Medicine and Health Sciences Commons^™

An Exploration Of Swallowing Stimulation In The Infant, Sarah Elizabeth Hegyi

Dissertations, 2014-2019

The purpose of this study was twofold: to determine the effects of two types of non-invasive, peripheral sensory stimulation on the frequency of infant swallowing and to explore the cortical activation patterns in response to stimulation in the somatosensory and motor regions of the brain during infancy, between 2-4 months and 7-9 months of age. The two different forms of mechanical stimulation investigated include pacifier stimulation to the lips and oral cavity and vibrotactile stimulation via the external throat area to the laryngeal tissues. The study represents a prospective, repeated experimental research design. Investigators utilized an accelerometer and an inductive …

Development Of An Evidence-Based Clinical Practice Guideline On Linear Growth Measurement Of Children, Jan Foote, L. Brady, A. Burke, J. Cook, M. Dutcher, K. Gradoville, J. Groos, K. Kinkade, R. Meeks, P. Mohr, D. Schultheis, B. S. Walker, K. Phillips

Jan M. Foote

Growth is an important indicator of child health; however, measurements are frequently inaccurate and unreliable. This article reviews the literature on linear growth measurement error and describes methods used to develop and evaluate an evidence-based clinical practice guideline on the measurement of recumbent length and stature of infants, children, and adolescents. Systematic methods were used to identify evidence to answer clinical questions about growth measurement. A multidisciplinary team critically appraised and synthesized the evidence to develop clinical practice recommendations using an evidence-based practice rating scheme. The guideline was prospectively evaluated through internal and external reviews and a pilot study to …

Getting A Healthy Start. Feeding Issues In The First Year Of Life, Jan Foote

Jan M. Foote

No abstract provided.

Effects Of Prenatal Food And Micronutrient Supplementation On Child Growth From Birth To 54 Months Of Age: A Randomized Trial In Bangladesh, Ashraful Islam Khan, Iqbal Kabir, Eva-Charlotte Ekström, Kajsa Åsling-Monemi, Dewan Shamsul Alam, Edward A. Frongillo Jr., Md Yunus, Shams Arifeen, Lars-Åke Persson

Faculty Publications

Background: There is a lack of information on the optimal timing of food supplementation to malnourished pregnant women and possible combined effects of food and multiple micronutrient supplementations (MMS) on their offspring's growth. We evaluated the effects of prenatal food and micronutrient interventions on postnatal child growth. The hypothesis was that prenatal MMS and early invitation to food supplementation would increase physical growth in the offspring during 0-54 months and a combination of these interventions would further improve these outcomes.

Methods: In the large, randomized MINIMat trial (Maternal and Infant Nutrition Interventions in Matlab), Bangladesh, 4436 pregnant women were enrolled …

Factors Affecting Growth In Infants With Single Ventricle Physiology: A Report From The Pediatric Heart Network Infant Single Ventricle Trial., Richard V. Williams, Victor Zak, Chitra Ravishankar, Karen Altmann, Jeffrey Anderson, Andrew M. Atz, Carolyn Dunbar-Masterson, Nancy Ghanayem, Linda Lambert, Karen Lurito, Barbara Medoff-Cooper, Renee Margossian, Victoria L. Pemberton, Jennifer Russell, Mario Stylianou, Daphne Hsu, Pediatric Heart Network Investigators, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: To describe growth patterns in infants with single ventricle physiology and determine factors influencing growth.

STUDY DESIGN: Data from 230 subjects enrolled in the Pediatric Heart Network Infant Single Ventricle Enalapril Trial were used to assess factors influencing change in weight-for-age z-score (z) from study enrollment (0.7 ± 0.4 months) to pre-superior cavopulmonary connection (SCPC; 5.1 ± 1.8 months, period 1) and pre-SCPC to final study visit (14.1 ± 0.9 months, period 2). Predictor variables included patient characteristics, feeding regimen, clinical center, and medical factors during neonatal (period 1) and SCPC hospitalizations (period 2). Univariate regression analysis was performed, …

Early- And Late-Onset Group B Streptococcal Infections: Overview And Case Studies, Rebecca Siewert, D. Holida

