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Xiang Q, Chen JJ, Feng NN, Li XH. Research progress of music intervention in nursing of premature infants in neonatal intensive care unit. Technol Health Care 2024:THC241263. [PMID: 39302405 DOI: 10.3233/thc-241263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2024]
Abstract
BACKGROUND With the continuous advancement of medical technology, the survival rate of preterm infants is gradually improving, However, due to the underdeveloped function of various organs and systems, preterm infants are often exposed to light, noise, medical as well as nursing operations and other stimuli during their hospitalization in neonatal intensive care unit (NICU); it is highly susceptible to a number of problems, such as pain, unstable vital signs, growth retardation, and sleep disruption. OBJECTIVE This article reviews the research progress of music intervention in nursing of premature infants in NICU with both traditional and conventional care. METHODS This article reviews the research background, methodology/design, and measurement/application effects of music interventions, including Chinese and Western traditional music, in the care of preterm infants in NICU. All scholarly literature retrieved from MEDLINE\PubMed, Science Citation Index Expanded, Google scholar, CNKI scholar, Scopus and PubsHub. RESULTS As a simple and effective non-pharmacological intervention, music intervention can effectively alleviate neonatal surgical pain, increase heart rate and oxygen saturation, promote sleep, growth and development, and improve neurological development. CONCLUSIONS This review provide theoretical references for clinical practice.
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Affiliation(s)
- Qiong Xiang
- Department of Nursing, Institute of Medicine, Jishou University, Hunan, China
- Institute of Medicine, Medical Research Center, Jishou University, Hunan, China
- Department of Nursing, Institute of Medicine, Jishou University, Hunan, China
| | - Jia-Jia Chen
- Department of Nursing, Institute of Medicine, Jishou University, Hunan, China
- Department of Nursing, Institute of Medicine, Jishou University, Hunan, China
| | - Ni-Na Feng
- Department of Nursing, Institute of Medicine, Jishou University, Hunan, China
| | - Xian-Hui Li
- Department of Nursing, Institute of Medicine, Jishou University, Hunan, China
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Erdei C, Sunwoo J, Corriveau GC, Forde M, El-Dib M, Inder T. Effect of music-based interventions on physiologic stability of hospitalized preterm infants. A pilot study. J Perinatol 2024; 44:665-670. [PMID: 38418527 DOI: 10.1038/s41372-024-01907-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 02/06/2024] [Accepted: 02/12/2024] [Indexed: 03/01/2024]
Abstract
BACKGROUND AND OBJECTIVE Hospitalized preterm infants experience reduced meaningful auditory exposures during a critical period of brain development. Music-based interventions (MBI) may be beneficial, though it remains unclear which stimuli optimally enhance infant stabilization. We investigated the relationship between three conceptually-different MBIs and short-term responses in hospitalized preterm infants. STUDY DESIGN This is a case-crossover pilot study including 21 preterm infants between 30 and 35 weeks postmenstrual age. Participants listened to three MBIs and 'no music'; each condition was provided three times in random order. We monitored physiologic and behavioral parameters around each exposure and analyzed results using linear mixed models. RESULTS Respiratory rates decreased after each MBI compared with 'no music' (p = 0.02). The most notable decrease occurred following exposure to a low, repetitive musical pattern resembling a lullaby (p = 0.01). We noted no significant changes for the remaining parameters. CONCLUSION Specific MBI characteristics may preferentially enhance physiologic stabilization in hospitalized preterm infants.
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Affiliation(s)
- Carmina Erdei
- Division of Newborn Medicine, Department of Pediatrics, Brigham and Women's Hospital, 75 Francis St, Boston, MA, USA.
- Harvard Medical School, Pediatrics, 25 Shattuck St, Boston, MA, USA.
| | - John Sunwoo
- Harvard Medical School, Pediatrics, 25 Shattuck St, Boston, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 149 13th St, Charlestown, MA, USA
| | - Gabriel Cote Corriveau
- Division of Newborn Medicine, Department of Pediatrics, Brigham and Women's Hospital, 75 Francis St, Boston, MA, USA
| | - Madison Forde
- Division of Newborn Medicine, Department of Pediatrics, Brigham and Women's Hospital, 75 Francis St, Boston, MA, USA
| | - Mohamed El-Dib
- Division of Newborn Medicine, Department of Pediatrics, Brigham and Women's Hospital, 75 Francis St, Boston, MA, USA
- Harvard Medical School, Pediatrics, 25 Shattuck St, Boston, MA, USA
| | - Terrie Inder
- Division of Newborn Medicine, Department of Pediatrics, Brigham and Women's Hospital, 75 Francis St, Boston, MA, USA
- Harvard Medical School, Pediatrics, 25 Shattuck St, Boston, MA, USA
- Division of Neonatology, Children's Hospital of Orange County and University of California Irvine, 1001, Health Sciences Rd, Irvine, CA, USA
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Keles E, Bagci U. The past, current, and future of neonatal intensive care units with artificial intelligence: a systematic review. NPJ Digit Med 2023; 6:220. [PMID: 38012349 PMCID: PMC10682088 DOI: 10.1038/s41746-023-00941-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 10/05/2023] [Indexed: 11/29/2023] Open
Abstract
Machine learning and deep learning are two subsets of artificial intelligence that involve teaching computers to learn and make decisions from any sort of data. Most recent developments in artificial intelligence are coming from deep learning, which has proven revolutionary in almost all fields, from computer vision to health sciences. The effects of deep learning in medicine have changed the conventional ways of clinical application significantly. Although some sub-fields of medicine, such as pediatrics, have been relatively slow in receiving the critical benefits of deep learning, related research in pediatrics has started to accumulate to a significant level, too. Hence, in this paper, we review recently developed machine learning and deep learning-based solutions for neonatology applications. We systematically evaluate the roles of both classical machine learning and deep learning in neonatology applications, define the methodologies, including algorithmic developments, and describe the remaining challenges in the assessment of neonatal diseases by using PRISMA 2020 guidelines. To date, the primary areas of focus in neonatology regarding AI applications have included survival analysis, neuroimaging, analysis of vital parameters and biosignals, and retinopathy of prematurity diagnosis. We have categorically summarized 106 research articles from 1996 to 2022 and discussed their pros and cons, respectively. In this systematic review, we aimed to further enhance the comprehensiveness of the study. We also discuss possible directions for new AI models and the future of neonatology with the rising power of AI, suggesting roadmaps for the integration of AI into neonatal intensive care units.
