Onset of word form recognition in English, Welsh, and English-Welsh bilingual infants

Children raised in the home as English or Welsh monolinguals or English–Welsh bilinguals were tested on untrained word form recognition using both behavioral and neurophysiological procedures. Behavioral measures confirmed the onset of a familiarity effect at 11 months in English but failed to identify it in monolingual Welsh infants between 9 and 12 months. In the neurophysiological procedure the familiarity effect was detected as early as 10 months in English but did not reach significance in monolingual Welsh. Bilingual children showed word form familiarity effects by 11 months in both languages and also revealed an online time course for word recognition that combined effects found for monolingual English and Welsh. To account for the findings, accentual, grammatical, and sociolinguistic differences between English and Welsh are considered.

Use of an auditory looming task to test infants' sensitivity to sound pressure level as an auditory distance cue

This study describes how an auditory looming technique was used to investigate 4-to 6-month-old infants' sensitivity to sound pressure level (SPL) as an auditory distance cue. Thirty-two infants were tested in complete darkness and presented with auditory stimuli that underwent unidirectional variations in SPL (40–70dB). The rate at which SPL was varied during the course of trials (past vs. slow) was manipulated by varying trial length (5s vs. 10s).

Markers of inflammation in South Asian and European infants from birth to 2 years in Manchester, UK

Inflammatory markers, including serum C-reactive protein (CRP), are predictors of coronary heart disease (CHD) in adults. South Asians in the UK have higher rates of CHD in adulthood than national rates.We tested the hypotheses that South Asian infants would have higher serum concentrations of CRP and homocysteine than European infants up to 2 years of age and that higher infant weight is associated with elevation of inflammatory markers. Infants of South Asian and European origin were investigated in a mixed cross sectional-longitudinal cohort study. Mothers were recruited ante-natally from St Mary’s Hospital,Manchester by postal invitation and telephone call to non-responders. Infants with metabolic or congenital abnormalities, known syndromes or pre-maturity were excluded. Measurements were collected at birth and either 3, 6, 12 or 24 months. High sensitivity CRP and homocysteine were measured by an immulite immunoassay. We used mixed linear modelling to assess whether infant weight, ethnicity, length of follow-up or their interaction were associated with inflammatory makers in infants during follow-up. Data are presented on 306 infants (109 South Asian and 197 European). We found that European infants had higher serum CRP than South Asian infants during follow-up which was of borderline significance.There was no difference in serum homocysteine between ethnic groups during followup and no significant interaction between ethnicity and follow-up. Infant weight was significantly associated with CRP but not homocysteine. In this ongoing longitudinal study,we found little difference in inflammatory markers in infants from birth to 2 years despite markedly higher rates of CHD in South Asian than European adults. Life course exposure to risk factors may play a more dominant role in the development of CHD.

Support needs of parents of sick and/or preterm infants admitted to a neonatal unit

Background: The sudden unexpected delivery of a preterm infant is a shock to parents with studies confirming the importance of providing them with nursing support. The purpose of this descriptive study was to identify the type and level of support that nurses provided to the parents of sick and/or preterm infants. It also investigated whether parents were satisfied with the support provided by nursing staff.
Method: A convenience sample of 112 parents in an Australian tertiary neonatal unit were invited to complete the ‘Nurse Parent Support Tool’ (NPST), which is a 21-item questionnaire. The NPST consists of four domains: emotional, informational, appraisal and instrumental support. A second tool was used to assess parents’ satisfaction with the nurse to parent support.
Results: Instrumental support had the highest mean score for both nurse to parent support at 4.51 (out of 5) and 4.36 (out of 5) for satisfaction. The mean score for nursing support was 4.21 followed by parental satisfaction with nurse to parent support which was 4.16. In contrast, emotional support had the lowest mean score for both nurse to parent support at 3.94 and 3.97 for satisfaction. Parents indicated that they needed further support with lactation, breastfeeding and assistance with parenting skills.
Conclusion: Overall, the results from the study indicated that parents’ perception of nursing support was positive and that parents were highly satisfied with the nursing support provided in the neonatal unit. However, some attention needs to be given to providing more support and information on breastfeeding and parenting skills.

Clinical effectiveness of barrier preparations in the prevention and treatment of nappy dermatitis in infants and preschool children of nappy age

Nappy dermatitis is a broad term used to describe an acute inflammatory reaction of the skin in the nappy area because of irritation from urine, faeces, moisture or friction. The prevalence is estimated to be between 7% and 35% in infants. Regular application of a barrier preparation at every nappy change may be a valuable component of nappy dermatitis prevention and/or treatment.

