Improvement In Infants Research Articles

Assessing Clinical Improvement of Infants Hospitalized for Respiratory Syncytial Virus-Related Critical Illness.

Pediatric respiratory syncytial virus (RSV)-related acute lower respiratory tract infection (LRTI) commonly requires hospitalization. The Clinical Progression Scale Pediatrics (CPS-Ped) measures level of respiratory support and degree of hypoxia across a range of disease severity, but it has not been applied in infants hospitalized with severe RSV-LRTI. We analyzed data from a prospective surveillance registry of infants hospitalized for RSV-related complications across 39 U.S. PICUs from October through December 2022. We assigned CPS-Ped (0=discharged home at respiratory baseline to 8=death) at admission, days 2-7,10, and 14. We identified predictors of clinical improvement (CPS-Ped≤2 or 3-point decrease) by day 7 using multivariable log-binomial regression models and estimated the sample size (80% power) to detect 15% between-group clinical improvement with CPS-Ped versus hospital length of stay (LOS). Of 585 hospitalized infants, 138 (23.6%) received invasive mechanical ventilation (IMV). Of the 49 (8.4%) infants whose CPS-Ped score worsened by 2 points after admission, one died. Failure to clinically improve by day 7 occurred in 205 (35%) infants and was associated with age <3 months, prematurity, underlying respiratory condition, and IMV in the first 24 hours in the multivariable analysis. The estimated sample size per arm required for detecting a 15% clinical improvement in a potential study was 584 using CPS-Ped clinical improvement versus 2,031 for hospital LOS. CPS-Ped can be used to capture a range of disease severity and track clinical improvement in infants who develop RSV-related critical illness and could be useful for evaluating therapeutic interventions for RSV.

Gastrointestinal symptom improvement in infants after restrictive tethered oral tissue release: a systematic review and meta analysis

Purpose: The purpose of this systematic review was to systematically explore improvements in gastrointestinal symptoms 1 week and 1 month following the frenotomy procedure, compared to before the procedure for infants under 12 months of age using meta-analysis calculations. Methods: Studies were selected that presented data on breastfed infants under 12 months of age, with gastrointestinal symptoms and reflux, who underwent surgical correction for restricted maxillary labial frenum and/or ankyloglossia, and/or maxillary buccal frena. Case reports, letters to editors, previous systematic reviews, in vitro and animal studies, and only abstracts were excluded. An integrative literature review was carried out in MEDLINE via PubMed, EBSCOhost, Scopus Embase, Web of Science &amp; Cochrane Library from April 2016 to March 2023. Risk of bias was evaluated using the Modified Newcastle‐Ottawa Scale. GRADE profiler (GRADEpro) was used to rate the quality of evidence. We conducted meta-analysis using random effects modelling with the RevMan Software 5.4. Results: Out of the 90 studies identified, nine studies were included, seven were prospective cohort studies, one was a prospective randomized trial, and one was a retrospective analysis. Gastroesophageal reflux symptoms showed statistically significant improvement in I-GERQ-R scores after 1 week (effect size = 3.40, p &lt; 0.00001) and 1 month (effect size = 6.37, p Conclusion: Tethered oral tissues should be considered as a potential etiology in the differential diagnosis of gastrointestinal reflux in infants.

Factors influencing auditory brainstem response changes in infants

BackgroundTo elucidate the factors influencing auditory brainstem response (ABR) threshold improvement in infants. MethodsThis retrospective study included 626 infants who underwent ABR at the our Health and Medical Center between 2016 and 2020. Preliminary assessment indicated that 352 infants had an ABR threshold ≥40 dBnHL in both ears. A second ABR examination was conducted 5 months after delivery. The participants were divided into the improved (improvement ≥20 dBnHL) and unchanged (improvement <20 dBnHL) groups. The associations between risk factors were evaluated. Furthermore, we measured and compared the latencies of waves I, III, and V between participants with normal hearing and those in the improved and unchanged groups. ResultsThe improved and unchanged groups consisted of 185 and 167 participants, respectively. ABR deterioration occurred in one infant with unilateral congenital cytomegalovirus-associated hearing loss. Binary logistic regression analysis revealed that the presence of otitis media with effusion and Down syndrome were factors contributing to ABR threshold improvement. In the ABR waveform analysis, patients in the improved group who had otitis media with effusion exhibited prolonged latencies of waves I, III, and V. Conversely, patients in the unchanged group who had Down syndrome showed shortened I–V interval. ConclusionsHalf of the infants tested the second time showed improvement in ABR threshold. Children with congenital syndromes (such as Down syndrome) or otitis media with effusion should undergo a second ABR examination or other auditory assessments to ensure an accurate diagnosis of hearing loss.

