s of Poster and Platform Presentations at the 2002 Combined Sections Meeting: Poster Presentations: PDF Only

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.

Objectives: To examine the utility of a risk-approach model in identifying infants at greater risk of postneonatal mortality (PNM) and to determine whether there is a relationship between PNM and linkage of at-risk infants to primary health care.Methods: The Sheffield Birth Score instrument was applied to 90,846 newborn infants to determine high-score (HS) and low-score (LS) infant risk groups. Health care visit data were collected on all HS infants who were referred for primary pediatric care. Mortality rates were calculated for both HS and LS infant groups and for HS infants who were linked and not linked to care.Results: The HS infant group was at significantly greater risk of PNM (p < 0.0001). The linked group had a lower PNM rate (p < 0.05), and linked/not-linked group differences were noted for 11 of 20 variables. When these 11 variables and the linked/not-linked variable were entered into a logistic regression analysis, linkage was the only significant variable (p < 0.01) in predicting PNM.Conclusions: The Sheffield Birth Score differentiated at birth those infants who were at greater risk of PNM. The lower incidence of PNM among linked HS infants suggests a promising argument for early pediatric intervention. Further research to clarify specific factors that influence health care participation decisions is suggested.

Cloud property retrievals from 3 decades of the Advanced Very High Resolution Radiometer (AVHRR) measurements provide a unique opportunity for a long-term analysis of clouds. In this study, the accuracy of AVHRR-derived cloud properties cloud mask, cloud-top height, cloud phase and cloud liquid water path is assessed using three state-of-the-art retrieval schemes. In addition, the same retrieval schemes are applied to the AVHRR heritage channels of the Moderate Resolution Imaging Spectroradiometer (MODIS) to create AVHRR-like retrievals with higher spatial resolution and based on presumably more accurate spectral calibration. The cloud property retrievals were collocated and inter-compared with observations from CloudSat, CALIPSO and AMSR-E The resulting comparison exhibited good agreement in general. The schemes provide correct cloud detection in 82 to 90% of all cloudy cases. With correct identification of clear-sky in 61 to 85% of all clear areas, the schemes are slightly biased towards cloudy conditions. The evaluation of the cloud phase classification shows correct identification of liquid clouds in 61 to 97% and a correct identification of ice clouds in 68 to 95%, demonstrating a large variability among the schemes. Cloud-top height (CTH) retrievals were of relatively similar quality with standard deviations ranging from 2.1 km to 2.7 km. Significant negative biases in these retrievals are found in particular for cirrus clouds. The biases decrease if optical depth thresholds are applied to determine the reference CTH measure. Cloud liquid water path (LWP) is also retrieved well with relative low standard deviations (20 to 28 g/m2), negative bias and high correlations. Cloud ice water path (IWP) retrievals of AVHRR and MODIS exhibit a relative high uncertainty with standard deviations between 800 and 1400 g/m2, which in relative terms exceed 100% when normalized with the mean IWP. However, the global histogram distributions of IWP were similar to the reference dataset.MODIS retrievals are for most comparisons of slightly better quality than AVHRR-based retrievals. Additionally, the choice of different near-infrared channels, 3.7 μm as opposed to 1.6 μm, can have a significant impact on the retrieval quality, most pronounced for IWP, with better accuracy for the 1.6 μm channel setup. This study presents a novel assessment of the quality of cloud properties derived from AVHRR channels, which quantifies the accuracy of the considered retrievals based on common approaches and validation data. Furthermore, it assesses the capabilities of AVHRR-like spectral information for retrieving cloud properties in the light of generating climate data records of cloud properties from three decades of AVHRR measurements.

Eighty-nine low-birthweight, preterm infants were enrolled in a longitudinal study to describe motor development, infantile reactions and postural responses during the first chronological year of life and to determine the relationship between these behaviors. There was a clear trend from prevalence of primitive patterns, such as the asymmetric tonic neck reflex, towards a prevalence of mature postural reactions such as the Landau, righting and protective extension reflexes. Statistical analysis suggested that a relationship exists between infantile patterns, automatic postural reactions and motor development that is similar to that accepted as normal in term infant development, when allowance is made for preterm birth. Correlations were also obtained between integration of the tonic labyrinthine response and the presence of the asymmetric tonic neck pattern at the time of hospital discharge and later achievement of motor milestones. These relationships warrant further investigation.

Forty-six of 97 available families (47%) participated in an investigation of mothers and their high-risk infants who had been discharged from a neonatal intensive care unit. Twenty-three infant demographic, infant medical, maternal demographic, and maternal medical variables were analyzed to determine if differences existed between participating and nonparticipating subjects. Subjects were categorized into three groups: (1) those who completed and returned their questionnaires, (2) those who agreed to participate but did not return their questionnaires, and (3) those who were contactable by letter only. Multivariate analyses of variance yielded no significant effect for Group Status for the Infant Medical, Maternal Demographic, and Maternal Medical variables. The multivariate analysis of the infant demographic variables yielded a significant Group effect with univariate analyses indicating that the groups differed on the Transport variable. Participating mothers more frequently had infants who had been transported to our facility than did nonparticipating mothers. The findings are discussed in relation to sample representativeness and suggestions are offered for reporting subject-loss data.

Since relatively little is known as to why parents find it difficult to recognize when their high-risk infant ceases to be ill, this investigation examined parental reports of infant complications and the relationship these reports had with parental education level and method of delivery. Using a questionnaire format, 60 parents reported complications their infants experienced during NICU (neonatal intensive care unit) hospitalization. Maternal and paternal reports were comparable, although both significantly differed from actual diagnoses; parents underreported their infant's complications. Reported complications were not related to parental education level but were associated with method of delivery. Parents of Caesarean-section (C-section) infants identified a significantly smaller percentage of complications than did parents of vaginally delivered babies. It is suggested that (1) medical caregivers have the potential for helping parents more fully comprehend infant complications, (2) supplemental communication methods may be necessary for the task in (1), and (3) information communicated to parents may need to incorporate the current findings about parental education level and delivery method.

The following discussion is a review of the eighth West Virginia University Biennial Conference on Life-Span Development. KathleenA. McCluskey and Hayne W.Reese served as chairpersons for this eighth conference whose topic was the influence of normative history-graded events upon human development. The need to dimensionalize life events, the role of context, the need for theory to infer causes, and the role of metacognition in the design and implementation of research methodology were themes that emerged and served to unify the various theoretical and empirical presentations. In accordance with the purpose of the conference, these themes were utilized as interfaces between history-graded effects, the course of human development, and the process whereby researchers examine life-span development within a sociohistorical context.