Infants’ behavioral styles in joint attention situations and parents’ socio-economic status

In this study the eco-cultural model of parenting (Keller, H. (2007). Cultures of infancy. Mahwah, NJ: Erlbaum) was applied to the study of joint attention behavior of children from families with different socio-economic status (SES). It was hypothesized that infants’ early communication styles would differ with SES reflecting more independent or interdependent interactions with their caregivers. It was also hypothesized that infants would use the same types of behaviors whether they have declarative or imperative communication goals. The Early Social Communication Scales (ESCS, Mundy et al., 2003) was administered to 103 typically developing infants of 12 months (approximately half of them siblings of children with autism). A factor analysis, yielding four behavioral factors, namely pointing, eye contact, actions and following points, confirmed the hypothesis that infants use behaviors consistently across situations independent of their communicative intent. MANOVAs (comprising parental education and income) revealed that higher SES infants showed actions more frequently in the ESCS whereas lower SES infants followed experimenter's points more frequently. The results are discussed in the context of presumably differing socialization goals for infants and the divergent contribution of parental education and income that seem to have additive contribution to some factors (actions, following points) but divergent contributions to others (pointing, eye contact).     

Influence of perinatal complications on the development of a sample of 36-month-old premature infants

ObjectiveThe lack of clear results in previous studies for this context makes us consider an exploratory study. The objective of this research is to examine the influence of certain perinatal factors on the development of premature infants over their first 36 months of life.MethodThe sample consisted of 59 preterm infants born between 25 and 34 weeks of gestational age in an NICU of a third-level hospital. At 36 months of age, the Bayley-III Infant Development Scale (Spanish adaptation) and a clinical history were collected.ResultsThe average scores on the Bayley-III Infant Development Scale were generally within the normal range, but significantly lower than normal for Fine Motor Function, Gross Motor Function, and Expressive Language. These differences remained when considering the degree of prematurity, gender, and perinatal complications. Infants who received mechanical ventilation, oxygen therapy or corticosteroid treatment due to bronchopulmonary dysplasia showed the greatest discrepancies from normal levels.ConclusionOur results support prior studies that show that a combination of perinatal risk factors constitutes the largest determinant for developmental issues at 36 months of age. This information establishes the need for a priority follow-up in this population beyond 24 months of corrected age.     

The Factor Structure of the Beavers Interactional Scales

Confirmatory factor analysis and regression analyses of the Beavers Interactional Scales did not appear to support the model offered by its developers, namely, several specified family attributes contributing respectively to two global factors of Family Competence and Family Style. Moreover, regression analysis indicated that only three of 12 items predicted raters' assessments of Global Family Health, and one of seven items predicted Global Family Style. Individuals interested in the family dynamic centripetal/centrifugal might best think of that as a unitary entity and rate it accordingly.     

A call to restructure the drug development process: Government over-regulation and non-innovative late stage (Phase III) clinical trials are major obstacles to advances in health care

The history of drug/vaccine development has included major advances guided primarily by risk/benefit analyses concerning the innovative agent, not by evidence-based clinical trials (Phase I–IV). Because the approval for new drugs is hindered under the present process, the system requires restructuring. The Phase I/II study period should be more flexible, using the “environment of knowledge” about the new agent, plus risk/benefit assessments. Phase III, as presently constructed, does not add new adverse events data, it provides a narrower profile of drug efficacy than properly done Phase II studies, and placebo-controlled trials continue to raise unresolved ethical and social issues. Phase III studies should be abandoned for most drugs, and substituted with properly powered Phase II doseranging studies plus careful post-marketing surveillance. Phase III should be a penalty for poor drug development, not a regulatory requirement. To accomplish efficient drug development, greater cooperation between pharmaceutical companies and governments in developing clinical trials is needed rather than over-regulation. These changes will synchronize the drug development and regulatory process with the current rapid drug discovery process, reduce drug development time and cost, and improve patient care. The author is Adjunct Professor of Medicine, Weill Medical College of Cornell University, New York, New York, USA.     

Visual attention control differences in 12-month-old preterm infants

There have been few previous attempts to assess the development of early markers of executive function in infants born preterm despite well-established deficits reported for older preterm children that have been closely linked to poorer academic functioning. The present study investigates early attention control development in healthy 12-month-old age-corrected pre-term infants who were born less than 30 weeks and compares their performance to full-term infants. Eye-tracking methodology was used to measure attention control. Preterm Infants spent less time focused on the target and were slower to fixate attention, with lower gestational age associated with poorer target fixation and slower processing speed. There were no significant group differences observed for inhibition of return or interference control. These findings suggest that specific emerging deficits in attention control may be observed using eye tracking methodology in very preterm infants at this early stage of development, despite scores within the average range on the Bayley Scales of Infant Development.     