Short-term symptom improvement in infants with suspected cow's milk protein allergy using amino acid formula: a prospective cohort analysis.

Cow's milk protein allergy (CMPA) occurs commonly in infants. While the long-term efficacy of amino acid formulas for managing CMPA is well-established, there is limited data on the short-term symptom improvement of using amino acid formula (AAF). This study aimed to determine the short-term effects of managing suspected CMPA in infants aged 6 months and under using a commercial AAF. Healthcare providers who treated infants with suspected CMPA aged 6 months or younger (n = 104) provided de-identified survey data in this prospective study. Healthcare providers scored symptoms for severity from 0 to 3 (none, low, moderate, severe) before using a commercial AAF at Visit 1 and at Visit 2 (3-6 weeks later). Gastrointestinal (94%), skin (87%), respiratory (86%), and uncategorized symptoms (89%) improved from AAF initiation, and these findings were consistent across different follow-up visit durations. This study is the most extensive prospective analysis conducted in the United States examining the short-term change in suspected CMPA symptoms using an AAF. These findings suggest that AAF may decrease the severity of suspected CMPA symptoms in infants 6 months or younger, often by the next follow-up visit. Further randomized controlled trials are required to confirm these initial findings.

The association between pulmonary vascular disease and respiratory improvement in infants with type I severe bronchopulmonary dysplasia.

To describe the association between echocardiographic measures of pulmonary vascular disease and time to respiratory improvement among infants with Type I severe bronchopulmonary dysplasia (sBPD). We measured the pulmonary artery acceleration time indexed to the right ventricular ejection time (PAAT/RVET) and right ventricular free wall longitudinal strain (RVFWLS) at 34-41 weeks' postmenstrual age. Cox-proportional hazards models were used to estimate the relationship between the PAAT/RVET, RVFWLS, and the outcome: days from 36 weeks' postmenstrual age to room-air or discharge with oxygen (≤0.5 L/min). For 102 infants, the mean PAAT/RVET and RVFWLS were 0.27 ± 0.06 and -22.63 ± 4.23%. An abnormal measurement was associated with an increased time to achieve the outcome (PAAT/RVET: 51v24, p < 0.0001; RVFWLS; 62v38, p = 0.0006). A normal PAAT/RVET was independently associated with a shorter time to outcome (aHR = 2.04, 1.11-3.76, p = 0.02). The PAAT/RVET may aid in anticipating timing of discharge in patients with type I severe BPD.

The effect of acetate Ringer\u2019s solution versus lactate Ringer\u2019s solution on acid base physiology in infants with biliary atresia

BackgroundThe choice of the perioperative crystalloid is a key component of the fluid management and must take into account the liver function and the appearing metabolic disorders to avoid increase the liver extra metabolism. The aim of this study is to analyze the effect of acetate Ringer’s solution or lactate Ringer’s solution in biliary atresia patients.MethodsWe included 68 infant patients aged between 21 ~ 65 d, ASA physical status II or III, who underwent elective Kasai hepatoportoenterostomy, received either AR and LR for intravenous fluid resuscitation according to their group allocation. Lactate concentration, serum electrolytes and pH were noteded before skin incision (T1), end of surgery (T2) and postoperative 12 h. We also recorded the time of operation, stay of hospital, loss of blood and urinary, total volume of infusion of crystalloid.ResultsLactate level was significantly higher in Group LR than in Group AR patients at T2 (0.76 ± 0.13 versus 0.57 ± 0.22, P = 0.03). Compared with T3, sodium and chlorine were significantly higher in two groups at T2 (145.2 ± 3.1 versus 143.4 ± 3.4 and 104.6 ± 3.7 versus 105.2 ± 2.1). No significant differences were noted in potassium, HCO3− and calcium. There was no statistically significant difference in pH. No glycopenia was recorded in two groups. No significant difference was noted in administration of vasoactive drug (0.7% versus 1%).ConclusionsResuscitation with AR and LR was associated with similar clinical improvement in infants with biliary atresia. Use of AR reduced the level of lactate comparison with LR.