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Affiliation(s)
- Elif Keles
- Northwestern University, Feinberg School of Medicine, Department of Radiology, Chicago, IL, USA.
| | - Ulas Bagci
- Northwestern University, Feinberg School of Medicine, Department of Radiology, Chicago, IL, USA
- Northwestern University, Department of Biomedical Engineering, Chicago, IL, USA
- Department of Electrical and Computer Engineering, Chicago, IL, USA
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Haslbeck FB, Mueller K, Karen T, Loewy J, Meerpohl JJ, Bassler D. Musical and vocal interventions to improve neurodevelopmental outcomes for preterm infants. Cochrane Database Syst Rev 2023; 9:CD013472. [PMID: 37675934 PMCID: PMC10483930 DOI: 10.1002/14651858.cd013472.pub2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
BACKGROUND Preterm birth interferes with brain maturation, and subsequent clinical events and interventions may have additional deleterious effects. Music as therapy is offered increasingly in neonatal intensive care units aiming to improve health outcomes and quality of life for both preterm infants and the well-being of their parents. Systematic reviews of mixed methodological quality have demonstrated ambiguous results for the efficacy of various types of auditory stimulation of preterm infants. A more comprehensive and rigorous systematic review is needed to address controversies arising from apparently conflicting studies and reviews. OBJECTIVES We assessed the overall efficacy of music and vocal interventions for physiological and neurodevelopmental outcomes in preterm infants (< 37 weeks' gestation) compared to standard care. In addition, we aimed to determine specific effects of various interventions for physiological, anthropometric, social-emotional, neurodevelopmental short- and long-term outcomes in the infants, parental well-being, and bonding. SEARCH METHODS We searched Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, PsycINFO, Web of Science, RILM Abstracts, and ERIC in November 2021; and Proquest Dissertations in February 2019. We searched the reference lists of related systematic reviews, and of studies selected for inclusion and clinical trial registries. SELECTION CRITERIA We included parallel, and cluster-randomised controlled trials with preterm infants < 37 weeks` gestation during hospitalisation, and parents when they were involved in the intervention. Interventions were any music or vocal stimulation provided live or via a recording by a music therapist, a parent, or a healthcare professional compared to standard care. The intervention duration was greater than five minutes and needed to occur more than three times. DATA COLLECTION AND ANALYSIS Three review authors independently extracted data. We analysed the treatment effects of the individual trials using RevMan Web using a fixed-effects model to combine the data. Where possible, we presented results in meta-analyses using mean differences with 95% CI. We performed heterogeneity tests. When the I2 statistic was higher than 50%, we assessed the source of the heterogeneity by sensitivity and subgroup analyses. We used GRADE to assess the certainty of the evidence. MAIN RESULTS We included 25 trials recruiting 1532 infants and 691 parents (21 parallel-group RCTs, four cross-over RCTs). The infants gestational age at birth varied from 23 to 36 weeks, taking place in NICUs (level 1 to 3) around the world. Within the trials, the intervention varied widely in type, delivery, frequency, and duration. Music and voice were mainly characterised by calm, soft, musical parameters in lullaby style, often integrating the sung mother's voice live or recorded, defined as music therapy or music medicine. The general risk of bias in the included studies varied from low to high risk of bias. Music and vocal interventions compared to standard care Music/vocal interventions do not increase oxygen saturation in the infants during the intervention (mean difference (MD) 0.13, 95% CI -0.33 to 0.59; P = 0.59; 958 infants, 10 studies; high-certainty evidence). Music and voice probably do not increase oxygen saturation post-intervention either (MD 0.63, 95% CI -0.01 to 1.26; P = 0.05; 800 infants, 7 studies; moderate-certainty evidence). The intervention may not increase infant development (Bayley Scales of Infant and Toddler Development (BSID)) with the cognitive composition score (MD 0.35, 95% CI -4.85 to 5.55; P = 0.90; 69 infants, 2 studies; low-certainty evidence); the motor composition score (MD -0.17, 95% CI -5.45 to 5.11; P = 0.95; 69 infants, 2 studies; low-certainty evidence); and the language composition score (MD 0.38, 95% CI -5.45 to 6.21; P = 0.90; 69 infants, 2 studies; low-certainty evidence). Music therapy may not reduce parental state-trait anxiety (MD -1.12, 95% CI -3.20 to 0.96; P = 0.29; 97 parents, 4 studies; low-certainty evidence). The intervention probably does not reduce respiratory rate during the intervention (MD 0.42, 95% CI -1.05 to 1.90; P = 0.57; 750 infants; 7 studies; moderate-certainty evidence) and post-intervention (MD 0.51, 95% CI -1.57 to 2.58; P = 0.63; 636 infants, 5 studies; moderate-certainty evidence). However, music/vocal interventions probably reduce heart rates in preterm infants during the intervention (MD -1.38, 95% CI -2.63 to -0.12; P = 0.03; 1014 infants; 11 studies; moderate-certainty evidence). This beneficial effect was even stronger after the intervention. Music/vocal interventions reduce heart rate post-intervention (MD -3.80, 95% CI -5.05 to -2.55; P < 0.00001; 903 infants, 9 studies; high-certainty evidence) with wide CIs ranging from medium to large beneficial effects. Music therapy may not reduce postnatal depression (MD 0.50, 95% CI -1.80 to 2.81; P = 0.67; 67 participants; 2 studies; low-certainty evidence). The evidence is very uncertain about the effect of music therapy on parental state anxiety (MD -0.15, 95% CI -2.72 to 2.41; P = 0.91; 87 parents, 3 studies; very low-certainty evidence). We are uncertain about any further effects regarding all other secondary short- and long-term outcomes on the infants, parental well-being, and bonding/attachment. Two studies evaluated adverse effects as an explicit outcome of interest and reported no adverse effects from music and voice. AUTHORS' CONCLUSIONS Music/vocal interventions do not increase oxygen saturation during and probably not after the intervention compared to standard care. The evidence suggests that music and voice do not increase infant development (BSID) or reduce parental state-trait anxiety. The intervention probably does not reduce respiratory rate in preterm infants. However, music/vocal interventions probably reduce heart rates in preterm infants during the intervention, and this beneficial effect is even stronger after the intervention, demonstrating that music/vocal interventions reduce heart rates in preterm infants post-intervention. We found no reports of adverse effects from music and voice. Due to low-certainty evidence for all other outcomes, we could not draw any further conclusions regarding overall efficacy nor the possible impact of different intervention types, frequencies, or durations. Further research with more power, fewer risks of bias, and more sensitive and clinically relevant outcomes are needed.
