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  • 1
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    Online Resource
    ABSTRACTS FROM THE 2019 ANNUAL MEETING OF THE SOCIETY FOR NORTHWESTERN VERTEBRATE BIOLOGY, HELD JOINTLY WITH THE WASHINGTON CHAPTER OF THE WILDLIFE SOCIETY, AND IN ASSOCIATION WITH NORTHWEST PARTNERS IN AMPHIBIAN AND REPTILE CONSERVATION, AT GREAT WOLF LODGE, GRAND MOUND, WASHINGTON, 25 FEBRUARY–1 M
    Northwestern Naturalist ; 2019
    In:  Northwestern Naturalist Vol. 100, No. 2 ( 2019-7-22), p. 132-
    Details
    In: Northwestern Naturalist, Northwestern Naturalist, Vol. 100, No. 2 ( 2019-7-22), p. 132-
    Type of Medium: Online Resource
    ISSN: 1051-1733
    URL: Article
    URL: Article
    DOI: 10.1898/1051-1733-100.2.132
    DOI: 10.1898/1051-1733-100.2.132.s1
    Language: Unknown
    Publisher: Northwestern Naturalist
    Publication Date: 2019
    detail.hit.zdb_id: 2175232-1
    SSG: 12
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  • 2
    Online Resource
    Online Resource
    A Quality Initiative for Optimal Therapeutic Hypothermia during Transport for Neonates with Neonatal Encephalopathy
    Ovid Technologies (Wolters Kluwer Health) ; 2018
    In:  Pediatric Quality & Safety Vol. 3, No. 2 ( 2018-03), p. e056-
    Details
    In: Pediatric Quality & Safety, Ovid Technologies (Wolters Kluwer Health), Vol. 3, No. 2 ( 2018-03), p. e056-
    Abstract: Neuroprotection with therapeutic hypothermia (TH) is standard of care for neonatal encephalopathy (NE) and decreases death and neurodevelopmental disability. TH initiated shortly after birth insult results in greater neuroprotection compared with delayed initiation. Methods: Quality improvement methodology was used to improve temperature control during transport to a level IV neonatal intensive care unit. We included neonates with NE transported to a single institution for TH from 2010 to 2016. The quality improvement interventions were 2-fold. Review of the Transport Body Cooling Protocol revealed a suboptimal temperature goal of 34–35°C; this protocol was revised to 33–34°C. The second intervention was the implementation of an active cooling protocol. Clinical characteristics were compared using 2-sample t tests for continuous variables and Fisher’s exact tests for categorical variables; statistical process control chart was used to monitor admission temperatures. Results: We obtained baseline data for 78 neonates admitted from 2010 to 2014. These data were compared with postintervention data for 26 patients admitted between 2015 and 2016. Distance transported, NE severity, and seizures were similar between the 2 groups. The use of active cooling increased from 8% preimplementation to 31% postimplementation ( P 〈 0.01). After implementation of the 2 interventions, more infants were admitted within the goal temperature of 33–34°C, 58% versus 22% ( P 〈 0.01), and the average neonatal intensive care unit admission temperature improved from 34.4 ± 0.8°C to 33.8 ± 0.8°C ( P 〈 0.01). Conclusion: Increased utilization of active cooling during transport for TH improves the percentage of neonates admitted within the target temperature range. However, 42% of neonates remained outside the target temperature range, supporting the need for additional tools to improve admission temperatures.