Klinefelter Syndrome and Turner Syndrome.

1. Carole Samango-Sprouse, EdD*,†,‡ 2. Sophia Q. Song, BA‡ 3. Angela E. Lin, MD§ 4. Cynthia M. Powell, MD¶ 5. Andrea L. Gropman, MD*,** 1. *George Washington University, Washington, DC 2. †Florida International University, Miami, FL 3. ‡Department of Research, The Focus Foundation, Davidsonville, MD 4. §Massachusetts General Hospital for Children, Boston, MA 5. ¶University of North Carolina at Chapel Hill, Chapel Hill, NC 6. **Children’s National Medical Center, Washington, DC Sex chromosome aneuploidy (SCA) syndromes refer to disorders with an abnormality of sex chromosome number. The most common are Klinefelter syndrome (KS), resulting from the gain of an X chromosome in males, and Turner syndrome (TS), reflecting the loss of an X chromosome or the presence of a structurally different X chromosome in females. Whereas most patients with KS have nonmosaic 47,XXY, only 40% of women with TS have 45,X; the remainder have a variety of mosaicisms. The syndromes also contrast in that males with KS are characteristically tall, whereas females with TS are typically short unless they receive hormonal treatment. Despite efforts to increase awareness, KS and TS are often underdiagnosed, leading to delayed care. Only 25% of men with KS are ever diagnosed, with fewer than 10% detected prenatally, and with a median age of 27 years for those identified later in life. For TS, the median age at diagnosis is 6.6 years. Although not exclusively, optimal neurocognitive outcomes depend on the timing of diagnosis and access to early targeted treatment, so fortunately the recent development of noninvasive prenatal screening is increasing the early identification of these disorders dramatically. Pediatricians should be aware of signs that allow for early detection, and the importance of prompt referral for testing and therapy. KS occurs in 1 in 660 live births, representing the most common SCA. Affected males have androgen deficiency, which affects endocrine, central nervous system, and neurodevelopmental function. Characteristics include increased height, clinodactyly of the fifth finger, pes planus, and hypogonadism manifesting as …

Measurement of epidermal hydration and skin ph in infants with atopic dermatitis before and after a bath

Introduction: The skin barrier function resides primarily in the stratum corneum (SC). Defect in SC hydration and skin surface pH leads to barrier impairment causing atopic dermatitis (AD). We have noticed a clinical improvement in infants with AD after a bath. We aimed to assess barrier functions in infants with AD before and after a single bath. There are no large controlled studies that clarify the optimal parameters of bathing. However, there are few studies recommending bath in AD. We proposed a “twenty minutes immersion bath.” Materials and Methods: We conducted an interventional analytic study without comparison group. The main instruments used were the corneometer and skin pH meter. Results: The measured values of SC hydration were significantly higher on the lesional skin immediately after a bath (P

Can Functional Electrical Stimulation affect Equilibrium and motor functions in Spastic hemiparetic Cerebral Palsy A Randomized Controlled Study

Background and aim: Using of F.E.S in rehabilitation program results is auspicious, although there’re doubts about FES efficiency in balance and main motor functions amelioration in hemiplegic infants. The research studied the impact of FES in balance and main motor skills improvement in infants diagnosed with hemiparetic cerebral palsy if we placed it on ventral muscle group of leg. Design and Place: Randomized controlled study in National Institute for Neuro-Motor System in Egypt. Methodology: 30 infants who are diagnosed with hemiplegic CP aging from 6 to 8 years is chosen from both genders. In two egalitarian sets randomly (control and study). Prior and after 3 months of treatment Assessment was carried out, utilizing Biodex balance system to gauge static balance plus Peabody progressive motor scale to evaluate gross motor functions. Control set is put in an elected Physiotherapy program. The other set (study one) received FES as well as the elected Physiotherapy program. Results: Study group patients showed a considerable amelioration in main motor skills test. Furthermore, in same group it’s showed that balance control was better according to the other set (control group) after training. Conclusion: Electrical stimulation addition to traditional Physiotherapy program over leg ventral group muscles can ameliorate balance and the gross motor functions in hemiparetic cerebral palsy infants.

