Early human development最新文献

Background and aim

Moderate preterm (MP) birth is associated with an increased risk of developmental problems. However, post-discharge support for this group is scarce. The aim of this study was to evaluate the feasibility of a post-discharge parenting program (TOP program) for MP infants. Three feasibility dimensions were evaluated (1) recruitment capability and compliance, (2) intervention acceptability, and (3) limited efficacy testing.

Methods

A group of MP infants with a gestational age (GA) between 32^0/7‐34^6/7 weeks and their parents received six home visits by a TOP interventionist until 6 months corrected age (CA). A pre-posttest intervention design with quantitative and qualitative measures was used.

Recruitment capability and compliance, acceptability, and satisfaction with the intervention were evaluated using a questionnaire, checklists, interviews, and a focus group. Infant socio-emotional development, parental distress, self-efficacy, and reflective functioning were measured with questionnaires. Observation measurements were used for infant motor development and parental sensitivity.

Results

Thirty-two families completed the six home visits. The satisfaction rate (scale 0–10) was remarkably high (Mean 9.4, range: 8–10). Parents reported that the program was suitable, enhanced their understanding of their infants' developmental needs, and increased their self-efficacy. The infants showed age-appropriate motor and socio-emotional development post-intervention. Parental self-efficacy, reflective functioning, and sensitivity improved from pre to post intervention, with small to large effect sizes.

Conclusion

The study demonstrated high compliance, acceptability, and satisfaction with the TOP program for MP infants with promising infant and parent outcomes. This study contributes to the preparatory work prior to a larger scale evaluation and dissemination.

The musculoskeletal and motor development of infants is affected by their environment, which varies from being held, lying on a firm flat surface, to seated in various nursery products. Nursery products can alter the body position of infants, particularly the position of the head/neck and trunk, which may inhibit an infant's ability to breathe. With U.S. infants spending an increasing amount of time in seated products, the purpose of this study was to assess muscle activation and body position in four commercial infant products (carrier, bouncer, rocker, and swing) during supine and prone positioning, compared to a firm flat surface. Thirteen healthy infants (age: 4.2 ± 1.4 months; 7 M/6F) were enrolled in this IRB-approved in-vivo biomechanics study. Surface electromyography sensors recorded muscle activity of the erector spinae, cervical paraspinals, quadriceps, and abdominal muscles and retro-reflective markers tracked movements to determine head-neck, trunk, and torso-pelvis flexion/extension in the sagittal plane. While supine, infants exhibited increased head-neck and trunk flexion of up to 21° and 27° above the playmat, respectively, in all seated products. While prone, high abdominal muscle activation compared to the playmat indicates that infants will fatigue faster in seated products. Additionally, the lower muscle activation levels exhibited in younger infants (< 4 months) compared to older infants (≥ 4 months) indicates that younger infants rely on the product design to maintain body position. However, offering infants a variety of environments to move within is important to avoid motor delay, therefore future work should explore how long-term use may impact an infant's development.

Bisphenols are mainly used as protective coatings for plastics and resin-based materials in various consumer products. Industrial producers have a high demand for bisphenol A (BPA) among all bisphenol substitutes for various consumer products. However, according to reports, prolonged exposure to BPA can cause multiple health issues, including neurodevelopmental disorders in young children. BPA exposure during pregnancy has been considered as the primary cause of increasing the risk of neurological disorders in children as their neural systems are designed to respond to any environmental changes during prenatal life. Recently, there has been an increased focus on the effects of prenatal exposure to BPA, as it has been found to alter gene expression related to epigenetic mechanisms like DNA methylation, histone modification, and microRNA expression. Based on the evidence, frequent interactions can lead to inherited changes in an individual's neural profile. In this review, we delve into the current knowledge regarding the toxicity mechanism of BPA for expecting mothers. Next, we will discuss the possible action of BPA on the epigenetic mechanism during brain development. This is especially important to portray an overview on the role of epigenetic modification caused by prenatal BPA exposure and next, give future directions for improving human health risk assessment caused by BPA exposure.