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Affiliation(s)
| | - Katharina Mueller
- Zentrum für Kinder und Jugendmedizin, University Freiburg, Freiburg, Germany
| | - Tanja Karen
- Department of Neonatology, University Hospital Zurich, Zurich, Switzerland
| | - Joanne Loewy
- Mount Sinai Health System, The Louis Armstrong Center for Music & Medicine, New York City, USA
| | - Joerg J Meerpohl
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Dirk Bassler
- Department of Neonatology, University Hospital Zurich, Zurich, Switzerland
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Brinkley M, Biard M, Masuoka I, Hagan J. Evaluation of Occupational Therapy and Music Therapy Co-Treatment in the Neonatal Intensive Care Unit. Phys Occup Ther Pediatr 2023; 44:513-525. [PMID: 37670470 DOI: 10.1080/01942638.2023.2253894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 08/28/2023] [Indexed: 09/07/2023]
Abstract
AIMS To examine co-treatment with music therapy and occupational therapy with infants in the neonatal intensive care unit (NICU). METHODS A quasi-experimental design was used to study the effect of standard care occupational therapy (SCOT) vs co-treatment with music therapy (Co-Tx) on behavioral state and physiologic measures. 46 participants were enrolled in the study. Interventions were implemented in approximately 20-minute sessions. Physiologic measures, heart rate (HR) and oxygen saturation (SpO2), were collected using Sickbay. Behavioral measures were collected using The Face, Legs, Activity, Cry, and Consolability (FLACC) Pain Assessment Tool. RESULTS Mean heartrates during Co-Tx (161.3 ± 15.4 BPM) did not differ significantly compared to SCOT (161.8 ± 15.7 BPM). In unadjusted comparisons, mean SpO2 levels were significantly higher during Co-Tx than SCOT (95.48 ± 3.43% vs. 95.12 ± 3.71%, p = 0.046). There was a significant decrease in pre- to post-test FLACC scores for Co-Tx when compared to SCOT (decrease of 0.97 ± 1.96 vs. 0.61 ± 1.65, p = 0.023). In adjusted comparisons, there were no statistically significant differences in physiological outcomes. CONCLUSIONS Co-treatment with music therapy may create a more stable and regulated environment for NICU infants. Further research is recommended on music therapy co-treatment with rehabilitative therapies.
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Affiliation(s)
| | | | | | - Joseph Hagan
- Texas Children's Hospital & Baylor College of Medicine, Houston, TX, USA
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6
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Smith AR, Hagan J, Walden M, Brickley A, Biard M, Rhee C, McIver P, Shoemark H, Brand MC. The Effect of Contingent Singing on Infants with Bronchopulmonary Dysplasia in the Neonatal Intensive Care Unit. J Music Ther 2023; 60:98-119. [PMID: 36592139 DOI: 10.1093/jmt/thac019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
A significant component of care for infants with bronchopulmonary dysplasia (BPD) is providing an optimal environment for supporting neurodevelopment and growth. Interventions that support the behavioral and physiologic stability of this population may play an important role in improving overall outcomes. Contingent singing is a music intervention that allows the caregiver to tailor certain musical elements, such as rhythm and tempo, to match behavioral and physiologic cues and support the infant in achieving optimal stabilization. A randomized crossover design was used to study the effect of contingent singing on the behavioral state and physiologic measures compared to standard care practices in the neonatal intensive care unit (NICU). Data were collected on a sample of 37 infants diagnosed with BPD. There were no significant differences in the physiologic measures or behavioral states of infants in the contingent singing sessions compared to control sessions. Parents and staff reported favorable views of music therapy in the NICU, and there were no adverse responses from infants during contingent singing. Further research is needed to determine the effectiveness of this intervention on the physiologic stability of infants with BPD.
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Affiliation(s)
| | - Joseph Hagan
- Texas Children's Hospital & Baylor College of Medicine
| | - Marlene Walden
- Arkansas Children's Hospital & University of Arkansas for Medical Sciences
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Plana D, Shung DL, Grimshaw AA, Saraf A, Sung JJY, Kann BH. Randomized Clinical Trials of Machine Learning Interventions in Health Care: A Systematic Review. JAMA Netw Open 2022; 5:e2233946. [PMID: 36173632 PMCID: PMC9523495 DOI: 10.1001/jamanetworkopen.2022.33946] [Citation(s) in RCA: 54] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
IMPORTANCE Despite the potential of machine learning to improve multiple aspects of patient care, barriers to clinical adoption remain. Randomized clinical trials (RCTs) are often a prerequisite to large-scale clinical adoption of an intervention, and important questions remain regarding how machine learning interventions are being incorporated into clinical trials in health care. OBJECTIVE To systematically examine the design, reporting standards, risk of bias, and inclusivity of RCTs for medical machine learning interventions. EVIDENCE REVIEW In this systematic review, the Cochrane Library, Google Scholar, Ovid Embase, Ovid MEDLINE, PubMed, Scopus, and Web of Science Core Collection online databases were searched and citation chasing was done to find relevant articles published from the inception of each database to October 15, 2021. Search terms for machine learning, clinical decision-making, and RCTs were used. Exclusion criteria included implementation of a non-RCT design, absence of original data, and evaluation of nonclinical interventions. Data were extracted from published articles. Trial characteristics, including primary intervention, demographics, adherence to the CONSORT-AI reporting guideline, and Cochrane risk of bias were analyzed. FINDINGS Literature search yielded 19 737 articles, of which 41 RCTs involved a median of 294 participants (range, 17-2488 participants). A total of 16 RCTS (39%) were published in 2021, 21 (51%) were conducted at single sites, and 15 (37%) involved endoscopy. No trials adhered to all CONSORT-AI standards. Common reasons for nonadherence were not assessing poor-quality or unavailable input data (38 trials [93%]), not analyzing performance errors (38 [93%]), and not including a statement regarding code or algorithm availability (37 [90%]). Overall risk of bias was high in 7 trials (17%). Of 11 trials (27%) that reported race and ethnicity data, the median proportion of participants from underrepresented minority groups was 21% (range, 0%-51%). CONCLUSIONS AND RELEVANCE This systematic review found that despite the large number of medical machine learning-based algorithms in development, few RCTs for these technologies have been conducted. Among published RCTs, there was high variability in adherence to reporting standards and risk of bias and a lack of participants from underrepresented minority groups. These findings merit attention and should be considered in future RCT design and reporting.
