Feasibility of a Relaxation Guided Imagery Intervention to Reduce Maternal Stress in the NICU

Objective: To test the feasibility of a relaxation guided imagery (RGI) intervention for mothers of hospitalized preterm infants and to explore the biobehavioral effects of RGI on their distress, responsiveness, and physiological stress. Design: Single sample, pretest-posttest design. Setting: A large Level III NICU in Southern California. Participants: Twenty mothers of hospitalized preterm infants (24-32 weeks gestational age). Methods: Correlational analyses of RGI use with self-reported measures of distress (perceived stress, state anxiety, and depression symptoms), awakening salivary cortisol level, and salivary cortisol awakening response collected from mothers at baseline and after 8 weeks of an RGI intervention. Results: Nineteen mothers completed the study. Average use of RGI varied from 1.7 to 7.4 times per week (mean = 4.46, standard deviation = 2.7). Greater average use of RGI was correlated with lower awakening cortisol levels (r = -.38), greater cortisol awakening response (r =.36), and lower levels of distress (perceived stress [r = -.38], anxiety [r = -.43], and depression [r = -.41]). Conclusion: Relaxation guided imagery may be a feasible and acceptable intervention to reduce mental and physiologic stress and improve responsiveness in mothers of hospitalized preterm infants

Life Sciences Institute for High School Students and Teachers

A two-day institute will be developed and presented on campus in late fall or early spring semester for selected high school students and teachers. The program content and activities will be designed to focus on a theme within the Life Sciences. Each year a theme will be selected in consideration of all the programs and schools associated with the Life Sciences Initiative at VCU. This includes biology, genetics, health-care sciences, the behavioral sciences, and the integration of arts and social sciences as feasible. The institute will lead to high school students earning one undergraduate credit and teachers will earn one graduate credit for continuing education or advanced study. The program is designed to attract students to attend VCU for the Life Sciences. The high school teachers will serve as student sponsors and potential recruiters for students at their local high schools. The learning experiences will be designed so teachers can incorporate Life Sciences’ content into their high school classrooms. Given the team’s vision and mission, the proposed project is designed to enhance collaborative efforts among the Life Science disciplines and university outreach to high schools within and outside of Virginia

Comparison of Biomarkers in Blood and Saliva in Healthy Adults

Researchers measure biomarkers as a reflection of patient health status or intervention outcomes. While blood is generally regarded as the best body fluid for evaluation of systemic processes, substitution of saliva samples for blood would be less invasive and more convenient. The concentration of specific biomarkers may differ between blood and saliva. The objective of this study was to compare multiple biomarkers (27 cytokines) in plasma samples, passive drool saliva samples, and filter paper saliva samples in 50 healthy adults. Demographic data and three samples were obtained from each subject: saliva collected on filter paper over 1 minute, saliva collected by passive drool over 30 seconds, and venous blood (3 mL) collected by venipuncture. Cytokines were assayed using Bio-Rad multiplex suspension array technology. Descriptive statistics and pairwise correlations were used for data analysis. The sample was 52% male and 74% white. Mean age was 26 (range = 19–63 years, sd = 9.7). The most consistent and highest correlations were between the passive drool and filter paper saliva samples, although relationships were dependent on the specific biomarker. Correlations were not robust enough to support substitution of one collection method for another. There was little correlation between the plasma and passive drool saliva samples. Caution should be used in substituting saliva for blood, and relationships differ by biomarker

Patterned feeding experience for preterm infants: study protocol for a randomized controlled trial