Objective

To investigate the effect of computer-based early intervention with a playpen to enhance standing and walking, and to examine the relationship between changes in gross motor percentile and segmental trunk control in preterm infants nine months corrected age.

Methods

Forty infants born before 37 weeks of gestation were randomly assigned to either the experimental or control group. The Alberta Infant Motor Scale (AIMS) and the Segmental Assessment of Trunk Control (SATCo) were administered before and after the intervention. The experimental group, consisting of twenty preterm infants, participated in a computer-based early intervention involving 45 min of play in standing and walking positions, five times a week for 4 weeks.

Results

There were significant between-group differences in the gross motor percentiles of the AIMS (p-value <0.001). In addition, there was a significant difference in all conditions of the SATCo scores (p-value <0.05) compared with baseline score. The change in percentiles of gross motor development was significantly correlated (r_s = 0.643; p-value <0.001) with reactive SATCo during walking in infants in the experimental group.

Conclusion

Early intervention with a playpen in a standing and walking position can be applied to improve changes in gross motor percentiles and segmental trunk control in preterm infants.

Beginning early in fetal development, the androgen receptor (AR) gene helps regulate bodily exposure to testosterone. Most studies of individuals have found an inverse correlation between the number of CAG repeats on this gene and serious forms of physical aggression. This two-phased study was primarily undertaken to determine if a link between AR CAGn and physical aggression also exists at an ecological level of analysis. To make this assessment, we first conducted a bivariate analysis of the average number of AR CAG repeats for a large number of countries and the rates of crime victimization in those same countries. Except for motor vehicle theft, as the national average number of CAG repeats increased, crime victimization rates decreased. This inverse relationship was especially strong for violent offenses. In the second phase of this study, we sought to determine if per capita gross domestic product, pathogen prevalence, and average intelligence might be mediating some of the AR CAG repeats-criminality relationship. Mediation analysis analysis indicated that, once gross domestic product and pathogenic prevalence were controlled, average intelligence was able to eliminate most of the links between CAG repeats and crime victimization rates, especially in the case of violent offenses. These findings suggest that the AR gene is not influencing criminality primarily by altering testosterone brain exposure (as we suspected). Instead, it may affect criminality mainly by affecting cognitive ability. In fact, once average national intelligence is included in the mediation analysis model, direct relationships between CAG repeats and measures of homicide, assault, and robbery were no longer statistically significant. Findings from this two-phased study point toward the AR gene as having multiple effects on brain functioning, particularly regarding intellectual development as hypothesized by Manning [62]. Replication is obviously needed.

Background

The rising incidence of preterm births worldwide presents a pressing public health challenge, affecting both infants and their preterm caregivers. Early Intervention (EI) programs aim to mitigate the negative impacts associated with preterm births on the physical, cognitive, and psychological health of both infants and their caregivers by providing personalized parental support and developmental monitoring. This study addressed the gap in research evaluating the long-term effects of community-based EI programs on the holistic coping mechanisms of families, encompassing mental wellbeing, caregiving competencies, and the transition process from hospital to home care.

Methods

This study evaluated the long-term effects of a community-based EI program (in-home only) and the added benefits of earlier Hospital-to-Home (H2H) support, focusing on preterm caregivers' mental wellbeing and caregiving practices.

Results

The findings highlight the extended benefits of EI, demonstrating that program duration and intensity significantly benefit families dealing with neonatal intensive care unit stays. For infants requiring extensive medical intervention, EI support markedly enhances caregiver mental wellbeing. Additionally, interventions initiated earlier yield a more substantial positive effect on preterm caregivers' mental wellbeing after discharge compared to those that commence later.

Conclusion

These findings suggest the potential role of community-based EI programs and the benefits of supporting preterm caregivers before transitioning home. The study calls for future research to explore the effects of various EI program components to identify which interventions are most effective for addressing preterm infants' specific developmental challenges.