    Type of Medium: Online Resource
    ISSN: 2472-0054
    URL: Article
    DOI: 10.1097/pq9.0000000000000056
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
    detail.hit.zdb_id: 2898348-8
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  • 3
    Online Resource
    Online Resource
    Effects of chronic hyperinsulinemia on metabolic pathways and insulin signaling in the fetal liver
    American Physiological Society ; 2020
    In:  American Journal of Physiology-Endocrinology and Metabolism Vol. 319, No. 4 ( 2020-10-01), p. E721-E733
    Details
    In: American Journal of Physiology-Endocrinology and Metabolism, American Physiological Society, Vol. 319, No. 4 ( 2020-10-01), p. E721-E733
    Abstract: The effect of chronic of hyperinsulinemia in the fetal liver is poorly understood. Here, we produced hyperinsulinemia with euglycemia for ∼8 days in fetal sheep [hyperinsulinemic (INS)] at 0.9 gestation. INS fetuses had increased insulin and decreased oxygen and amino acid (AA) concentrations compared with saline-infused fetuses [control (CON)] . Glucose (whole body) utilization rates were increased, as expected, in INS fetuses. In the liver, however, there were few differences in genes and metabolites related to glucose and lipid metabolism and no activation of insulin signaling proteins (Akt and mTOR). There was increased p-AMPK activation and decreased mitochondrial mass ( PGC1A expression, mitochondrial DNA content) in INS livers. Using an unbiased multivariate analysis with 162 metabolites, we identified effects on AA and one-carbon metabolism in the INS liver. Expression of the transaminase BCAT2 and glutaminase genes GLS1 and GLS2 was decreased, supporting decreased AA utilization. We further evaluated the roles of hyperinsulinemia and hypoxemia, both present in INS fetuses, on outcomes in the liver. Expression of PGC1A correlated only with hyperinsulinemia, p-AMPK correlated only with hypoxemia, and other genes and metabolites correlated with both hyperinsulinemia and hypoxemia. In fetal hepatocytes, acute treatment with insulin activated p-Akt and decreased PGC1A, whereas hypoxia activated p-AMPK. Overall, chronic hyperinsulinemia produced greater effects on amino acid metabolism compared with glucose and lipid metabolism and a novel effect on one-carbon metabolism in the fetal liver. These hepatic metabolic responses may result from the downregulation of insulin signaling and antagonistic effects of hypoxemia-induced AMPK activation that develop with chronic hyperinsulinemia.
    Type of Medium: Online Resource
    ISSN: 0193-1849 , 1522-1555
    URL: Article
    DOI: 10.1152/ajpendo.00323.2020
    Language: English
    Publisher: American Physiological Society
    Publication Date: 2020
    detail.hit.zdb_id: 1477331-4
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  • 4
    Online Resource
    Online Resource
    Comparisons of Three Measures of Maternal Engagement Activities in the Neonatal Intensive Care Unit
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Nursing Research Vol. 71, No. 3 ( 2022-5), p. 241-249
    Details
    In: Nursing Research, Ovid Technologies (Wolters Kluwer Health), Vol. 71, No. 3 ( 2022-5), p. 241-249
    Abstract: Mothers’ engagement with their hospitalized preterm infant(s) is recognized as an important aspect of treatment in neonatal intensive care units (NICUs). However, no gold standard exists for measuring maternal engagement, and the various methods used to measure mothers’ time have documented limitations. Objectives This study sought to compare three measurement methods of maternal engagement (a five-item maternal cross-sectional survey, time use diaries, and electronic health records [EHRs]) to identify whether these methods capture consistent data and patterns in detected differences in measures of engagement. Methods Maternal engagement was defined as time spent visiting the infant in the NICU (presence), holding (blanket holding in the mother’s arms or by kangaroo care [KC]), and caregiving (e.g., bathing and changing diapers). The survey estimating daily maternal engagement was administered in two Level III NICUs and one Level IV NICU at study enrollment, at least 2 weeks after admission. Mothers then completed the daily time use diaries until infant discharge. Data were also collected from participants’ EHRs, charted by nursing staff. Wilcoxon signed-rank tests were used for pairwise analysis of the three measures for maternal engagement activities. Results A total of 146 participants had data across all three measurement types and were included in the analysis. In the Level III NICUs ( n = 101), EHR data showed significantly more time spent with all engagement activities than the diary data. In the Level IV data, only differences in time holding were significant when comparing EHR data with survey data, with mothers reporting more time doing KC and less time blanket holding. Comparison of EHR data with diary data showed more time in all activities except KC. Discussion In most cases, time spent in engagement activities measured in the EHR was higher than in the surveys or time use diaries. Accuracy of measurements could not be determined because of limitations in data collection, and there is no gold standard for comparison. Nevertheless, findings contribute to ongoing efforts to develop the most valuable and accurate strategies for measuring maternal engagement—a significant predictor of maternal and infant health.