Rebecca Siewert

Infants that are admitted and cared for in the neonatal intensive care unit are at risk for sepsis. Group B Streptococcus (GBS) is the most common cause of neonatal sepsis and meningitis. Group B Streptococcus is classified into early- and late-onset sepsis. With early onset, infants develop symptoms within 7 days of birth. With late onset, they develop symptoms between 7 days and 3 months of life. Prompt identification and treatment of suspected septic infants are crucial. Infants who develop early- or late-onset GBS sepsis are at risk for sequelae ranging from normal physiologic outcome to devastating long-term conditions and …

Breastfeeding Success With Preterm Quadruplets, L. Mead, Rebecca Chuffo, P. Lawlor-Klean, P. Meier

Rebecca Siewert

Although the incidence of triplet and quadruplet birth has increased in the United States, few research-based guidelines are available for assisting mothers of these multiple births with breastfeeding. The purpose of this case study is to report a successful breastfeeding experience of a mother with preterm quadruplets. The quadruplets were born by cesarean delivery at 34 weeks' gestation and weighed from 1,820 g to 2,240 g. In-hospital breastfeeding experiences were managed by the authors, according to research-based guidelines for breastfeeding preterm neonates and infants. During the first month after discharge of the four newborns, the mother breastfed 12-34 times daily. …

Reliability Of In-Bed Weighing Procedures For Critically Ill Infants, J. Engstrom, K. Kavanaugh, P. Meier, E. Boles, J. Hernandez, D. Wheeler, Rebecca Chuffo

Rebecca Siewert

The purpose of this study was to describe the intra- and interexaminer reliability of weight measurements obtained from critically ill infants on an in-bed electronic scale. Weight measurements were obtained using the in-bed scale (Smart Model 35, Olympic Medical, Seattle, Washington) for 32 infants; 16 were in an incubator, and 16 were under a radiant warmer. Two nurses each obtained two weight measurements for each infant for three consecutive days, for a total of 96 data collection sessions. The nurses were blinded to their own and to the other nurse's weight measurements. The average mean absolute difference for individual nurses' …

Screening And Counseling For Postpartum Depression By Nurses: The Women's Views, Lisa Segre, M. O'Hara, S. Arndt, C. Beck

Lisa S. Segre

PURPOSE: In this part 2 article of research examining a model of care in which nurses screen and counsel postpartum women for postpartum depression, acceptability of such a model to postpartum patients was evaluated with a diverse sample of American women. STUDY DESIGN AND METHODS: Descriptive survey of two groups: 691 predominately white postpartum women with relatively high annual incomes (Sample 1) and 132 low-income women, some of whom were ethnic minorities (Sample 2). The surveys were distributed and needed to be mailed back to the investigators. The response rate was 72% in Sample 1 and 30% in Sample 2. …

Postenucleation Adjuvant Chemotherapy With Vincristine, Etoposide, And Carboplatin For The Treatment Of High-Risk Retinoblastoma., Swathi Kaliki, Carol L Shields, Sanket U Shah, Ralph C Eagle, Jerry A Shields, Ann Leahey

Wills Eye Hospital Papers

BACKGROUND: Analysis of 52 eyes with high-risk retinoblastoma managed with postenucleation adjuvant chemotherapy using vincristine sulfate, etoposide phosphate, and carboplatin showed no evidence of systemic metastasis in any case during a mean (range) follow-up of 66 (12-202) months.

PURPOSE: To determine the efficacy of postenucleation adjuvant chemotherapy with vincristine, etoposide, and carboplatin in the prevention of metastasis for patients with high-risk retinoblastoma.

