends to be higher with social interaction, may be a salient factor facilitating phonetic change. Three experiments were designed to test infants’ phonetic plasticity at 10 months, after phonetic categories have formed. A non-social distributional learning paradigm was chosen, and infants’ attention was monitored to probe whether a facilitating role would be revealed. In Experiment 1, 10-month-old English-learning infants heard tokens from along a continuum that is no longer discriminated at this age that formed a distribution suggestive of a category boundary (useful distinction). The results failed to reveal evidence of discrimination, suggesting that the distributional information did not have any effect. A second experiment used slightly different sound tokens, ones that are farther from the typical English pronunciation and are heard less frequently in the language environment. Infants still failed to discriminate the sounds following the learning period. However, a median split revealed that the high attending infants evinced learning. Experiment 3 increased the length of the learning phase to allow all infants to become sufficiently high attending, and revealed phonetic change. Thus, after phonetic categories have formed, attention appears to be important in learning.

Audition is perhaps the most developed and acute sense available to infants at birth. One theory supported by speech and music researchers alike proposes that the auditory system is biased to salient properties such as pitch and allocates processing of such stimuli to specialized areas. In the current study, we sought to investigate whether infants would show similar patterns for processing music and language, as they both contain predictable changes in pitch. In a previous study, we established that language processing is lateralized to the left temporal region in the infant brain. We hypothesized music would be processed in the right temporal area. Although it contains a rule-based structure somewhat akin to language, it is heavily dependent on fine distinctions in pitch. Preverbal infants watched a video of animated shapes (visual stimuli) coupled with either speech (1 of 10 different stories in infant-direct speech) or music (Scriabbin's Ballade No. 3 in A flat) while hemodynamic activity in bilateral temporal sites was recording using near-infrared spectroscopy. Results indicated significant right temporal decreases in HbO2 concentration in comparison with baseline measures during music trials relative to the left temporal area. These results suggest that even at the preverbal stage, infants process speech differently than other similarly structured auditory stimuli.

The ability to individuate objects is one of our most fundamental cognitive capacities. Recent research has revealed that, when objects vary in color or luminance alone, infants fail to individuate until 11.5 months. However, color and luminance frequently co-vary in the natural environment, and color and luminance interact in pattern detection, motion detection, and stereopsis. For this reason, we propose that infants may be more likely to individuate when objects vary in both color and luminance. Using the narrow-screen task of Wilcox and Baillargeon, Experiments 1 and 2 assessed 7.5-month-old infants’ ability to individuate uniformly colored objects that either varied in both color and luminance or varied in luminance alone. The results indicated that infants used these features to individuate only when the objects varied in both color and luminance. Thus, when color and luminance co-varied, infants used these features to individuate objects a full 4 months earlier than infants use either feature alone. Experiment 3 further explored the link between color and luminance by assessing 7.5-month-old infants’ ability to use pattern differences to individuate objects. Although infants use pattern differences created from a combination of luminance and color contrast by 7.5 months, results from Experiment 3 indicated that when pattern was created from either color contrast or luminance contrast alone, infants fail to individuate based on pattern. The results of Experiment 3 suggest that it is not the number of feature dimensions that is important, but the unique contribution of both color and luminance that is particularly salient to infants. These studies add to a growing body of literature investigating the interaction of color and luminance in object processing in infants, and have implications for developmental changes in the nature and content of infants’ object representations.

Thesis--PlanB (M.S.)--University of Wisconsin--Stout, 2004. / Includes bibliographical references.

Thesis (M. A.)--Catholic Theological Union at Chicago, 2000. / Vita. Includes bibliographical references (leaves [51]-52).