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Affiliation(s)
| | - Dennis L Shung
- Department of Medicine, Yale University, New Haven, Connecticut
| | - Alyssa A Grimshaw
- Harvey Cushing/John Hay Whitney Medical Library, Yale University, New Haven, Connecticut
| | - Anurag Saraf
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts
| | - Joseph J Y Sung
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Benjamin H Kann
- Artificial Intelligence in Medicine Program, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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Artificial Intelligence in NICU and PICU: A Need for Ecological Validity, Accountability, and Human Factors. Healthcare (Basel) 2022; 10:healthcare10050952. [PMID: 35628089 PMCID: PMC9140402 DOI: 10.3390/healthcare10050952] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/17/2022] [Accepted: 05/19/2022] [Indexed: 02/04/2023] Open
Abstract
Pediatric patients, particularly in neonatal and pediatric intensive care units (NICUs and PICUs), are typically at an increased risk of fatal decompensation. That being said, any delay in treatment or minor errors in medication dosage can overcomplicate patient health. Under such an environment, clinicians are expected to quickly and effectively comprehend large volumes of medical information to diagnose and develop a treatment plan for any baby. The integration of Artificial Intelligence (AI) into the clinical workflow can be a potential solution to safeguard pediatric patients and augment the quality of care. However, before making AI an integral part of pediatric care, it is essential to evaluate the technology from a human factors perspective, ensuring its readiness (technology readiness level) and ecological validity. Addressing AI accountability is also critical to safeguarding clinicians and improving AI acceptance in the clinical workflow. This article summarizes the application of AI in NICU/PICU and consecutively identifies the existing flaws in AI (from clinicians’ standpoint), and proposes related recommendations, which, if addressed, can improve AIs’ readiness for a real clinical environment.
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Soltani N, Seyedrasooli A, Jabraeili M, Mousavi S. The effect of maternal multisensory stimulations on bath stress in premature infants: A randomized controlled clinical trial. Infant Behav Dev 2022; 67:101720. [PMID: 35561627 DOI: 10.1016/j.infbeh.2022.101720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 04/17/2022] [Accepted: 04/23/2022] [Indexed: 11/28/2022]
Abstract
Bathing in Neonatal Intensive Care Unit (NICU) is a stressful experience to preterm infants. Reducing this stress is an important challenge in bathing preterm infants. The aim of present study was to evaluate the effects of maternal supportive interventions on the stress caused by swaddled bathing in preterm infants. In this randomized clinical trial, 48 preterm infants randomly allocated into control and intervention groups. In intervention group the mothers were asked to initiate multisensory supportive interventions 5 min before and through swaddled bathing. In controls the mothers were only present during bathing. To determine the level of stress, infant responses were recorded by camera 5 min before bathing and 5 min after bathing. Then infants' stress measured by using Newborn Stress Scale (NSS). Finding was shown that the level of stress in control group was especially increased after bathing that was statistically significant (p < 0.001). Although there was an increase in stress among interventions but it was not statistically significant (p > 0.05). Considering the positive effects of multisensory interventions in decreasing the stress of preterm infants, it can be recommended as cost-free and non-pharmacological care during infants bathing.
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Affiliation(s)
- Nasim Soltani
- Master of Science Neonatal Intensive Care Nursing, Student Research Center of Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Alehe Seyedrasooli
- Department of Medical surgical, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Mahnaz Jabraeili
- Department of Pediatrics, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Saeed Mousavi
- Department of Statistics and Epidemiology, Tabriz University of Medical Sciences, Faculty of Health Sciences, Tabriz, Iran.
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Costa VS, Bündchen DC, Sousa H, Pires LB, Felipetti FA. Clinical benefits of music-based interventions on preterm infants' health: A systematic review of randomised trials. Acta Paediatr 2022; 111:478-489. [PMID: 34919292 DOI: 10.1111/apa.16222] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 11/26/2021] [Accepted: 12/15/2021] [Indexed: 11/29/2022]
Abstract
AIM This systematic review aimed to differentiate and isolate the results of different music-based interventions used with preterm infants in the neonatal intensive care unit and explore their clinical benefits. METHODS The last search was performed on 5 July 2021 on Web of Science, Scopus, EMBASE, PsycINFO, CINAHL, LILACS and CENTRAL. Only randomised clinical trials that explored the health benefits of music-based interventions were considered. RESULTS A total of 39 studies were included. All music-based interventions were divided into music medicine and music therapy. The overall results suggested that music medicine interventions were associated with a significant improvement in pain relief; in turn, improvements in cardiac and respiratory function, weight gain, eating behaviour, and quiet alert and sleep states were more consistent in studies that followed a music therapy approach with the presence of a music therapist. CONCLUSION This review supports the beneficial effects of music-based interventions on the health of preterm infants in a neonatal intensive care unit; however, it also offers suggestions for future studies in order to increase the number of interventions with music therapists, since the results of music therapy approaches were more consistent for physiological and behavioural outcomes.