Action research on infants’ dietary habits improvement by 4-year-old class teachers in an open daycare center

본 연구는 열린어린이집을 적용한 만 4세반 교사의 유아식습관 개선에 대한 실행연구이다. 열린어린이집 목적을 기반으로 유아의 식습관 개선에 대한 문제해결을 교사의 실천적 지식과 부모의 협력을 이끄는 실행연구를 통해 해결하고자 하였다. Mills의 변증법적 나선형 연구모형을 참고하여 3차의 걸친 실행과정을 걸쳤다. 1차 실행은 두 연구자의 협의를 통해 어린이집에서의 유아 식습관 현황을 부모가 살펴봄으로써 유아의 관점에서 식습관 개선이 시작되어야 함을 논의하였다. 1차 평가를 반영하여 2차 실행은 유아 식습관 개선을 위해 원인과 결과의 이분법적 관점에서 벗어나 이해의 관점에서 다양한 지원이 필요함을 인식하였다. 즉, 유아 스스로부터의 식습관 개선을 위해 주변의 동기부여가 필요했다. 이에 따라, 교사의 동기부여는 일회성이 아닌 하루일과 안에서 지속적으로 이루어져야 했으며, 부모와 지역사회의 지속적인 참여는 모바일 앱을 통해 확장되었다. 3차 실행결과는 식습관 개선에 대한 목적변화이다. 식습관 개선에 따른 다양한 동기부여는 놀이형태로 지원되었으며, 부모의 참여는 서로를 믿고 지지하는 신뢰적 관계를 만들었다. 이러한 실행과정은 유아의 식습관 개선에 긍정적인 영향을 미쳤다.This study was an action research on improvement of infant s dietary habits by four-year-old class teachers in a open daycare center. Based on the purposes of establishment of the open daycare center, the study sought to solve problems related with improvement of infants’ dietary habits through the action research leading to practical knowledge of teachers and parents cooperation. For this purpose, it conducted three phases of action plans, referring to Mills dialectic action research spiral model. The first phase, which examined the current status of infants dietary habits on a daily basis by the parents through the discussion of two researchers, planned and practised so that dietary habits improvement should be initiated from the standpoint of the infants. The second phase, reflecting the assessment from the first phase, recognized and realized the necessity of diverse supports via understanding the infants, shaking away from the dichotomous viewpoint of cause and effect for improvement of infant s dietary habits. The study found motivation from the surroundings played an important role for the infants themselves to improve their dietary habits. In other words, motivation by teachers should be done continually on a daily basis instead of one-time event. Also, continuous participation by parents and local communities was being expanded through mobile apps. The third phase was the alteration of purposes of dietary habits improvement. Diverse motivations for dietary habits improvement made by perceptual change of teachers were experienced by means of plays and games. Using these phases, the teachers and parents experienced a sort of partnership as well as mutually trusting and supporting relationship between them. The processed phases also had a positive effect on dietary habits improvement for infants.

Interventions to reduce Staphylococcus aureus in the management of eczema.

Interventions to reduce Staphylococcus aureus in the management of eczema.