METHODS: Retrospective, nonrandomized, interventional case series of 52 eyes in 51 patients with high-risk retinoblastoma consisting of tumor invasion into the anterior segment, posterior uvea 3 mm or greater, postlaminar optic nerve, or any combination of posterior uvea …

Mother-Infant Breastfeeding Progress Tool: A Guide For Education And Support Of The Breastfeeding Dyad, T. Johnson, Pamela Mulder, K. Strube

Pamela J. Mulder

OBJECTIVE: To describe the development of the Mother-Infant Breastfeeding Progress Tool to be used at the bedside by nurses to guide ongoing support and education for the mother-baby dyad. DESIGN: Cross-sectional study. SETTING: Community hospital in a Midwestern city. PARTICIPANTS: Sixty-two English-speaking mother-infant dyads. METHODS: Three nurse raters (two per session) independently scored the eight characteristics on the Mother-Infant Breastfeeding Progress Tool during 81 breastfeeding sessions. MAIN OUTCOME MEASURE: Percent agreement between raters and suggested modifications for the Mother-Infant Breastfeeding Progress Tool. RESULTS: The results support the use of the tool as a checklist for assessment of the breastfeeding mother-infant …

A Concept Analysis Of Effective Breastfeeding, Pamela Mulder

Pamela J. Mulder

OBJECTIVE: To provide a concept analysis of effective breastfeeding. DATA SOURCES: Medline and CINAHL electronic databases, reference lists from selected articles, and 7 breastfeeding assessment tools. Search terms included the following: breastfeeding and effective, adequate, successful. STUDY SELECTION: Literature was selected according to whether the concept of effective breastfeeding was defined or described. DATA EXTRACTION: Literature was reviewed and data organized as definitions or descriptions, with descriptions grouped into categories sharing similar characteristics. DATA SYNTHESIS: Four characteristics were chosen as essential attributes of effective breastfeeding: positioning, latch, sucking, and milk transfer. CONCLUSIONS: The concept of effective breastfeeding requires further concept …

Excessive Weight Loss In Breastfed Infants During The Postpartum Hospitalization, Pamela Mulder, T. Johnson, L. Baker

Pamela J. Mulder

OBJECTIVE: To examine differences in breastfeeding frequency, voids, and stools in infants with weight losses or =7% during the postpartum hospitalization. DESIGN: Secondary analysis of data from a primary psychometric study examining the Mother Infant Breastfeeding Progress Tool (MIBPT). Setting: A midwestern community hospital in a multicultural racially diverse community. PARTICIPANTS: Convenience sample of 53 breastfeeding women and infants hospitalized after birth. METHODS: Data were collected during a chart review; infants were divided into or =7% weight loss groups at 2 days postpartum, and breastfeeding frequency, voiding, and stooling were examined between groups and used to predict a > or =7% …

Nurse Practitioner-Patient Interactional Analyses During Well-Child Visits, C. Webster-Stratton, J. Glascock, Ann Mccarthy

Ann Marie McCarthy

No abstract provided.

Description Of The Methodology Used In An Ongoing Pediatric Care Interventional Study Of Children Born With Cleft Lip And Palate In South America [Nct00097149, G. L. Wehby, E. E. Castilla, N. Goco, M. Rittler, V. Cosentino, L. Javois, Ann Marie Mccarthy, G. Bobashev, S. Litavecz, A. Mariona, G. Dutra, J. S. Lopez-Camelo, I. M. Orioli, J. C. Murray

Ann Marie McCarthy

BACKGROUND: The contribution of birth defects, including cleft lip and palate, to neonatal and infant mortality and morbidity is substantial. As other mortality and morbidity causes including infections, hygiene, prematurity, and nutrition are eradicated in less developed countries, the burden of birth defects will increase proportionally. METHODS/DESIGN: We are using cleft lip and palate as a sentinel birth defect to evaluate its burden on neonatal and infant health and to assess the effectiveness of systematic pediatric care during the first month and first two years of life in decreasing this burden. The neonatal intervention, consisting of weekly pediatric evaluation and …

Fetal Alcohol Syndrome: A Review And Case Presentation, E. Lindor, Ann Mccarthy, M. Mcrae

Ann Marie McCarthy

No abstract provided.