Massage therapy improves the development of HIV-exposed infants living in a low socio-economic,peri-urban community of South Africa

The aim of this study was to assess the effect of massage therapy on the growth and development of infants of HIV-infected mothers in a low socio-economic community in Cape Town. It was a prospective, randomised, controlled intervention trial that included massage therapy and control groups of HIV-infected mothers and their normal birth weight infants who were enrolled in the prevention of mother-to-child transmission (PMTCT) programme. Participants were recruited at the 6-week clinic visit and followed up every 2 weeks until their infants were 9 months of age. Mother–infant pairs in the massage therapy and control groups included 73 and 88 at 6 weeks and 55 and 58 at 9 months, respectively. Mothers in the intervention group were trained to massage their infants for 15 min daily. The socioeconomic status, immunity, relationship with the partner and mental pain of mothers; the infants’ dietary intake, anthropometry and development (Griffiths Mental Development Scales); and haematological and iron status of mothers and infants were assessed at baseline and follow-up. Nine infants (5.3%) were HIV-infected on the HIV DNA PCR test at 6 weeks. Despite significantly higher levels of maternal mental pain, infants in the massage therapy compared to control group scored higher in all five of the Griffiths Scales of Mental Development and significantly higher in the mean quotient (p = 0.002) and mean percentile (p = 0.004) for the hearing and speech scale at 9 months. Based on the mean difference in scores, the massage therapy group showed greater improvement for all five scales compared to the control group. The mean difference in scores was significantly greater for the hearing and speech quotient (21.9 vs. 11.2) (p < 0.03) and the general quotient percentile (19.3 vs. 7.7) (p = 0.03) in the massage therapy compared to the control group. These scales remained significant when adjusting for the relationship with the partner and maternal mental pain. Both groups had lower scores in the performance scale at 9 months although this was significantly worse in the control compared to the massage therapy group when adjusting for maternal CD4 count, anaemia, relationship with the partner and mental pain. There were no significant differences in the anthropometric measurements between the two groups. In conclusion, based on the Griffiths Scales, massage therapy improved the overall development and had a significant effect on the hearing and speech and general quotient of HIV-exposed infants in this study.     

The key role of nanoscale surface facets on the mechanical strength and failure of wurtzite and periodically twinned zinc-blende nanowires

Using molecular dynamics, we study the role of the surface facets of III–V nanowires on their failure during tensile deformation. We find that wurtzite (WZ) nanowires can withstand higher levels of stress and strain at failure compared to zinc-blende (ZB) nanowires. We observe that it is easier to nucleate a crack on a ZB nanowire due to the stress singularities that occur at the intersection of two opposing {111} facets. In WZ nanowires, we observe that cracks always nucleate at the intersection between two adjacent {112} surface facets. We explain these phenomena using fracture mechanics techniques based on energetics of crack formation.     

Comparison of Griffiths-II and Bayley-II tests for the developmental assessment of high-risk infants

IntroductionTwo important risk factors for abnormal neurodevelopment are preterm birth and neonatal hypoxic ischemic encephalopathy. The new revisions of Griffiths Mental Development Scale (Griffiths-II, [1996]) and the Bayley Scales of Infant Development (BSID-II, [1993]) are two of the most frequently used developmental diagnostics tests. The Griffiths-II is divided into five subscales and a global development quotient (QD), and the BSID-II is divided into two scales, the Mental scale (MDI) and the Psychomotor scale (PDI).The main objective of this research was to establish the extent to which developmental diagnoses obtained using the new revisions of these two tests are comparable for a given child.Material and methodsRetrospective study of 18-months-old high-risk children examined with both tests in the follow-up Unit of the Clinic of Neonatology of our tertiary care university Hospital between 2011 and 2012. To determine the concurrent validity of the two tests paired t-tests and Pearson product-moment correlation coefficients were computed. Using the BSID-II as a gold standard, the performance of the Griffiths-II was analyzed with receiver operating curves.Results61 patients (80.3% preterm, 14.7% neonatal asphyxia) were examined. For the BSID-II the MDI mean was 96.21 (range 67–133) and the PDI mean was 87.72 (range 49–114). For the Griffiths-II, the QD mean was 96.95 (range 60–124), the locomotors subscale mean was 92.57 (range 49–119). The score of the Griffiths locomotors subscale was significantly higher than the PDI (p < 0.001). Between the Griffiths-II QD and the BSID-II MDI no significant difference was found, and the area under the curve was 0.93, showing good validity. All correlations were high and significant with a Pearson product-moment correlation coefficient >0.8.ConclusionsThe meaning of the results for a given child was the same for the two tests. Two scores were interchangeable, the Griffiths-II QD and the BSID-II MDI.