Odds of Receiving Vaccines, but Not Vitamin A, Increased over Time in Urban and Rural Ethiopia, 2000–2016: A Secondary Data Analysis of DHS Data (P04-095-19)

ObjectivesChildhood vaccines and biannual vitamin A delivery by health systems are key to child health; suboptimal administration may be a result of inadequate coverage or access to health systems. There have been national programs set in Ethiopia, such as the health sector development program, to improve child health. Therefore, we sought to describe trends in infant vaccines and vitamin A in urban and rural settings in Ethiopia. We hypothesized there would be an increase over time in infants (1) receiving all basic vaccines and (2) vitamin A in the past 6 months. We also hypothesized (3) coverage would be higher in urban settings. MethodsWe used four nationally representative Demographic and Health Surveys (DHS) from Ethiopia between 2000 and 2016. The analysis comprised 11,621 infants 6–23 months old. Logistic regression models using a forward-stepwise approach were created to test these 3 hypotheses, controlling for wealth, age, sex of infant, and mother’s highest education level. Interaction terms were fitted between survey year and education level, setting and education level, and setting and wealth index quintile, and tested using the Wald test. Results(1) The percentage of infants having received all basic vaccines increased from 11.1% in 2000 to 31.0% in 2016; the odds of having received these vaccines increased over time also. (2) This is not true for vitamin A, where there was no pattern in the odds of having received vitamin A between survey years. (3) Rural infants were 40% less likely to have received all basic vaccines, compared to urban infants (adjusted odds ratio (AOR): 0.60; 95% CI: 0.43, 0.83), and there was no evidence of an association between setting and receiving vitamin A (AOR: 0.81; 95% CI: 0.61, 1.09). There was strong evidence for interaction between setting and mother’s highest education level, setting and wealth index quintile, and survey year and education level (all P < 0.01). ConclusionsThese results suggest that (1) while there has been improvement in infants receiving basic vaccines, (2) progress may be slowing slightly in vitamin A coverage and (3)there is a need to improve coverage of basic vaccines for infants in rural areas. Strengthening of and improved access to health services should remain a priority to ensure proper distribution of vaccines and vitamin A in Ethiopia. Funding SourcesN/A. Supporting Tables, Images and/or Graphs▪▪▪

Does heliox administered by low-flow nasal cannula improve respiratory distress in infants with respiratory syncytial virus acute bronchiolitis? A randomised controlled trial

ObjectivesThe aim of our study is to evaluate whether the use of heliox (79:21) delivered through a low flow nasal cannula would improve respiratory distress in infants with acute bronchiolitis caused by RSV. MethodsWe have conducted a prospective randomised controlled study. All patients fulfilling inclusion criteria were randomised to either heliox (79:21) or air via NC at 2L/min for a continuous 24h. Measurements were taken at baseline, after 2h and at the end of the 24h. ResultsWe have included 104 patients into our study. The MCA-S did not show any significant difference between the two groups after 2h 4.3 vs. 4.1 (P=.78), or at 24h after 4.2 vs. 4.3 (P=.89). No difference was found in the proportion of participants progressed to MV, n-CPAP or oxygen via nasal cannula (RR 1.0, 0.86 and 0.89) (P=1.0, .77 and .73). There was no notable reduction in length of treatment in Heliox group 2.42 days vs. 2.79 days in air group P=.65. The oxygen saturation, PaO2, and PaCO2 did not have any statistical difference between the two studied groups after 2h and 24h of treatment. ConclusionOur data showed absence of any beneficial effect of heliox in a concentration (79:21) delivered through low flow nasal cannula in terms of respiratory distress improvement in infants with RSV acute bronchiolitis.

The effect of a parental education program for preventing emotional abuse of infants on infants’ Socio-Emotional development

The central purpose of the present research is to identify the effect of such preventive educational programs on improvement of infants’ emotional development and reduction of parenting stress. The research subjects consisted of experimental group of 12 mothers and a control group of 15 mothers who spontaneously agreed to participate in the educational program. Both groups were given both a pre-and a post-test before and after implementation of the program. Wilcoxon signed rank test was conducted to examine the differences between the pre-and the post-tests. The results are that the educational program to prevent emotional abuse had a positive effect on infants’ social-emotional development. The mothers who participated in the program were not really aware of their emotions and had a chance to see the ways of expressing their emotions to others. Through the educational program, they also learned to recognize and express emotions sensitively by having interactions with affection. Further research needs to examine, develop, and apply a program so that preventing emotional abuse and further researches might differentiate a set of programs according to different ages of infants.

Longitudinal Assessment of Developmental Outcomes in Infants Undergoing Late Craniosynostosis Repair.