Infant And Preschool Well-Child Care: Master's- And Nonmaster's-Prepared Pediatric Nurse Practitioners, J. Glascock, C. Webster-Stratton, Ann Mccarthy

Ann Marie McCarthy

The nursing and medical literature reveals considerable debate over whether graduate or continuing education is the appropriate level for nurse practitioner preparation. These arguments have been rhetorical since the research literature lacks data on the scope of practice of master's- and nonmaster's-prepared nurse practitioners. The purpose of this study was to examine possible differences between the two types of practitioners in one area--well-child care provided by pediatric nurse practitioners (PNPs). A total of 236 master's- and nonmaster's-prepared PNPs completed a background questionnaire and checklists of nursing activities involving infant and preschool well-child care. Analysis of study results showed that master's …

Cognitive Behavioral Pain And Anxiety Interventions In Pediatric Oncology Centers And Bone Marrow Transplant Units, Ann Mccarthy, V. Cool, M. Petersen, D. Bruene

Ann Marie McCarthy

Although research conducted on the treatment of pain and anxiety in children has found a number of cognitive behavioral interventions to be effective, it is not known to what extent this research has been put into practice. The purpose of this project was to obtain information on the use of cognitive behavioral interventions to help children and families cope with the pain and anxiety experienced during lumbar punctures and bone marrow aspirations. In this descriptive study, 15 Pediatric Bone Marrow Transplant Units and 32 Pediatric Hematology/Oncology Centers from across the country were surveyed using a questionnaire developed to obtain information …

A Randomized Trial Of Heparin And Saline For Maintaining Intravenous Locks In Neonates, J. Heilskov, Charmaine Kleiber, K. Johnson, J. Miller

Charmaine Kleiber

PURPOSE: To determine the effects of saline, heparin 2 units (U) per ml saline, and heparin 10 U/ml saline flush solutions on the duration of intravenous (i.v.) locks and the incidence of i.v. infiltration in neonates. DESIGN: Randomized double-blind experiment. SETTING: Tertiary-care nursery. PARTICIPANTS: Neonates (N = 90) hospitalized at birth in the intensive, intermediate care, or newborn units. MAIN OUTCOME MEASURES: Total hours from the time the i.v. was inserted to the time the i.v. was removed; hours from the time the i.v. was first flushed to the time the i.v. was removed; number of i.vs. removed because of …

Health Status And Resources Of Rural Homeless Women And Children, Martha Craft-Rosenberg, S. Powell, Kennith Culp

Kennith R. Culp

The purpose of this research is to describe the health status and health resources for homeless women and children in a Midwestern rural community. A group of 31 rural homeless women in a shelter participated in the study by answering questions on the Rural Homeless Interview developed by the investigators. The findings revealed higher than expected rates of illness, accidents, and adverse life events, with the incidence ofsubstance abuse and mental illness being comparable to data from other homeless populations. The data on children were limited by lack of knowledge on the part of their mothers. Some mothers reported that …

Genetic Determinants Of Facial Clefting: Analysis Of 357 Candidate Genes Using Two National Cleft Studies From Scandinavia, A. Jugessur, M. Shi, H. K. Gjessing, R. T. Lie, A. J. Wilcox, C. R. Weinberg, K. Christensen, A. L. Boyles, Sandra Daack-Hirsch, T. N. Trung, C. Bille, A. C. Lidral, J. C. Murray

Sandra Daack-Hirsch

BACKGROUND: Facial clefts are common birth defects with a strong genetic component. To identify fetal genetic risk factors for clefting, 1536 SNPs in 357 candidate genes were genotyped in two population-based samples from Scandinavia (Norway: 562 case-parent and 592 control-parent triads; Denmark: 235 case-parent triads). METHODOLOGY/PRINCIPAL FINDINGS: We used two complementary statistical methods, TRIMM and HAPLIN, to look for associations across these two national samples. TRIMM tests for association in each gene by using multi-SNP genotypes from case-parent triads directly without the need to infer haplotypes. HAPLIN on the other hand estimates the full haplotype distribution over a set of …

Candidate Genes For Nonsyndromic Cleft Lip And Palate And Maternal Cigarette Smoking And Alcohol Consumption: Evaluation Of Genotype-Environment Interactions From A Population-Based Case-Control Study Of Orofacial Clefts, P. Romitti, A. Lidral, R. Munger, Sandra Daack-Hirsch, T. Burns, J. Murray

