Kek Khee Loo

Time Series Analysis of Spontaneous Upper-Extremity Movements of Premature Infants With Brain Injuries

Background and Purpose: Comparisons of spontaneous movements of premature infants with brain injuries and those without brain injuries can provide insights into normal and abnormal processes in the ontogeny of motor development. In this study, the characteristics of spontaneous upper-extremity movements of premature infants with brain injuries and those without brain injuries were examined with time series analysis. Subjects: Participants were 7 premature infants with brain injuries and 7 matched, low-risk, premature infants at the age of 1 month after term. Methods: A triaxial accelerometer was used to measure upper-extremity limb acceleration in 3-dimensional space. Acceleration signals were recorded from the right wrist when the infant was in an active, alert state and lying in the supine position. The recording time was 200 seconds. The acceleration signal was sampled at a rate of 200 Hz. The acceleration time series data were analyzed by nonlinear analysis as well as linear analysis. Results: The nonlinear time series analysis indicated that spontaneous movements of premature infants have nonlinear, chaotic, dynamic characteristics. The movements of the infants with brain injuries were characterized by larger dimensionality, and they were more unstable and unpredictable than those of infants without brain injuries. Discussion and Conclusion: As determined by nonlinear analysis, the spontaneous movements of the premature infants with brain injuries had the characteristics of increased disorganization compared with those of the infants without brain injuries. Infants with brain injuries may manifest problems with self-organization as a function of the coordination of subsystems. Physical therapists should be able to support interactions among the subsystems and promote self-organization of motor learning through the individualized provision of various sensorimotor experiences for infants.

Using knowledge to cope with stress in the NICU: how parents integrate learning to read the physiologic and behavioral cues of the infant.

Parental stress in the NICU has at least a short-term impact on the establishment of the parent-child relationship and potential repercussions on long-term child development outcomes. One way to help parents mitigate stress is to help them learn what they need to know about their infant’s condition and care. In this article, we examine how learning to read the infant’s physiologic and behavioral cues helps parents cope with stress. We view parental learning as a process in which parents target specific domains of information for learning according to the temporal relevance of the domain to their concerns. It is important that we recognize the fluidity of the process and anticipate what parents need to learn at different times during hospitalization. The NICU staff assumes a crucial role in reducing parental stress by delivering information that is relevant to the parents’ needs and by helping parents understand this information.

Effect of therapeutic touch on brain activation of preterm infants in response to sensory punctate stimulus: a near-infrared spectroscopy-based study

Objective The purpose of this study was to determine whether therapeutic touch in preterm infants can ameliorate their sensory punctate stimulus response in terms of brain activation measured by near-infrared spectroscopy. Methods The study included 10 preterm infants at 34–40 weeks’ corrected age. Oxyhaemoglobin (Oxy-Hb) concentration, heart rate (HR), arterial oxygen saturation (SaO2) and body movements were recorded during low-intensity sensory punctate stimulation for 1 s with and without therapeutic touch by a neonatal development specialist nurse. Each stimulation was followed by a resting phase of 30 s. All measurements were performed with the infants asleep in the prone position. Results sensory punctate stimulus exposure significantly increased the oxy-Hb concentration but did not affect HR, SaO2 and body movements. The infants receiving therapeutic touch had significantly decreased oxy-Hb concentrations over time. Conclusions Therapeutic touch in preterm infants can ameliorate their sensory punctate stimulus response in terms of brain activation, indicated by increased cerebral oxygenation. Therefore, therapeutic touch may have a protective effect on the autoregulation of cerebral blood flow during sensory punctate stimulus in neonates.

Frontal brain activation in young children during picture book reading with their mothers

Aim:  This study was to measure changes in frontal brain activation in young children during picture book reading with their mothers.

Cross-cultural comparison of the neurobehavioral characteristics of Chinese and Japanese neonates

Background : Similarities and differences in the neurobehavioral repertoire of neonates from different cultures have been noted using the Brazelton Neonatal Behavioral Assessment Scale (NBAS). By identifying the behavioral attributes of newborns that are seen more universally versus those that are culture‐specific, comparative studies increase understanding of the roles of cultural factors in shaping the behavioral trajectory of infants. This study compared the neurobehavioral characteristics of neonates in Chengdu, China and Nagasaki, Japan.

Neurobehaviors of Japanese Newborns in Relation to the Characteristics of Early Mother-Infant Interaction.

The authors examined the relationship between newborn neurobehavioral profiles and the characteristics of early mother-infant interaction in Nagasaki, Japan. The authors administered the Brazelton Neonatal Behavioral Assessment Scale (NBAS; T. B. Brazelton & J. K. Nugent, 1995) in the newborn period and the Nursing Child Assessment Teaching Scale at 1 month (NCATS; G. Sumner & A. Spietz, 1994). They administered the Perceived Stress Scale (S. Cohen, T. Kamarck, & R. Mermelstein, 1983) as an index of maternal stress experienced over the past month. Lower irritability, higher stability in skin coloration, and lower tremulousness in the neonatal period were correlated with higher levels of maternal nurturing behaviors at 1 month. Birth weight and 2 NBAS range-of-state items (peak of excitement, irritability) predicted 31% of the variance in NCATS caregiver subscale score. The NBAS autonomic stability items (tremulousness, startles, lability of skin color) predicted 31% of the variance in the NCATS child subscale score. Perceived stress and maternal sociodemographic variables (education, income, age, parity) were not associated with child, caregiver, and total scores on the NCATS. The results suggested that lack of autonomic stability in Japanese neonates might serve as an early indicator of infant frailty, negative behavioral cues, and decreased maternal responsiveness.

Prenatal anxiety associated with male child preference among expectant mothers at 10-20 weeks of pregnancy in Xiangyun County, China.

To examine the relationship between male child preference and maternal prenatal psychological distress among expectant mothers from Xiangyun County, Yunnan Province, China.

Procedural Challenges in International Collaborative Research

ObjectiveKnowledge of the procedural requirements for international research is not widely disseminated to investigators involved in the administration of a federal grant with a foreign component. The purpose of this article is to highlight the major challenges in administrative, procedural, and equipment management aspects of grant implementation when federal funding is involved in international collaborative research.MethodsThe author describes the procedural requirements for international research from the time of priority score receipt to the implementation of the grant.ResultsThere is tremendous promise for rewarding experiences in international research projects due to the collaboration, mutual learning, and cultural bridging that intrinsically occur. However, there are also inherent cross-national procedural requirements that can be demanding in time and effort for the investigator and other stakeholders of the grant.ConclusionsIt is hoped that awareness of these difficulties and demystification of the process for future investigators can minimize the potential encumbrances in such international research.