Evaluation of infants with craniosynostosis for surgical intervention, as opposed to conservative management, remains a challenge within the field of craniofacial surgery. Studies have consistently demonstrated that surgical repair of craniosynostosis is ideally performed between 3 and 12 months of age. As such, there is limited data regarding neurocognitive development in infants who initially present with uncorrected craniosynostosis after 12 months of age. Moreover, the impact of cranial vault surgery on neurocognitive development at all ages remains under investigation. A prospective, nonrandomized study was performed. All children with nonsyndromic craniosynostosis who presented for initial evaluation after 12 months of age were enrolled. The Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) was utilized to assess pre- and postoperative cognitive development and comparisons were made to normative values. Developmental delay is defined as scoring < 85. Five infants, average age 26 months (13-43 months) at initial presentation, underwent cranial vault remodeling and developmental testing. Fused cranial sutures involved: metopic (n = 4), and right coronal (n = 1). Cognitive testing demonstrated that 4 of 5 infants (80%) were developmentally delayed at presentation (scores: 60, 70, 72, and 80), and 1 infant was within normal limits (score: 100). Postoperative testing was performed between 2 and 12 months postoperatively. Universal improvement was observed in infants who were delayed prior to surgery (80, 80, 75, and 90, respectively). The infant who was not delayed prior to surgery remained within normal limits after surgery. This study demonstrates an association between cranial vault surgery and cognitive improvement in infants presenting late with developmental delay.

Hearing improvement with softband and implanted bone-anchored hearing devices and modified implantation surgery in patients with bilateral microtia-atresia

ObjectiveTo evaluate auditory development and hearing improvement in patients with bilateral microtia-atresia using softband and implanted bone-anchored hearing devices and to modify the implantation surgery. MethodsThe subjects were divided into two groups: the softband group (40 infants, 3 months to 2 years old, Ponto softband) and the implanted group (6 patients, 6–28 years old, Ponto). The Infant-Toddler Meaning Auditory Integration Scale was used conducted to evaluate auditory development at baseline and after 3, 6, 12, and 24 months, and visual reinforcement audiometry was used to assess the auditory threshold in the softband group. In the implanted group, bone-anchored hearing devices were implanted combined with the auricular reconstruction surgery, and high-resolution CT was used to assess the deformity preoperatively. Auditory threshold and speech discrimination scores of the patients with implants were measured under the unaided, softband, and implanted conditions. ResultsTotal Infant-Toddler Meaning Auditory Integration Scale scores in the softband group improved significantly and approached normal levels. The average visual reinforcement audiometry values under the unaided and softband conditions were 76.75 ± 6.05 dB HL and 32.25 ± 6.20 dB HL (P < 0.01), respectively. In the implanted group, the auditory thresholds under the unaided, softband, and implanted conditions were 59.17 ± 3.76 dB HL, 32.5 ± 2.74 dB HL, and 17.5 ± 5.24 dB HL (P < 0.01), respectively. The respective speech discrimination scores were 23.33 ± 14.72%, 77.17 ± 6.46%, and 96.50 ± 2.66% (P < 0.01). ConclusionsUsing softband bone-anchored hearing devices is effective for auditory development and hearing improvement in infants with bilateral microtia-atresia. Wearing softband bone-anchored hearing devices before auricle reconstruction and combining bone-anchored hearing device implantation with auricular reconstruction surgery may bethe optimal clinical choice for these patients, and results in more significant hearing improvement and minimal surgical and anesthetic injury.