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Affiliation(s)
- Victor Seabra Costa
- Department of Health Sciences Federal University of Santa Catarina (UFSC) Araranguá Brazil
| | | | - Helena Sousa
- Department of Education and Psychology Center for Health Technology and Services Research (CINTESIS.UA) University of Aveiro Aveiro Portugal
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Yoo GE, Hong SJ, Chong HJ. Nighttime Walking with Music: Does Music Mediate the Influence of Personal Distress on Perceived Safety? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031383. [PMID: 35162401 PMCID: PMC8835712 DOI: 10.3390/ijerph19031383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 01/22/2022] [Accepted: 01/24/2022] [Indexed: 02/04/2023]
Abstract
There is growing interest in identifying the environmental factors that contribute to individuals’ perceptions of safety and sense of well-being in public spaces. As such, this study examined how music listening during nighttime walking influenced female university students’ psychological state and perceptions of their campus. A total of 178 female university students with a mean age of 23.0 years participated in this study. One group of 78 students listened to prerecorded music while walking across their campus at night, while the other 100 students did not listen to music during nighttime walking. Immediately following their nighttime walking, participants were asked to rate their psychological state, perceptions on the safety of their campus, and the music (only for the music-listening group). For the non-music-listening group, significant correlations were found between the perceived safety of the campus and psychological states (both anxiety and psychological distress); the correlations were not significant in the music-listening group. The results indicate that music can mediate psychological states, supporting the proactive use of music as a psychological resource for coping with their perceptions of adverse environments. Given the limitations of this preliminary study, further studies with controlled music listening conditions, type of music, and environmental issues are suggested.
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Affiliation(s)
- Ga Eul Yoo
- Department of Music Therapy, Graduate School, Ewha Womans University, Seoul 03760, Korea;
| | - Sung Jin Hong
- KU Program in Urban Regeneration, Graduate School, Korea University, Seoul 02841, Korea;
- Strategic Sales HQ Consulting Group, S-1 Corporation, Seoul 04511, Korea
| | - Hyun Ju Chong
- Department of Music Therapy, Graduate School, Ewha Womans University, Seoul 03760, Korea;
- Correspondence:
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Adegboro CO, Choudhury A, Asan O, Kelly MM. Artificial Intelligence to Improve Health Outcomes in the NICU and PICU: A Systematic Review. Hosp Pediatr 2022; 12:93-110. [PMID: 34890453 DOI: 10.1542/hpeds.2021-006094] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
CONTEXT Artificial intelligence (AI) technologies are increasingly used in pediatrics and have the potential to help inpatient physicians provide high-quality care for critically ill children. OBJECTIVE We aimed to describe the use of AI to improve any health outcome(s) in neonatal and pediatric intensive care. DATA SOURCE PubMed, IEEE Xplore, Cochrane, and Web of Science databases. STUDY SELECTION We used peer-reviewed studies published between June 1, 2010, and May 31, 2020, in which researchers described (1) AI, (2) pediatrics, and (3) intensive care. Studies were included if researchers assessed AI use to improve at least 1 health outcome (eg, mortality). DATA EXTRACTION Data extraction was conducted independently by 2 researchers. Articles were categorized by direct or indirect impact of AI, defined by the European Institute of Innovation and Technology Health joint report. RESULTS Of the 287 publications screened, 32 met inclusion criteria. Approximately 22% (n = 7) of studies revealed a direct impact and improvement in health outcomes after AI implementation. Majority were in prototype testing, and few were deployed into an ICU setting. Among the remaining 78% (n = 25) AI models outperformed standard clinical modalities and may have indirectly influenced patient outcomes. Quantitative assessment of health outcomes using statistical measures, such as area under the receiver operating curve (56%; n = 18) and specificity (38%; n = 12), revealed marked heterogeneity in metrics and standardization. CONCLUSIONS Few studies have revealed that AI has directly improved health outcomes for pediatric critical care patients. Further prospective, experimental studies are needed to assess AI's impact by using established implementation frameworks, standardized metrics, and validated outcome measures.
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Affiliation(s)
- Claudette O Adegboro
- Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
| | - Avishek Choudhury
- Division of Engineering Management, School of Systems and Enterprise, Stevens Institute of Technology, Hoboken, New Jersey
| | - Onur Asan
- Division of Engineering Management, School of Systems and Enterprise, Stevens Institute of Technology, Hoboken, New Jersey
| | - Michelle M Kelly
- Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
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Mikulis N, Inder TE, Erdei C. Utilising recorded music to reduce stress and enhance infant neurodevelopment in neonatal intensive care units. Acta Paediatr 2021; 110:2921-2936. [PMID: 34107110 DOI: 10.1111/apa.15977] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 06/02/2021] [Accepted: 06/08/2021] [Indexed: 12/01/2022]
Abstract
AIM This paper summarises published evidence on the use of recorded music in high-risk infants to reduce stress and improve neurodevelopment, forming recommendations for proposed clinical applications in neonatal intensive care units. METHODS We searched two comprehensive library catalogues and two databases for articles evaluating the impact of recorded music interventions on hospitalised preterm infants. Original and review papers published in English in the 10 years prior to this search were selected if the study included a component of recorded music interventions. RESULTS Most original studies (80.95%) and all literature reviews (100%) reported positive effects of recorded music interventions for preterm infants, primarily in the short term. No negative effects were reported. Evidence is emerging regarding the neurobiological mechanisms of recorded music on longer-term effects on preterm infant neurodevelopment. Clinical applications were suggested drawing upon available evidence. Due to generally small sample sizes and variability in study design, unanswered questions remain. CONCLUSION Carefully designed recorded music interventions appear to be safe, feasible and effective in reducing stress and improving neurodevelopment of hospitalised infants. Additional rigorous, well-powered trials with relevant outcomes are needed to further refine specific elements for recorded music interventions to better inform practice.
