It has been repeatedly documented that during mother-infant inter- action, mothers of pre-term infants exhibit higher rates of stimulation than do mothers of full-term infants. The present research explored characteristics of mother and infant which may contribute to this pattern. In Study 1, pre-term and full-term infants were compared on two dimensions of neonatal behavior thought to elicit heightened maternal activity: (1) lesser positive responsiveness and (2) greater irritability or drowsiness. Further, the pre-term sample was divided into two groups (mildly ill, moderately ill) to explore the impact of severity of neonatal medical complications on infant behavior. Assessment of neonatal responsiveness included orientation items and ratings of alertness and state control adapted from the Brazelton Neonatal Behavior Assessment Scale. Pre-terms exhibited less mature visual tracking of moving stimuli than full-terms but showed similar optimal responsiveness to an animate visual and auditory stimulus. Within the pre-term sample, the two illness groups did not differ on any measure. In Study 2, variations in maternal folk theories about special needs of pre-terms were explored. Mothers of mildly ill and moderately ill pre-terms were compared on three sets of attitudes thought to affect maternal stimulation during interaction- -Vigilance, Protection, and Developmental Expectations. Vigilance refers to providing attention, monitoring behavior, and worry about future development. Protection reflects a view of the infant as vulnerable and fragile. Pre-term mothers were also compared to full-term mothers on expectations for infant achievement of cognitive and motoric milestones. Mothers of moderately ill pre-terms expressed more Vigilance attitudes than mothers of mildly ill pre-terms; no difference in Protection attitudes were found. Mothers of pre-terms expected delayed motoric development more frequently than mothers of full-terms. The implications of the findings from these studies for hypotheses about the origins of the high maternal activity pattern were discussed. / This thesis was digitized as part of a project begun in 2014 to increase the number of Duke psychology theses available online. The digitization project was spearheaded by Ciara Healy.

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01

MS(Med), Child Health: Neurodevelopment, Faculty of Health Sciences, University of the Witwatersrand / Background: ELBW preterm infants are at extremely high risk for adverse neurodevelopmental (ND) outcome. Systemic hypotension is an important peri-natal risk factor in neurodevelopmental outcome. Numerous other risk factors exist for adverse neurodevelopmental outcome. Aim: To assess whether early mean systemic blood pressure and other risk factors contribute to poor ND outcome in ELBW preterm infants managed at Panorama Medi-Clinic. Methods: A retrospective, analytical study using data obtained from 2003 to 2008. Data from the Vermont Oxford Network database of which Panorama Medi-Clinic is a member was used to select a cohort of inborn, surviving infants weighing ≤ 1000g or ≤ 30 weeks gestational age. Early mean systemic BP records were obtained from nursing records. ND data was obtained from the neurodevelopmental clinic or routine follow up clinics notes. Infants with major defects at birth were excluded. The cohort was classified according to their general developmental quotient and whether or not they had signs of cerebral palsy into a normal or abnormal neurodevelopmental group. All patients remained completely anonymous and ethical clearance was obtained from the ethics committee at Panorama Medi- Clinic. P a g e | VII Results: 82 infants were eligible. 78 were entered the study. 4 were lost to follow up. Average birth weight was 782.1g ± 148.23. Average gestational age was 27.06w ± 1.32. Normal neurodevelopmental outcome was found in 64(82%). An abnormal neurodevelopmental outcome was found in 14(18%). No statistically significant difference was found by logistical regression when mean systemic blood was compared between normal and abnormal neurodevelopmental groups. If a cut off BP of <30 mm Hg, or inotropic agents were administered, no statistical difference was found between the normal and abnormal groups. Severe grades of IVH, ROP, post-natal steroids, and chronic lung disease, and gastro-intestinal perforation, were identified as risk factor of adverse outcome

There are different opinions on who the appropriate decision makers are for extremely premature infants. Some argue the responsibility should fall to the parents, and others argue the neonatal experts should be responsible for decision making. This study explored parental perceptions of their involvement in decision making in the neonatal intensive care (NICU). The NICU operated from the philosophy of Family Centered Care (FCC). FCC situates the parents as central to all aspects of their child’s care and as such, the parents should be well informed and actively involved in decision making. An interpretative descriptive approach was used to examine the experiences of seven parents who had infants born at 24-26 weeks gestation who were admitted to the NICU. Thematic analysis revealed that the culture of the NICU along with the relationships developed in the NICU had an impact on the parents’ perceptions of decision making.

Thesis (M.P.H.)--University of Wisconsin -- La Crosse, 2009. / Includes bibliographical references (leaves 57-63)

Thesis (M.A.S.)--Memorial University of Newfoundland, 2002. / Bibliography: leaves 51-52.

published_or_final_version / Nursing Studies / Master / Master of Nursing

published_or_final_version / Nursing Studies / Master / Master of Nursing

Skin is the major protective barrier in a human body. In premature infants, the immature skin barrier reduces the protection against germs. Emollient therapy is an effective prophylactic measure to improve premature infants’ skin condition so as to protect the premature infants against infection. A systematic review of studies shows that emollient therapy is a simple, safe and cost effective intervention for premature infants to improve skin condition. Evidence shows that emollient therapy can also decrease transdermal water loss, conserve heat and energy, stabilize fluid and electrolytes and prevent nosocomial sepsis. The potential of implementing the proposed evidence-based guideline is explored. It will be carried out in a clinical setting. The transferability of the findings, feasibility and cost-benefit ratio of the emollient therapy will be discussed. In order to ensure the evidence-based guideline will be carried out smoothly, a communication plan is necessary to be made in consultation with the stakeholders. A pilot study will also be conducted before the innovation is implemented to ensure frontline staff members to be familiar with the emollient therapy. At the end, the effectiveness of the emollient therapy will be evaluated in terms of skin score. Patients’ outcome and healthcare provider’s outcome will also be evaluated. / published_or_final_version / Nursing Studies / Master / Master of Nursing

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