Sandra Daack-Hirsch

Previous studies suggest that the relationship between genes and nonsyndromic cleft lip +/- cleft palate (CLP) or cleft palate only (CP) may be modified by the environment. Using data from a population-based case-control study, we examined allelic variants for three genes, i.e., transforming growth factor alpha (TGFA), transforming growth factor beta 3 (TGFB3), and Msh (Drosophila) homeobox homolog 1 (MSX1), and their interactions with two exposures during pregnancy (maternal cigarette smoking and alcohol consumption) as risk factors for CLP and CP. For each cleft phenotype, risk estimates associated with most allelic variants tended to be near unity. Risk estimates for …

Clinical And Epidemiologic Studies Of Cleft Lip And Palate In The Philippines, J. Murray, Sandra Daack-Hirsch, K. Buetow, R. Munger, L. Espina, N. Paglinawan, E. Villanueva, J. Rary, K. Magee, W. Magee

Sandra Daack-Hirsch

Clinical and epidemiologic studies of defined geographic populations can serve as a means of establishing data important for genetic counseling and as a first step in identifying strategies best suited for identification of causes. Under the sponsorship of Operation Smile International, clinical, genetic, and epidemiologic studies were carried out at six sites within the Philippines between 1989 and 1996. Patients who were being evaluated for surgical repair of craniofacial anomalies (primarily clefts of the lip and palate) were briefly examined for the presence of associated anomalies, and a family history was obtained to look for the frequency of cleft lip …

Burden Of Traumatic Spine Fractures In Tehran, Iran., Maziar Moradi-Lakeh, Mohammad R Rasouli, Alexander Vaccaro, Soheil Saadat, Mohammad R Zarei, Vafa Rahimi-Movaghar

Rothman Institute Faculty Papers

UNLABELLED: ABSTRACT:

BACKGROUND: The Disability-Adjusted Life Year (DALY) was designed by the World Health Organization (WHO) to measure, compare, and analyze the burden of various diseases. To the best of our knowledge, this is the first study on the assessment of burden of traumatic spinal fracture (TSF) in an Iranian community. We estimated burden of TSF includes both isolated (iTSF) and associated injuries related to traumatic spinal fractures (aTSF) in Tehran, the capital of Iran, for the year 2006-2007 using DALYs.

METHODS: Burden of TSF was estimated based on information provided by the national data on Iranian trauma, data from …

Executive Summary: The Management Of Community-Acquired Pneumonia In Infants And Children Older Than 3 Months Of Age: Clinical Practice Guidelines By The Pediatric Infectious Diseases Society And The Infectious Diseases Society Of America., John S. Bradley, Carrie L. Byington, Samir S. Shah, Brian Alverson, Edward R. Carter, Christopher Harrison, Sheldon L. Kaplan, Sharon E. Mace, George H. Mccracken, Matthew R. Moore, Shawn D. St Peter, Jana A. Stockwell, Jack T. Swanson, Pediatric Infectious Diseases Society And The Infectious Diseases Society Of America

Manuscripts, Articles, Book Chapters and Other Papers

Evidenced-based guidelines for management of infants and children with community-acquired pneumonia (CAP) were prepared by an expert panel comprising clinicians and investigators representing community pediatrics, public health, and the pediatric specialties of critical care, emergency medicine, hospital medicine, infectious diseases, pulmonology, and surgery. These guidelines are intended for use by primary care and subspecialty providers responsible for the management of otherwise healthy infants and children with CAP in both outpatient and inpatient settings. Site-of-care management, diagnosis, antimicrobial and adjunctive surgical therapy, and prevention are discussed. Areas that warrant future investigations are also highlighted.

Protection And Attachment Of Vibrio Cholerae Mediated By The Toxin-Coregulated Pilus In The Infant Mouse Model, Shelly J. Krebs, Ronald K. Taylor

Dartmouth Scholarship

Colonization of the human small intestine by Vibrio cholerae is an essential step in pathogenesis that requires the type IV toxin-coregulated pilus (TCP). To date, three functions of TCP have been characterized: it serves as the CTXΦ receptor, secretes the colonization factor TcpF, and functions in microcolony formation by mediating bacterium-bacterium interactions. Although type IV pili in other pathogenic bacteria have been characterized as playing a major role in attachment to epithelial cells, there are very few studies to suggest that TCP acts as an attachment factor. Taking this into consideration, we investigated the function of TCP in attachment to …

Surgical Management Of Complete Atrioventricular Septal Defect: Associations With Surgical Technique, Age, And Trisomy 21., Andrew M. Atz, John A. Hawkins, Minmin Lu, Meryl S. Cohen, Steven D. Colan, James Jaggers, Ronald V. Lacro, Brian W. Mccrindle, Renee Margossian, Ralph S. Mosca, Lynn A. Sleeper, L Luann Minich, Pediatric Heart Network Investigators, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: We sought to evaluate the contemporary results after repair of a complete atrioventricular septal defect and to determine the factors associated with suboptimal outcomes.