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Affiliation(s)
- Nicole Mikulis
- Brigham and Women's Hospital, Pediatric Newborn Medicine Boston Massachusetts USA
| | - Terrie E. Inder
- Brigham and Women's Hospital, Pediatric Newborn Medicine Boston Massachusetts USA
- Harvard Medical School Boston Massachusetts USA
| | - Carmina Erdei
- Brigham and Women's Hospital, Pediatric Newborn Medicine Boston Massachusetts USA
- Harvard Medical School Boston Massachusetts USA
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Hasegawa Y, Hoshiyama M. Effect of environmental music on autonomic function in infants in intensive and growing care units. J Neonatal Perinatal Med 2021; 13:395-401. [PMID: 31771074 DOI: 10.3233/npm-180174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND The aim of this study is (1) to observe the effect of the background music (BGM) in the incubator on heart rate variability (HRV) during the first few weeks of life in preterm infants in the neonatal intensive (NICU) and growing care units (GCU) and (2) to investigate the effect of environmental music on autonomic function in the infants. METHODS Thirty infants, including premature (26 3/7 - 38 4/7 weeks) and low-birth weight (LBW) (946-2,440 g) infants, admitted to the NICU or GCU were involved. The heart rate, low- (LF, 0.05-0.15 Hz) and high- (HF, 0.15-0.4 Hz) frequency HRV components, and LF/HF ratio were measured. The BGM, lullabies for a baby, was delivered through a speaker in the incubator, and the HRV components were compared among before, during, and after intervention with BGM. RESULTS The mean HR did not change among the experimental conditions. The LF and HF values decreased during the BGM condition, but not LF/HF, compared with the condition before BGM. CONCLUSIONS The present results showed that an auditory environment affected the autonomic function of infants with a range of BGM in the NICU/GCU. The present study also suggested that BGM, a non-invasive and non-pharmacological intervention, could be an evaluation tool for autonomic function in infants in NICU/GCU.
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Affiliation(s)
- Y Hasegawa
- Department of Rehabilitation Sciences, Graduate School of Health Sciences, Nagoya University, Nagoya, Japan
| | - M Hoshiyama
- Brain and Mind Research Center, Nagoya University, Higashi-ku, Nagoya, Japan
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15
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Lafferty MA, Mackley A, Green P, Ottenthal D, Locke R, Guillen U. Can Mozart Improve Weight Gain and Development of Feeding Skills in Premature Infants? A Randomized Trial. Am J Perinatol 2021; 40:793-798. [PMID: 34157772 DOI: 10.1055/s-0041-1731279] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The study aimed to assess in a prospective randomized study the effect of Mozart's music on time to regain birth weight (BW) and development of oral feeding skills in babies born between 280/7 and 316/7 weeks of gestation. STUDY DESIGN Healthy premature infants born between 280/7 and 316/7 completed weeks of gestation were randomized within 3 days of birth to either music or no music exposure. Infants in the music group were exposed to Mozart's double piano sonata twice per day for 14 days. The primary outcome was time to regain birth weight. The secondary outcome was development of oral feeding skills as evaluated by a speech/language pathologist blinded to the intervention. We hypothesized that exposure to Mozart's double piano sonata would decrease time to regain BW and improve feeding skills. A total of 32 newborns were needed to detect a 3-day difference in time to regain BW. RESULTS Forty infants were enrolled and randomized. There were no significant differences between the two groups regarding the time to regain BW (p = 0.181) and the time to achievement of full oral feeds (p = 0.809). CONCLUSION Exposure to Mozart's double piano sonata for 14 days after birth did not significantly improve time to regain BW or time to achieve full oral feedings in very premature infants. It is possible that Mozart's music has no effect or that the duration of music exposure was not sufficient to have a physiologic effect on growth and oral feeding skills. KEY POINTS · Classical music improves the medical condition of adults.. · Music decreases neonatal resting energy expenditure.. · Music exposure did not significantly impact weight gain.. · This clinical relevance warrants further evaluation..
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Affiliation(s)
- Margaret A Lafferty
- Department of Pediatrics, Christiana Care Health System, Newark, Delaware.,Department of Pediatrics, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Amy Mackley
- Department of Pediatrics, Christiana Care Health System, Newark, Delaware
| | - Pam Green
- Department of Pediatrics, Christiana Care Health System, Newark, Delaware
| | - Deborah Ottenthal
- Department of Pediatrics, Christiana Care Health System, Newark, Delaware
| | - Robert Locke
- Department of Pediatrics, Christiana Care Health System, Newark, Delaware.,Department of Pediatrics, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Ursula Guillen
- Department of Pediatrics, Christiana Care Health System, Newark, Delaware.,Department of Pediatrics, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania
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16
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Shabnam J, Mahsa A, Manoochehr M, Sonia O. Effect of music on the growth monitoring of low birth weight newborns. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2021. [DOI: 10.1016/j.ijans.2021.100312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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17
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Foroushani SM, Herman CA, Wiseman CA, Anthony CM, Drury SS, Howell MP. Evaluating physiologic outcomes of music interventions in the neonatal intensive care unit: a systematic review. J Perinatol 2020; 40:1770-1779. [PMID: 32737404 DOI: 10.1038/s41372-020-0756-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 06/02/2020] [Accepted: 07/22/2020] [Indexed: 11/09/2022]
Abstract
Music is widely used in the neonatal intensive care unit. The objectives of this systematic review are: (1) clarify the current literature in regards to the impact of music on neonatal physiologic parameters, (2) highlight the variability in definitions utilized for music interventions, and (3) provide a foundation for future music therapy research focused on influencing neonatal physiology. A systematic literature review was conducted in accordance with PRISMA guidelines, with search terms including "music," "music therapy," "neonates," "newborn," and "NICU." Four hundred and fifty-eight studies were reduced to 16 clinical trials divided based on methodological description of music intervention. Our review highlights variability in the existing literature specifically on neonatal physiological impact of music. Future studies should focus on consistent and well-defined data collection, utilization of standardized definitions for music interventions, and consideration of more sensitive markers of physiology, such as heart rate variability, to enhance study rigor and reproducibility.
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Affiliation(s)
| | - Cade A Herman
- School of Science and Engineering, Tulane University, New Orleans, LA, USA
| | - Carlie A Wiseman
- School of Science and Engineering, Tulane University, New Orleans, LA, USA
| | | | - Stacy S Drury
- Department of Psychiatry, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Pediatrics, Tulane University School of Medicine, New Orleans, LA, USA
| | - Meghan P Howell
- Department of Pediatrics, Tulane University School of Medicine, New Orleans, LA, USA.