    Type of Medium: Online Resource
    ISSN: 1538-9847 , 0029-6562
    URL: Article
    DOI: 10.1097/NNR.0000000000000582
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 1480527-3
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  • 5
    Online Resource
    Online Resource
    The Association of Social Factors and Time Spent in the NICU for Mothers of Very Preterm Infants
    American Academy of Pediatrics (AAP) ; 2021
    In:  Hospital Pediatrics Vol. 11, No. 9 ( 2021-09-01), p. 988-996
    Details
    In: Hospital Pediatrics, American Academy of Pediatrics (AAP), Vol. 11, No. 9 ( 2021-09-01), p. 988-996
    Abstract: Evaluate the association between maternal social factors and maternal time spent in the NICU for very preterm infants admitted to 4 level III and IV NICUs. METHODS In this prospective observational cohort study, we enrolled mother–infant dyads whose infants were born & lt;32 weeks' gestation. Enrollment occurred after 2 weeks of NICU exposure, when maternal social factors and demographic information was collected. Maternal time spent in the NICU was abstracted from the electronic medical record and was dichotomized into 0 to 6 days and ≥6 days per week. Demographic differences between the 2 groups were compared by using χ2 tests. Logistic regression was used to assess the independent association between maternal social factors and the average number of days per week spent in the NICU. RESULTS A total of 169 mother–infant dyads were analyzed. Maternal social factors associated with more time spent in the NICU included an annual household income of & gt;$100 000, compared with those with an annual household income of & lt;$50 000 (adjusted odds ratio [aOR]: 5.68; 95% confidence interval [CI] 1.77–18.19), a travel time & lt;30 minutes to the NICU (compared with those who traveled & gt;60 minutes [aOR: 7.85; 95% CI 2.81–21.96]), and the lack of other children in the household, compared with women with other children (aOR: 3.15; 95% CI 1.39–7.11). CONCLUSIONS Maternal time spent in the NICU during a prolonged birth hospitalization of a very preterm infant differed by socioeconomic status, travel time, and presence of other dependents. Strategies to better identify and reduce these disparities to optimize engagement and, subsequently, improve infant health outcomes is needed.
    Type of Medium: Online Resource
    ISSN: 2154-1663 , 2154-1671
    URL: Article
    DOI: 10.1542/hpeds.2021-005861
    Language: English
    Publisher: American Academy of Pediatrics (AAP)
    Publication Date: 2021
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  • 6
    Online Resource
    Online Resource
    Prevalence and Predictors of Back-Transport Closer to Maternal Residence After Acute Neonatal Care in a Regional NICU
    Springer Science and Business Media LLC ; 2019
    In:  Maternal and Child Health Journal Vol. 23, No. 2 ( 2019-2), p. 212-219
    Details
    In: Maternal and Child Health Journal, Springer Science and Business Media LLC, Vol. 23, No. 2 ( 2019-2), p. 212-219
    Type of Medium: Online Resource
    ISSN: 1092-7875 , 1573-6628
    URL: Article
    DOI: 10.1007/s10995-018-2635-6
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2019
    detail.hit.zdb_id: 2017901-7
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  • 7
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    NICU Visitation Time and Adherence to Safe Sleep Practices Among Mothers of Very Preterm Infants
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Advances in Neonatal Care Vol. 23, No. 4 ( 2023-08), p. 365-376
    Details
    In: Advances in Neonatal Care, Ovid Technologies (Wolters Kluwer Health), Vol. 23, No. 4 ( 2023-08), p. 365-376
    Abstract: Sleep-associated infant death is the leading cause of postneonatal mortality in the United States. Preterm infants are at higher risk for sleep-associated death, but maternal adherence to safe sleep practices is lower than for mothers of full-term infants. Data are lacking on whether maternal neonatal intensive care unit (NICU) visitation time impacts safe sleep compliance after hospital discharge. Purpose: For mothers of preterm infants, to investigate the association of time days per week spent in the NICU and adherence to safe sleep practices after discharge. Methods: A prospective observational study of 109 mothers with infants born at less than 32 weeks from 4 Colorado NICUs who completed a survey at 6 weeks after discharge about infant sleep practices. Maternal time spent in the NICU was defined as the average number of days spent in the NICU per week of infant hospitalization, as documented in the electronic medical record. Multivariable logistic regression models assessed the relationship between time in the NICU and safe sleep adherence. Covariates included maternal/infant characteristics significant at P 〈 .2 level in bivariate analysis. Results: Predictors of compliance with all safe infant sleep practices included public/no insurance compared with private insurance (adjusted odds ratio [AOR] 0.29; 95% confidence interval [CI] 0.09-0.96), some college/associate-level education versus bachelor's degree (AOR 5.88; 95% CI 1.21-28.67), and depression/anxiety symptoms (AOR 0.37; 95% CI 0.14-0.97). NICU visitation days was not associated with adherence to safe sleep practices. Implications for Practice and Research: Maternal visitation days was not associated with adherence to safe infant sleep practices after discharge, highlighting the need to identify barriers and facilitators to engaging families about SUID risk-reducing behaviors.