METHODS: The demographic, procedural, and outcome data were obtained within 1 and 6 months after repair of a complete atrioventricular septal defect in 120 children in a multicenter observational study from June 2004 to 2006.

RESULTS: The median age at surgery was 3.7 months (range, 9 days to 1.1 years). The type of surgical repair was a single patch (18%), double patch (72%), and a single atrial septal defect patch with primary ventricular septal defect …

Antibiotics For Bronchiolitis In Children, Geoffrey Spurling, Jenny Doust, Chris Del Mar, Lars Ericksson

Jenny Doust

Background: Bronchiolitis is a serious, potentially life-threatening respiratory illness commonly affecting babies. It is often caused by respiratory syncytial virus (RSV). Antibiotics are not recommended for bronchiolitis unless there is concern about complications such as secondary bacterial pneumonia or respiratory failure. Nevertheless, they are used at rates of 34% to 99% in uncomplicated cases. Objectives: To evaluate the effectiveness of antibiotics for bronchiolitis. Search strategy: We searched the Cochrane Central Register of Controlled Trials (CENTRAL 2010, issue 4), which includes the Cochrane Acute Respiratory Infection Group’s Specialised Register, and the Database of Abstracts of Reviews of Effects, MEDLINE (January 1966 …

Renin-Angiotensin-Aldosterone Genotype Influences Ventricular Remodeling In Infants With Single Ventricle., Seema Mital, Wendy K. Chung, Steven D. Colan, Lynn A. Sleeper, Cedric Manlhiot, Cammon B. Arrington, James F. Cnota, Eric M. Graham, Michael E. Mitchell, Elizabeth Goldmuntz, Jennifer S. Li, Jami C. Levine, Teresa M. Lee, Renee Margossian, Daphne T. Hsu, Pediatric Heart Network Investigators, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

Background: We investigated the effect of polymorphisms in the renin-angiotensin-aldosterone system (RAAS) genes on ventricular remodeling, growth, renal function, and response to enalapril in infants with single ventricle.

Methods and results: Single ventricle infants enrolled in a randomized trial of enalapril were genotyped for polymorphisms in 5 genes: angiotensinogen, angiotensin-converting enzyme, angiotensin II type 1 receptor, aldosterone synthase, and chymase. Alleles associated with renin-angiotensin-aldosterone system upregulation were classified as risk alleles. Ventricular mass, volume, somatic growth, renal function using estimated glomerular filtration rate, and response to enalapril were compared between patients with ≥2 homozygous risk genotypes (high risk), and those …

Evaluation Of Kawasaki Disease Risk-Scoring Systems For Intravenous Immunoglobulin Resistance., Lynn A. Sleeper, L Luann Minich, Brian M. Mccrindle, Jennifer S. Li, Wilbert Mason, Steven D. Colan, Andrew M. Atz, Beth F. Printz, Annette Baker, Victoria L. Vetter, Jane W. Newburger, Pediatric Heart Network Investigators, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: To assess the performance of 3 risk scores from Japan that were developed to predict, in children with Kawasaki disease, resistance to intravenous immunoglobulin (IVIG) treatment.

STUDY DESIGN: We used data from a randomized trial of pulsed steroids for primary treatment of Kawasaki disease to assess operating characteristics of the 3 risk scores, and we examined whether steroid therapy lowers the risk of coronary artery abnormalities in patients prospectively classified as IVIG resistant.

RESULTS: For comparability with published cohorts, we analyzed the data of 99 patients who were not treated with steroids (16% IVIG-retreated) and identified male sex, lower …