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18
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Montero-Ruiz A, Fuentes LA, Pérez Ruiz E, García-Agua Soler N, Rius-Diaz F, Caro Aguilera P, Pérez Frías J, Martín-Montañez E. Effects of music therapy as an adjunct to chest physiotherapy in children with cystic fibrosis: A randomized controlled trial. PLoS One 2020; 15:e0241334. [PMID: 33125399 PMCID: PMC7598495 DOI: 10.1371/journal.pone.0241334] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Accepted: 10/12/2020] [Indexed: 11/18/2022] Open
Abstract
Airway clearance therapy (ACT) is considered an important approach to improve airway clearance in children with cystic fibrosis (CF). Daily ACT administration requires substantial commitments of time and energy that complicate ACT and reduce its benefits. It is crucial to establish ACT as a positive routine. Music therapy (MT) is an aspect of integrative strategies to ameliorate the psycho-emotional consequences of chronic diseases, and a MT intervention could help children with CF between the ages of 2 and 17 develop a positive response. The aim of this randomized controlled trial was to evaluate the effects of specifically composed and recorded instrumental music as an adjunct to ACT. We compared the use of specifically composed music (Treated Group, TG), music that the patient liked (Placebo Group, PG), and no music (Control Group, CG) during the usual ACT routine in children with CF aged from 2 to 17. The primary outcomes, i.e., enjoyment and perception of time, were evaluated via validated questionnaires. The secondary outcome, i.e., efficiency, was evaluated in terms of avoided healthcare resources. Enjoyment increased after the use of the specifically composed music (children +0.9 units/parents +1.7 units; p<0.05) compared to enjoyment with no music (0 units) and familiar music (+0.5 units). Perception of time was 11.1 min (±3.9) less than the actual time in the TG (p<0.05), 3.9 min (±4.2) more than the actual time in the PG and unchanged in the CG. The potential cost saving related to respiratory exacerbations was €6,704.87, while the cost increased to €33,524.35 in the CG and to €13,409.74 in the PG. In conclusion, the specifically composed, played and compiled instrumental recorded music is an effective adjunct to ACT to establish a positive response and is an efficient option in terms of avoided costs. Trial registered as ISRCTN11161411. ISRCTN registry (www.isrctn.com).
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Affiliation(s)
- Alberto Montero-Ruiz
- Departamento de Farmacología y Pediatría, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga, Facultad de Medicina, Málaga, Spain
- Consejería de Educación, Junta de Andalucía, Delegación Territorial de Málaga, Málaga, Spain
| | - Laura A. Fuentes
- Departamento de Farmacología y Pediatría, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga, Facultad de Medicina, Málaga, Spain
| | - Estela Pérez Ruiz
- Departamento de Farmacología y Pediatría, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga, Facultad de Medicina, Málaga, Spain
- Hospital Regional Universitario de Málaga, Sección de Neumología Pediátrica, Málaga, Spain
| | - Nuria García-Agua Soler
- Departamento de Farmacología y Pediatría, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga, Facultad de Medicina, Málaga, Spain
| | - Francisca Rius-Diaz
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Málaga, Facultad de Medicina, Málaga, Spain
| | - Pilar Caro Aguilera
- Departamento de Farmacología y Pediatría, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga, Facultad de Medicina, Málaga, Spain
- Hospital Regional Universitario de Málaga, Sección de Neumología Pediátrica, Málaga, Spain
| | - Javier Pérez Frías
- Departamento de Farmacología y Pediatría, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga, Facultad de Medicina, Málaga, Spain
- Hospital Regional Universitario de Málaga, Sección de Neumología Pediátrica, Málaga, Spain
- * E-mail: (EM-M); (JPF)
| | - Elisa Martín-Montañez
- Departamento de Farmacología y Pediatría, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga, Facultad de Medicina, Málaga, Spain
- * E-mail: (EM-M); (JPF)
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19
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Bertsch M, Reuter C, Czedik-Eysenberg I, Berger A, Olischar M, Bartha-Doering L, Giordano V. The "Sound of Silence" in a Neonatal Intensive Care Unit-Listening to Speech and Music Inside an Incubator. Front Psychol 2020; 11:1055. [PMID: 32528386 PMCID: PMC7264369 DOI: 10.3389/fpsyg.2020.01055] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 04/27/2020] [Indexed: 11/18/2022] Open
Abstract
Background: The intrauterine hearing experience differs from the extrauterine hearing exposure within a neonatal intensive care unit (NICU) setting. Also, the listening experience of a neonate drastically differs from that of an adult. Several studies have documented that the sound level within a NICU exceeds the recommended threshold by far, possibly related to hearing loss thereafter. The aim of this study was, first, to precisely define the dynamics of sounds within an incubator and, second, to give clinicians and caregivers an idea about what can be heard “inside the box.” Methods: Audio recordings within an incubator were conducted at the Pediatric Simulation Center of the Medical University Vienna. They contained recorded music, speech, and synthesized sounds. To understand the dynamics of sounds around and within the incubator, the following stimuli were used: broadband noise with decreasing sound level in 10 steps of 6 dB, sine waves (62.5, 125, 250, 500, 1000, 2000, 4000, 8000, and 16,000 Hz), logarithmic sweep (Chirp) over the frequency band 20 Hz to 21 kHz, singing male voice, singing, and whispering female voice. Results: Our results confirm a protective effect of the incubator from noises above 500 Hz in conditions of “no-flow” and show almost no protective effect of an incubator cover. We, furthermore, observed a strong boost of low frequencies below 125 Hz within the incubator, as well as a notable increase of higher frequency noises with open access doors, a significant resonant effect of the incubator, and a considerable masking effect of the respiratory support against any other source of noise or sound stimulation even for “low-flow” conditions. Conclusion: Our study reveals high noise levels of air supply at high flow rates and the boost of low frequencies within the incubator. Education of medical staff and family members as well as modifications of the physical environment should aim at reducing noise exposure of preterm infants in the incubator. Audiovisual material is provided as Supplementary Material.
