Newborn infants with differential patterns of fetal growth, as determined by their weight-for-length, typically display behaviors which have been conceptualized as reflecting the integrity of the infant's behavioral organization. The newborn infant's sucking is one behavior that has been hypothesized to both reflect the effects of previous experiences on behavioral organization and affect the infant's future behavioral development. In particular, the infant's pattern of sucking activity may not only reflect the integrity of the infant's nervous system, it may also alter the temporal organization of the infant's behavioral state and motor activity by increasing behavioral quiescence. The purpose of this study was to compare the sucking activity of underweight-for-length (N = 30) and average-weight-for-length (N = 30) infants and its effects on behavioral state and motor activity. Fifteen low-PI and 15 average-PI infants were randomly assigned to each of two experimental conditions. / Master of Science

published_or_final_version / Paediatrics / Master / Master of Philosophy

published_or_final_version / Applied Statistics / Master / Master of Social Sciences

Thesis (MD)-University of Natal, Durban, 1967.

M.Cur. / Neonates born with respiratory distress require supplementary oxygen. In some cases it is necessary to ventilate these neonates in order to obtain adequate tissue oxygenation. Due to the potential complications of mechanical ventilation it is necessary to extubate the neonate as soon as possible after intubation and administer supplementary oxygen by an alternate method. Any form of oxygen therapy carries the risk of oxygen toxicity. It is therefore essential that the method of oxygen therapy opted for after extubation will result in the infant being weaned in the shortest time possible. In the two NICUs from which the sample was taken for this study, neonates are currently extubated and placed either in a head box, on nasal CP AP or on a nasal cannula, these being the methods used to administer oxygen to a neonate. The decision regarding the method of choice is currently directed by customary practices rather than physiological variables as indicators/criteria of effectiveness. The questions that arise from the research problem are as follows: • Which physiological variables should be considered when faced with the decision regarding the method of oxygen therapy to initiate after extubation of a neonate? • Are there any differences in the effectiveness of the two methods of oxygen therapy, namely headbox and nasal cannula, after extubation of a neonate? The purpose of this study was to compare two methods of oxygen therapy, after extubation of the neonate with respiratory distress syndrome, in an attempt to formulate guidelines; based on physiological variables as criteria/indicators of effectiveness. After analyzing the data, as described in Chapter 4, it became evident that it would not be possible to formulate guidelines. Therefore only a comparison was done between the two methods of oxygen therapy (headbox and nasal cannula,) based on both biographical and physiological variables as criteria/indicators, to determine whether there were any significant differences in the effectiveness of the two methods after extubation of the neonate.

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.

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.

The ultra-processing of food has become a much more important aspect of dietary patterns and dietary quality in terms of its impact on body weight, diet related diseases, health, and well-being in the past decades. NOVA is a set of guidelines developed that classifies diet quality by degree of food processing. The NOVA guidelines distinguish four categories: unprocessed /minimally processed foods; culinary ingredients; processed foods; and ultra-processed foods. Numerous studies have found an association of ultra-processed foods and health conditions such as obesity and metabolic syndrome. This study analyzed the associations between maternal diet quality as measured by NOVA and maternal anthropometric and neonatal body composition outcomes. The optimal method of nutrition intervention and education for this special population remains unknown; using NOVA may provide researchers with a different lens to assess diet quality and health care professionals with additional vocabulary to convey more tailored messages regarding optimal nutrition strategies for mother and offspring. Using data collected from a large randomized controlled intervention trial at pre and post intervention, this study aimed to compare the NOVA guidelines assessment of maternal diet quality to the parent study assessment of diet quality, the Healthy Eating Index (HEI), using statistical correlations. Secondly, this study aimed to look at the relationship of ultra-processed food intake to the maternal gestational weight gain experience using a logistic regression. Thirdly, this dissertation aimed to explore the relationship between maternal ultra-processed food intake and neonatal lean mass as measured by quantitative magnetic resonance (QMR) and fat free mass as measured by air displacement plethysmography (ADP: PEAPOD). In terms of maternal outcomes, the study found that NOVA and HEI were significantly correlated at pre intervention but not at post intervention. The odds of gaining excessive gestational weight decreased as maternal ultra-processed food intake increased - which was not in the hypothesized direction - when using study participant data. However, the odds of gaining excessive gestational weight increased as maternal ultra-processed food intake increased - which was in the hypothesized direction - when using the Institute of Medicine weight gain recommendations. Also, while obesity did not predict excessive gestational weight gain, those with obesity ultra-processed food intake did predict gestational weight gain. These various inconsistencies are likely due to the instability of the dietary intake data because only one 24 -hour dietary recall was obtained from mother. In addition, the mothers’ diets were very healthy to begin with, where ultra-processed food intake formed about 45% of calories both pre and post intervention, when the national average is 57%. Race was also significant predictors of gestational weight gain for the mothers. Being non-white significantly increased the odds of gaining excessively as did the interaction of having obesity and eating more ultra-processed foods. In terms of neonatal outcomes, findings from this study suggest that length and fat mass are significant predictors of lean mass in neonates. In terms of the impact of maternal ultra-processed food intake, the higher the consumption of ultra-processed food, the greater the neonatal lean mass, which this was not in the hypothesized direction. However, the association was minimal with very small beta weights and regression line, when plotted was quite flat, so that the finding is not clinically meaningful. It remains important to know whether maternal ultra-processed food intake influences gestational weight gain and the body composition of the neonate. Thus, future research should include using similar data analyses on a population with a more nationally representative diet, a larger sample size, and a more robust measure of dietary intake such as three 24-hour recalls. Given that a similar recent study found ultra-processed food to be highly predictive of maternal and neonatal outcomes, and many other studies have demonstrated that ultra-processed food is related to several health conditions in many countries that this study did not measure, it seems prudent for healthcare providers to take advantage of prenatal visits as a window of opportunity to encourage the consumption of unprocessed and minimally foods and help women make informed decisions regarding ultra-processed foods.

Typescript (photocopy). / Digitized by Kansas Correctional Industries