Effectiveness of a modified mother–infant transaction program on outcomes for preterm infants from 3 to 24 months of age

Mothers of hospitalised preterm infants were randomised into an intervention or control condition. Intervention mothers received a modified Mother–Infant Transaction Program over seven sessions prior to infant discharge and two sessions over the next 3 months. Infant temperament, mother–infant interaction and parenting stress were assessed at 3 and 6 months and infant development was measured by parental report at 24 months. Intervention compared with control dyads showed enhanced mother–infant interactions, infants were temperamentally more “approaching” and “easier”, had fewer regulatory problems (colic, sleep, excessive crying), and had more developed communication skills, while mothers were less stressed by their infant at 3 months. These early gains in the development of preterm infants and in the relationship with and adjustment of their mothers, may explain the process by which intervention infants in the original study showed increasing cognitive advantages to 9 years of age [Rauh, V. A., Nurcombe, B., Achenbach, T., & Howell, C. (1990). The mother–infant transaction program. Clinical Perinatology, 17, 31–45].

Support needs of parents of sick and/or preterm infants admitted to a neonatal unit

The sudden unexpected delivery of a preterm infant elicits many emotional responses from parents, with studies confirming the importance of providing parents with nursing support. The purpose of this study was to measure parents' perception of the type and level of support that nurses provided in an Australian neonatal unit, and to determine the extent to which parents were satisfied with the support currently provided. A convenience sample of 112 parents in an Australian tertiary neonatal unit were invited to complete the nurse parent support tool (NPST), which is a 21-item questionnaire used to measure the level of nursing support. The NPST consists of four domains -emotional, informational, appraisal and instrumental support. A second tool was used to assess parent satisfaction with nurse-to-parent support. A total of 62 parents completed the NPST and satisfaction tool.

Results showed that instrumental support had the highest mean score for both nurse-to-parent support 4.51 (out of 5) and 4.36 for satisfaction. The mean score for nursing support was 4.21 followed by satisfaction with nurse-to-parent support at 4.16. In contrast, emotional support had the lowest mean score for both nurse-to-parent support at 3.94 and 3.97 for satisfaction. Parents indicated that they needed further support with lactation, breastfeeding and assistance with parenting skills. Overall, results indicated that parent perception of nursing support was positive and that parents were highly satisfied with the nursing support provided in the neonatal unit. However, some attention needs to be given to providing more support and information on breastfeeding and parenting skills.

Skin prick test can identify eczematous infants at risk of asthma and allergic rhinitis

Background: Assessment of allergic sensitization is not routinely performed in infants and young children with eczema.

Objective: To determine whether infants who have atopic eczema (with sensitization) are at a greater risk of developing asthma and allergic rhinitis (AR) than those with non-atopic eczema (without concurrent sensitization).

Methods: The presence of eczema was prospectively documented until 2 years of age in a birth cohort of 620 infants with a family history of atopic disease. Sensitization status was determined by skin prick tests (SPTs) at 6, 12, and 24 months using six common allergens. Interviews were conducted at 6 and 7 years to determine the presence of asthma and AR.

Results: Within the first 2 years of life, 28.7% of the 443 children who could be classified had atopic eczema: 20.5% had non-atopic eczema, 19.0% were asymptomatic but sensitized and 31.8% were asymptomatic and not sensitized. When compared with children with non-atopic eczema in the first 2 years of life, children with atopic eczema had a substantially greater risk of asthma [odds ratio (OR)=3.52, 95% confidence interval=1.88–6.59] and AR (OR=2.91, 1.48–5.71). The increased risk of asthma was even greater if the infant had a large SPT (OR=4.61, 2.34–9.09) indicative of food allergy. There was no strong evidence that children with non-atopic eczema had an increased risk of asthma or AR compared with asymptomatic children.

Conclusion: In children with eczema within the first 2 years of life, SPT can provide valuable information on the risk of childhood asthma and AR.

Teaching Zambian traditional birth attendants to monitor growth of infants : evaluation of an education program

