Biomedical subjects

M D Mullett

Publications and source records attributed to M D Mullett.

24 records · Page 2Linked to original sources

PubMedDate not supplied

Relationships between parental ratings of infant temperament, risk status, and delivery method.

One hundred forty parents rated the temperament of their infants between the ages of 4 and 8 months. Analyses of the data examined the relationships between temperament and infant risk status (high or low), delivery method (vaginal or cesarean section), and the combined effects of infant risk status and delivery method. Although high-risk and low-risk infants were similar on the easy-difficult profile ratings of the revised infant temperament questionnaire, high-risk infants were rated more adaptable and more positive in mood than were the low-risk infants. Low-risk infants delivered by cesarean section were rated less optimally on three of the temperament factor scores, including withdrawal, mood, and adaptability. Interpretations of these findings are discussed and suggestions are offered for nurse practitioners and their provision of pediatric care to infants and their families.

Adult↗

PubMedDate not supplied

Parents' perceptions of medical diagnoses and related issues for their high-risk infants.

INTRODUCTION: The objectives of this study were (a) to compare maternal and paternal perceptions of infant medical diagnoses with hospital-chart diagnoses, (b) to examine whether parental perceptions of infant medical condition (using three variables) were related to eight other parental perceptions, and (c) to determine what medical diagnoses were associated with parental expectations that neonatal diagnoses were having current effects of would have future effects on their infant. METHOD: With a questionnaire format 76 parents reported information about medical diagnoses and their perceptions about eight other issues for their infants who had been hospitalized in an NICU. RESULTS: Parents reported approximately 62% of the medical diagnoses for their infants during NICU hospitalization; these significantly differed from hospital-chart diagnoses. Parents who reported current or future effects of neonatal diagnoses also (a) had fears for their infants while in the hospital or currently, (b) perceived prematurity as having current or future effects, (c) reported restrictions for their infants caused by neonatal diagnoses, and (d) gave less optimal ratings for their infants' current health status. Parents' perceptions of current or future effects of neonatal diagnoses appeared to be inaccurate given the actual diagnoses for their infants. DISCUSSION: The underreporting of diagnoses by parents raises several issues as to how accurately parents are perceiving their infants. Parents who perceived continued effects of neonatal diagnoses also had less optimal perceptions of other related issues. Parent's perceptions of continued effects of neonatal diagnoses appeared to be unwarranted with respect to the actual diagnoses assigned to their infants.

Adult↗

PubMedDate not supplied

Assessment of motor development in very low birth weight infants.

OBJECTIVE: The purpose of the current investigation was to describe the fine- and gross-motor acquisitions of very low birth weight (VLBW) infants during their first 12 months without imposing traditional assessment assumptions. STUDY DESIGN: A nonrandomized, prospective study was used for a sample consisting of 89 VLBW infants whose motor development was assessed neonatally and at 4, 8, and 12 months chronological age. Fine- and gross-motor assessment items were selected and adapted from three standardized assessment instruments. RESULTS: The fine- and gross-motor systems of development appeared to be relatively independent of one another before the 8-month assessment. Thus, early fine-motor control appeared to develop almost to the exclusion of gross-motor progress. Once fine-motor control was established by 8 months, numerous gross-motor milestones followed and were present at 12 months chronological age. CONCLUSION: Current and previous data continue to define a developmental picture in which VLBW and fullterm infants achieve the same fine- and gross-motor milestones; however, the developmental pathways whereby milestones are achieved, during at least the first 12 months, appear to be different. Accordingly, applying instruments standardized on fullterm infants to the assessment of VLBW babies may not be serving us well on a number of different issues.

Aging↗

PubMedDate not supplied

Effects in premature infants of normalizing breath H2 concentrations with CO2: increased H2 concentration and reduced interaliquot variation.

Interval sampling of expired breath samples from the anterior nares is a feasible and noninvasive method for detecting elevated breath H2 and thus colonic carbohydrate fermentation, especially in nontherapeutic research studies of healthy premature infants. However, there may be a risk of falsely low breath H2 concentration and an unacceptable experimental error due to contamination with room air as well as with dead space air. We studied ten premature infants (28-32 week gestational age and 2-4 weeks postnatal age) who were receiving either a proprietary formula containing equal proportions of lactose and glucose polymer, or a similar formula in which lactose was the sole carbohydrate. In 70 breath samples (obtained 30-180 min after feeding) we assessed the coefficient of variation in breath hydrogen concentration among three aliquots obtained over a 3-5 min interval. Breath was collected from the anterior nares. The interaliquot coefficient of variation averaged 11% when expressed as parts per million per 5% CO2, compared to 19% when expressed as parts per million (Wilcoxon, p less than 0.001). Mean breath hydrogen concentration at each time period using the former method (parts per million per 5% CO2) was about 100% higher than when using the latter method. Although ventilation rate can alter alveolar CO2, normalizing for CO2 concentration reduces a major source of experimental error.

Analysis of Variance↗

PubMedDate not supplied

Radiation safety and protection of neonates in radiological examinations.

Radiation reduction methods in neonatal radiographic examinations are discussed. Studies performed on radiation exposures to the neonates, scattered radiation level, exposure to the nursery personnel, effectiveness of the various shielding methods, uniformity of the x-ray field, heel effect, and skin exposure estimation are described. In summary, recommendations for exposure reduction based on our experimental findings as well as on the ALARA concept of radiation safety are provided.

Humans↗

PubMedDate not supplied

Nosocomial sepsis in the neonatal intensive care unit.

OBJECTIVE: To evaluate the risk factors for nosocomial sepsis among infants hospitalized in 23 neonatal intensive care units. METHODS: Risk factors for nosocomial sepsis among 5760 admissions are analyzed by birth weight groups, <1 kg, 1 to 1.5 kg, and >1.5 kg. A Cox hazard regression model was used to evaluate further detail in the two lower weight groups. RESULTS: Use of corticosteroids had no effect on the incidence of nosocomial sepsis in the two lower weight categories although it was significant among the >1.5 kg infants. In a simple Cox model, significant risk factors included lowest birth weight category, ventilatory support, and presence of a central venous catheter. The complex Cox model revealed that an increase in total days of presence of central arterial catheter, use of antibiotics, and ventilatory support were significant but that total days of presence of a central venous catheter was not. A model for Candida sepsis revealed as a risk factor an increase in total days of use of antibiotics before infection. CONCLUSIONS: The risk for infection associated with presence of a central venous catheter is the same for each day of exposure (i.e., the same risk on day 5 of presence of the line as on day 30), but the risk associated with ventilatory support increases over time. Candida sepsis is associated with prolonged antibiotic use before the first episode of nosocomial sepsis and not with birth weight group.

Candidiasis↗