    Type of Medium: Online Resource
    ISSN: 1536-0903
    URL: Article
    DOI: 10.1097/ANC.0000000000001066
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
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  • 8
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    Online Resource
    Prevalence and Predictors of Pediatric COVID-19 Vaccine Acceptance
    Georg Thieme Verlag KG ; 2023
    In:  American Journal of Perinatology Vol. 40, No. 01 ( 2023-01), p. 106-114
    Details
    In: American Journal of Perinatology, Georg Thieme Verlag KG, Vol. 40, No. 01 ( 2023-01), p. 106-114
    Abstract: Objective As pediatric COVID-19 vaccine eligibility expands, understanding predictors of vaccine intent is critical to effectively address parental concerns. Objectives included: (1) Evaluate maternal COVID-19 vaccine intent for child(ren) and associated predictors of stated intent; (2) Describe attitudes related to hypothetical vaccination policies; (3) Summarize themes associated with intention to vaccinate child(ren) for COVID-19. Study Design Mothers enrolled in Heath eMoms, a longitudinal survey project, were recruited for this electronic COVID-19 survey. Chi-square analysis was used to compare proportions of respondent characteristics based on vaccination intent. Population survey logistic regression was used for multivariable modeling to assess the independent association between vaccine intent and demographics. Results The response rate was 65.3% (n = 1884); 44.2% would choose vaccination, 20.3% would not choose vaccination, and 35.5% are unsure whether to have their child(ren) vaccinated for COVID-19. Black mothers (AOR 0.26, 95% CI 0.13, 0.54), respondents with less than high school education (AOR 0.26, 95% 0.12, 0.56) and those in rural areas (AOR 0.28, 95% CI 0.16, 0.48) were less likely to choose vaccination. Commonly cited reasons for vaccine hesitancy include the belief that the vaccine was not tested enough, is not safe, and there are concerns regarding its side effects. Conclusion Over 50% of respondents do not intend or are unsure about their intent to vaccinate their child(ren) for COVID-19 with variability noted by demographics. Opportunities exist for perinatal and pediatric providers to educate pregnant people, parents, and caregivers with a focus on addressing concerns regarding vaccine safety and efficacy. Key Points
    Type of Medium: Online Resource
    ISSN: 0735-1631 , 1098-8785
    URL: Article
    DOI: 10.1055/a-1850-3199
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2023
    detail.hit.zdb_id: 2042426-7
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  • 9
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    Online Resource
    The Role of Distance from Home to Hospital on Parental Experience in the NICU: A Qualitative Study
    MDPI AG ; 2023
    In:  Children Vol. 10, No. 9 ( 2023-09-20), p. 1576-
    Details
    In: Children, MDPI AG, Vol. 10, No. 9 ( 2023-09-20), p. 1576-
    Abstract: Prolonged admission to the neonatal intensive care unit presents challenges for families, especially those displaced far from home. Understanding specific barriers to parental engagement in the NICU is key to addressing these challenges with hospital-based interventions. The objective of this qualitative study was to explore the impact of distance from home to hospital on the engagement of parents of very preterm infants (VPT) in the neonatal intensive care unit (NICU). We used a grounded theory approach and conducted 13 qualitative interviews with parents of VPT who were admitted ≥14 days and resided ≥50 miles away using a semi-structured interview guide informed by the socio-ecological framework. We used constant comparative method with double coders for theme emergence. Our results highlight a multitude of facilitators and barriers to engagement. Facilitators included: (1) individual—delivery preparedness and social support; (2) environmental—medical team relationships; and (3) societal—access to perinatal care. Barriers included: (1) individual—transfer stressors, medical needs, mental health, and dependents; (2) environmental—NICU space, communication, and lack of technology; and (3) societal—lack of paid leave. NICU parents with geographic separation from home experienced a multitude of barriers to engagement, many of which could be addressed by hospital-based interventions.
    Type of Medium: Online Resource
    ISSN: 2227-9067
    URL: Article
    DOI: 10.3390/children10091576
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2732685-8
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  • 10
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    How does family integrated care in the NICU affect short‐term infant and parent outcomes?
    Wiley ; 2020
    In:  Acta Paediatrica Vol. 109, No. 12 ( 2020-12), p. 2820-2821
    Details
    In: Acta Paediatrica, Wiley, Vol. 109, No. 12 ( 2020-12), p. 2820-2821
    Type of Medium: Online Resource
    ISSN: 0803-5253 , 1651-2227
    URL: Issue
    URL: Article
    DOI: 10.1111/apa.v109.12
    DOI: 10.1111/apa.15421
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 1492629-5
    detail.hit.zdb_id: 1501466-6
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