Relation between probiotic properties of isolates isolated from breast milk and infants’ stools

Purpose Breast milk has been hypothesized to be a source of bacteria for the infant gut. This paper aims to search for probiotic bacteria among 415 isolates belonging to the Enterococcus, Lactobacillus, Streptococcus and Bifidobacterium genera recovered from breast milk of 50 lactating mothers and their respective infant stools, and then, determine whether their levels in stools vary with different modalities of breast feeding. Design/methodology/approach To prove that the isolates were probable probiotics, subtractive screening was done using three major selection criteria, namely, resistance to low pH, tolerance against bile salts and testing for their antimicrobial activity. Findings The three criteria were fulfilled by 31.7 and 31 per cent of the isolates recovered from mothers’ breast milk and infants’ stool specimens, respectively. The majority of probiotic strains, isolated from milk and infants’ stools were phenotypically identical, suggesting breast milk as their probable source. Moreover, there was a positive correlation between exclusive breast milk feeding and the number of probiotics in the infants’ stools. Originality/value Viable bacteria could be retrieved from breast milk of healthy women, not suffering from mastitis, by using different types of media and different cultivation conditions. Up to five different species belonging to the same genus could be isolated in the same specimen of whether milk or stools. Breast milk could be a source of probiotic bacteria for intestinal microflora of infants, which help improvement of infants’ gut and growth.

Comparative analysis of the effects of two chest physical therapy interventions in patients with bronchiolitis during hospitalization period.

Objective To evaluate and compare the effects of two chest physiotherapy interventions in patients hospitalized due to acute bronchiolitis.Methods Prospective randomized study with a sample of 83 calls for 29 patients aged between 3 months and 1 year hospitalized for acute bronchiolitis. Patients were distributed randomly into two groups: Group 1, submitted to postural drainage, tapping and tracheal aspiration; and Group 2, submitted to postural drainage, expiratory acceleration flow and tracheal aspiration. Assessments were made before and 10 and 60 minutes after the end of therapy. Patients also underwent drug treatment. The endpoint was to compare two physical therapy interventions as to clinical improvement in infants with acute bronchiolitis by means of oxygen saturation and the Respiratory Distress Assessment Instrument score. The parents/guardians was requested to answer a questionnaire about the treatment applied before the last evaluation in order to measure their satisfaction related to the interventions made.Results The groups were similar regarding the use of antibiotics and bronchodilators. A greater number of patients used corticosteroids in Group 2. A relevant improvement was observed on Respiratory Distress Assessment Instrument score with physical therapy, with reduction of the score 10 minutes after interventions, and the same score 60 minutes later, with no differences between techniques applied. There was no significant variation of pulse oximetry after chest physiotherapy. Most items assessed by the questionnaire had satisfactory answers.Conclusion No differences were observed between groups regarding the items assessed (time required to discharge from study, pulse oximetry in room air and disease severity according to the Respiratory Distress Assessment Instrument score). Parents answered positively about the effects of therapy in the majority of items in the questionnaire, both for the expiratory acceleration flow technique and for tapping.

Imitative Learning of Nso and German Infants at 6 and 9 Months of Age

The present study focused on the assessment of imitation performance in a large sample of 6- and 9-month-old infants from two different cultural contexts: German middle-class infants from urban areas and Nso infants from a rural area in northwestern Cameroon were tested by using age-adapted deferred imitation tasks that were varied regarding their cultural familiarity (two types of instruments each being highly familiar for one of the two cultural contexts). Within both cultural groups and without being influenced by the cultural familiarity of the instruments, infants performed more target actions in the test compared with the baseline phase, even though this difference did not yield significance in the group of 6-month-old Cameroonian Nso infants. Moreover, a higher mean number of imitated actions has been observed for 9-month-olds compared with 6-month-olds demonstrating an age-related improvement of infants’ learning ability. Furthermore, at 9 months of age, German infants showed a higher level of baseline activity compared with the infants in the Cameroonian sample, which is assumed to be based on differences regarding the degree of object experiences. Results provide evidence that early in infancy, imitation is a universal learning tool in different cultural environments.

Infants' developing understanding of social gaze.

Young infants are sensitive to self-directed social actions, but do they appreciate the intentional, target-directed nature of such behaviors? The authors addressed this question by investigating infants' understanding of social gaze in third-party interactions (N = 104). Ten-month-old infants discriminated between 2 people in mutual versus averted gaze, and expected a person to look at her social partner during conversation. In contrast, 9-month-old infants showed neither ability, even when provided with information that highlighted the gazer's social goals. These results indicate considerable improvement in infants' abilities to analyze the social gaze of others toward the end of their 1st year, which may relate to their appreciation of gaze as both a social and goal-directed action.