Background Neurobehavioral disabilities occur in 5–15 % of preterm infants with an estimated 50–70 % of very low birth weight preterm infants experiencing later dysfunction, including cognitive, behavioral, and social delays that often persist into adulthood. Factors implicated in poor neurobehavioral and developmental outcomes are hospitalization in the neonatal intensive care unit (NICU) and inconsistent caregiving patterns. Although much underlying brain damage occurs in utero or shortly after birth, neuroprotective strategies can stop lesions from progressing, particularly when these strategies are used during the most sensitive periods of neural plasticity occurring months before term age. The purpose of this randomized trial is to test the effect of a patterned feeding experience on preterm infants’ neurobehavioral organization and development, cognitive function, and clinical outcomes. Methods This trial uses an experimental, longitudinal, 2-group design with 120 preterm infants. Infants are enrolled within the first week of life and randomized to an experimental group receiving a patterned feeding experience from the first gavage feeding through discharge or to a control group receiving usual feeding care experience. The intervention involves a continuity of tactile experiences associated with feeding to train and build neuronal networks supportive of normal infant feeding experience. Primary outcomes are neurobehavioral organization as measured by Neurobehavioral Assessment of the Preterm Infant at 3 time points: the transition to oral feedings, NICU discharge, and 2 months corrected age. Secondary aims are cognitive function measured using the Bayley Scales of Infant and Toddler Development, Third Edition at 6 months corrected age, neurobehavioral development (sucking organization, feeding performance, and heart rate variability), and clinical outcomes (length of NICU stay and time to full oral feeding). The potential effects of demographic and biobehavioral factors (perinatal events and conditions of maternal or fetal/newborn origin and immunologic and genetic biomarkers) on the outcome variables will also be considered. Discussion Theoretically, the intervention provided at a critical time in neurologic system development and associated with a recurring event (feeding) should enhance neural connections that may be important for later development, particularly language and other cognitive and neurobehavioral organization skills

Psychological, cultural and neuroendocrine profiles of risk for preterm birth

BACKGROUND: Preterm birth remains a major obstetrical problem and identification of risk factors for preterm birth continues to be a priority in providing adequate care. Therefore, the purpose of this study was to elucidate risk profiles for preterm birth using psychological, cultural and neuroendocrine measures. METHODS: From a cross sectional study of 515 Mexican American pregnant women at 22–24 weeks gestation, a latent profile analysis of risk for preterm birth using structural equation modeling (SEM) was conducted. We determined accurate gestational age at delivery from the prenatal record and early ultrasounds. We also obtained demographic and prenatal data off of the chart, particularly for infections, obstetrical history, and medications. We measured depression (Beck Depression Inventory), mastery (Mastery scale), coping (The Brief Cope), and acculturation (Multidimensional Acculturation Scale) with reliable and valid instruments. We obtained maternal whole blood and separated it into plasma for radioimmunoassay of Corticotrophin Releasing Hormone (CRH). Delivery data was obtained from hospital medical records. RESULTS: Using a latent profile analysis, three psychological risk profiles were identified. The “low risk” profile had a 7.7 % preterm birth rate. The “moderate risk” profile had a 12 % preterm birth rate. The “highest risk” profile had a 15.85 % preterm birth rate. The highest risk profile had double the percentage of total infections compared to the low risk profile. High CRH levels were present in the moderate and highest risk profiles. CONCLUSION: These risk profiles may provide a basis for screening for Mexican American women to predict risk of preterm birth, particularly after they are further validated in a prospective cohort study. Future research might include use of such an identified risk profile with targeted interventions tailored to the Hispanic culture

Blastomere Analysis: Issues for Discussion

There has been little professional discussion about the implications of blastomere analysis for genetic screening. In this article, some of the legal, ethical, and practical issues associated with the technology are identified. Issues are categorized as those involving availability and payment, phenotype selection, and imperfect genes. Nurses need to be knowledgeable about these issues to participate in the formation of policies governing the use of blastomere analysis and other genetic screening procedures

The Technology and Use of Blastomere Analysis

With the use of blastomere analysis, it is possible to screen for serious genetic disease before initiating pregnancy through in vitro fertilization. The analysis provides information about an embryo's genetic composition before implantation. This article describes the technique of blastomere analysis and its current and potential uses. Implications for nursing practice and education are identified

Gene therapy for inherited disorders

With an increase in understanding of the role of genes in disease pathogenesis, gene therapy has become a reality for some disorders and an increased possibility for many others. One type of gene therapy requires only gene addition for treatment. Different methods for gene addition are being tested, based on the cell typology necessary to make the therapy effective. Gene therapy trials for patients with adenosine deaminase deficiency involve a retroviral approach. Gene therapy trials for patients with cystic fibrosis involve an adenoviral approach. This article describes the differences between these two methods of gene therapy. The application of this knowledge to pediatric nursing practice is discussed