The high infant mortality in Zambia is largely attributable to malnutrition. It is exacerbated by the inability of mothers to recognise threats to nutritional status and take corrective action. Advice in ‘Health Centres’ is often inaccessible to mothers. The Traditional Birth Attendants (TBAs) work with pregnant women in local communities, and the purpose of this study was to develop and implement an educationprogram in growth monitoring and nutrition for the TBAs and then to evaluate its effects. Twenty five TBAs from two peri-urban areas of Kitwe were enrolled in this pilot study and eighteen completed the program. The researcher developed and taught a program to the TBAs over ten days. A pretest was given before the teaching program to enable the researcher to obtain information about the knowledge and skills of the TBAs. Following the teaching program the TBAs were re-tested, with the same questionnaire. Focus groups were conducted to enable the TBA to provide information on the teaching materials and the education program. The TBAs then returned to their communities and put into practice the skills and knowledge they had learned for six months. Their practice was monitored by a trained Public Health Nurse. The researcher also surveyed 38 pregnant women about their knowledge of growth monitoring and nutrition before the TBAs went into the field to work with their local communities. The same questionnaire used with the pregnant women was administered to 38 new mothers with children aged 0 to 6 months to gain information of their knowledge and skills following the work of the TBAs. The program was evaluated by assessing the extent to which TBAs knowledge and skills were increased, the knowledge and understanding of a selection of their clients and the rates of malnutrition of infants in the area under study. The results from the research clearly indicated that the teaching program on growth monitoring and nutrition given to the selected group of TBAs had a positive effect on their knowledge and skills. It was found that the teaching developed their knowledge, practical skills, evaluative skills. That they were able to give infants’ mothers sound advice regarding their children’s nutrition was revealed by the mother’s increased knowledge and the decrease in numbers of malnourished children in the study areas at the conclusion of the research. The major outcomes from the study are: that Zambian TBAs can be taught to carry out an expanded role; field experience is a key factor in the teaching program; making advice available in local communities is important; and preliminary data on the Zambian experience were generated. Recommendations are: The pilot program should be expanded with continuing support from the Health Department. Similar educational programs should be introduced into other areas of Zambia with support from the Ministry of Health. That in administering a teaching program: Sufficient time must be allocated to practical work to allow poorly educated women to attain the basic skills needed to master the complex skills required to competently reduce faltering in their communities. The teaching materials to illustrate nutritional principles for feeding programs must be developed to suite locally available foods and conditions. Methods of teaching should suit the local area, for example, using what facilities are locally available. The timing of the teaching program should be suitable for the TBAs to attend. This may vary from area to area, for example it may be necessary to avoid times traditionally given to fetching water or working in the fields. For similar reasons, the venue for the teaching program should be suitable to the TBAs. The teachers should go into the TBAs’ community rather than causing disruption of the TBAs’ day by expecting them to go to the teacher. Data should be collected from a larger group of TBAs and clients to enable sophisticated statistical analysis to complement data from this pilot program. The TBAs should be given recognition for their work and achievement. This is something which they asked for. They do not ask for payment, rather acknowledgment through regular follow up and approbation.

Mothers' transition back to work and infants' transition to child care : does work-based child care make a difference?

The overall aim in this study was twofold: to compare the use of work-based (WB) and non-work-based (NWB) child care on the transition back to the workplace for women after a period of maternity leave, and on the transition into child care for the infants of these women. Thirty-five mothers with infants in WB centres and 44 mothers with infants in NWB centres completed a battery of questionnaires, retrospectively, in relation to their first four weeks of resuming work and their infant’s transition into child care. We first explored whether the mothers of infants in WB centres were less stressed and anxious
about separating from their infant, were more satisfied with their child care, and whether they felt more productive and supported at work than mothers of infants in NWB child
care centres. Our findings revealed no differences between mothers using WB centres and NWB centres in their transition to work. In exploring whether infants placed in WB centres settled faster and more easily than infants placed in NWB centres, the findings, once again, revealed no differences in the infant’s affective states at child care and maintenance of their routines, such that all infants were equally settled and happy irrespective of the type of care used. The theoretical and practical implications of our findings are discussed.

The behaviour of infants/toddlers at 'falling-off' places

Toddlers were observed as they freely explored different 'falling-off' places on a visual cliff. Toddlers played extensively with wet / non-rigid surfaces (e.g. water) and briefly explored dry / rigid surfaces. Edges were crossed intentionally and unintentionally, either as an extension or consequence of edge engagement, by a sub-group of toddlers. The findings have implications for drowning / injury prevention.

Overweight and obesity in infants and pre-school children in the European Union : a review

The objective of this study was to synthesize available information on prevalence and time trends of overweight and obesity in pre-school children in the European Union. Retrieval and analysis or re-analysis of existing data were carried out. Data sources include WHO databases, Medline and Google, contact with authors of published and unpublished documents. Data were analysed using the International Obesity Task Force reference and cut-offs, and the WHO standard. Data were available from 18/27 countries. Comparisons were problematic because of different definitions and methods of data collection and analysis. The reported prevalence of overweight plus obesity at 4 years ranges from 11.8% in Romania (2004) to 32.3% in Spain (1998–2000). Countries in the Mediterranean region and the British islands report higher rates than those in middle, northern and eastern Europe. Rates are generally higher in girls than in boys. With the possible exception of England, there was no obvious trend towards increasing prevalence in the past 20–30 years in the five countries with data. The use of the WHO standard with cut-offs at 1, 2 and 3 standard deviations yields lower rates and removes gender differences. Data on overweight and obesity in pre-school children are scarce; their interpretation is difficult. Standard methods of surveillance, and research and policies on prevention and treatment, are urgently needed.