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Affiliation(s)
- Matthias Bertsch
- Department of Music Physiology, University of Music and Performing Arts Vienna, Vienna, Austria
| | | | | | - Angelika Berger
- Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Monika Olischar
- Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Lisa Bartha-Doering
- Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Vito Giordano
- Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
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20
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Maternal and Neonatal Hair Cortisol Levels and Psychological Stress Are Associated With Onset of Secretory Activation of Human Milk Production. Adv Neonatal Care 2019; 19:E11-E20. [PMID: 31764138 DOI: 10.1097/anc.0000000000000660] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Several factors can influence the production of mothers' own milk. PURPOSE To assess the influence of maternal psychological stress, maternal cortisol levels, and neonatal hair cortisol levels on timing of secretory activation. METHODS A prospective study was conducted at 2 public health centers in Andalusia, Spain. Participants were 60 pregnant women and their 60 neonates. Hair cortisol levels and psychological stress (pregnancy-specific stress [Prenatal Distress Questionnaire, PDQ] and perceived stress [Perceived Stress Scale, PSS]) were evaluated during the third trimester and the postpartum period. This study was part of the GESTASTRESS cohort study on the effects of stress during pregnancy. RESULTS Higher PDQ and PSS scores (P < .05) in the third trimester were associated with later onset of secretory activation. Higher postpartum maternal hair cortisol levels were associated with a delayed secretory activation of mother's own milk (P < .05). IMPLICATIONS FOR RESEARCH Future studies should look at the influence of psychological stress and cortisol levels on hormones involved in mother's own milk production. IMPLICATIONS FOR PRACTICE Neonatal nurses and other healthcare providers should be familiar with levels of neonates' exposure to maternal prenatal stress prior to birth.
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21
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Multimodal Neurological Enhancement Intervention for Self-regulation in Premature Infants. Adv Neonatal Care 2019; 19:E3-E11. [PMID: 30946037 DOI: 10.1097/anc.0000000000000595] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND The neonatal intensive care unit is often a noisy, overstimulating environment that disrupts infants' regulation of physiological and behavioral states and interrupts caregiver bonding; however, infants benefit from early intervention, including the use of multimodal neurological enhancement (MMNE) intervention to provide appropriate neurodevelopmental stimulation. No one has investigated whether it assists infants in self-regulation. PURPOSE The purpose of this retrospective longitudinal analysis was to examine the effect of a music therapy intervention, MMNE, on self-regulation of premature infants as measured by changes in heart rate (HR). METHODS A convenience sample of 60 premature infants received 486 MMNE sessions provided by a board-certified music therapist (MT-BC). Documentation, taken during routine clinical services, involved recording infant's HRs from the standard monitor for 3 minutes at baseline, during, and after a 20-minute MMNE intervention. RESULTS Infants' mean HRs were decreased during and post-MMNE sessions compared with baseline (P < .004 and P < .001, respectively). Furthermore, infants with a baseline HR above 170 had significant decreases both during and after the MMNE session (P < .001 for both time periods). IMPLICATIONS FOR PRACTICE Results of this study support the existing body of evidence showing the benefits of MMNE with premature infants. Based on our results, MMNE may help infants develop and demonstrate self-regulation as indicated by maintained HRs during and after the intervention as well as a lowered HR for infants who had high HRs prior to MMNE. IMPLICATIONS FOR RESEARCH Further research needs to be done regarding how infants process MMNE and its potential to aid sensory processing.
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Abstract
BACKGROUND Perinatal substance exposure is an increasing concern in infants being cared for in neonatal intensive care units. Current recommendations support nonpharmacologic treatments for this population of infants. Multimodal (motion, sound) seats are often employed to soothe infants. PURPOSE The purpose of this study was to survey neonatal intensive care unit nurses on their practices regarding the use of a motion/sound infant seat. METHODS Sixty-six nurses (52% of 126 total nurses) completed the survey about their self-disclosed practices that included (1) reasons for use; (2) rationale for choice of settings of motion and sound; (3) duration of time infants spent in seat in one session; (4) perception of positive infant response; (5) who places infants in the seat; and (6) nursing instructions dispensed prior to use. RESULTS Chief reasons for use were infant state, lack of persons to hold infants, and a diagnosis of neonatal abstinence syndrome. Rationale for choice of motion and sound settings included trial and error, prior settings, personal preferences/patterns, assumptions, and random selection. Nurse responses regarding the amount of time the infant was placed in the seat in a single session ranged from 10 to 360 minutes, with determining factors of infant cues, sleeping, feeding, and someone else to hold the infant. IMPLICATIONS FOR PRACTICE As nonpharmacologic treatments evolve, nurses need guidelines for safe, effective interventions to care for infants. IMPLICATIONS FOR RESEARCH Further research is necessary to ascertain the responses of withdrawing infants and to establish guidelines and education for use of the motion/sound infant seat.
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23
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Caparros-Gonzalez RA, Romero-Gonzalez B, Quesada-Soto JM, Gonzalez-Perez R, Marinas-Lirola JC, Peralta-Ramírez MI. Maternal hair cortisol levels affect neonatal development among women conceiving with assisted reproductive technology. J Reprod Infant Psychol 2019; 37:480-498. [DOI: 10.1080/02646838.2019.1578949] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Rafael A. Caparros-Gonzalez
- Mind, Brain and Behavior Research Center (CIMCYC), Faculty of Psychology, University of Granada, Granada, Spain
- Department of Obstetrics and Gynaecology, Hospital de Poniente, Almeria, Spain
| | - Borja Romero-Gonzalez
- Mind, Brain and Behavior Research Center (CIMCYC), Faculty of Psychology, University of Granada, Granada, Spain
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Granada, Granada, Spain
| | - Juan M. Quesada-Soto
- Mind, Brain and Behavior Research Center (CIMCYC), Faculty of Psychology, University of Granada, Granada, Spain
| | - Raquel Gonzalez-Perez
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Granada, Granada, Spain
- Department of Pharmacology, CIBERehd, Instituto de Investigacion Biosanitaria ibs.GRANADA, School of Pharmacy, University of Granada, Granada, Spain
| | - Juan C. Marinas-Lirola
- Department of Pharmacology, CIBERehd, Instituto de Investigacion Biosanitaria ibs.GRANADA, School of Pharmacy, University of Granada, Granada, Spain
| | - María Isabel Peralta-Ramírez
- Mind, Brain and Behavior Research Center (CIMCYC), Faculty of Psychology, University of Granada, Granada, Spain
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Granada, Granada, Spain
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