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Biomedical subjects

M S Miles

Publications and source records attributed to M S Miles.

At least 19 recordsLinked to original sources
PubMed2004

Historical polycyclic aromatic and petrogenic hydrocarbon loading in Northern Central Gulf of Mexico shelf sediments.

The distribution of selected hydrocarbons within ten dated sediment cores taken from the Mississippi River Bight off coastal Louisiana suggests a chronic contaminant loading from several sources including the river itself, oil and gas exploration in the central Gulf of Mexico (GOM) shelf area, and natural geologic hydrocarbon seeps. Data were grouped as either total polycyclic aromatic hydrocarbons (PAH's), which were indicative of pyrogenic PAH's; or estimated total hopanes (indicative of petrogenic hydrocarbons). The total PAH concentrations and estimated total hopanes begin increasing above background levels (approximately 200 ng g(-1)) after the 1950s. The distribution of these hydrocarbons and hopanes within the dated sediment cores suggests that the Mississippi River is a regional source of pyrogenic PAH's, and that the hopanes are from natural geologic hydrocarbon seeps, oil and gas exploration in the GOM, or both.

Atlantic Ocean↗
PubMed2001

Developmental outcomes of infants with bronchopulmonary dysplasia: comparison with other medically fragile infants.

The purpose of this study was to compare the developmental outcomes and mother-infant interactions of infants with bronchopulmonary dysplasia (BPD) and those of other medically fragile infants. One-hour behavioral observations were made of the interactions of mothers with two groups of infants (23 with BPD, 39 medically fragile without BPD or neurological problems) at enrollment, every 2 months during hospitalization, 1 month after discharge, and at 6 months' and 12 months' corrected age. Assessment of the home environment also was done at 6 and 12 months. Multiple regressions were calculated separately for child mental, adaptive, language, and motor outcomes. Predictors were: home environment assessment, measures of maternal interactive behaviors (positive attention, expression of negative affect, medicalized caregiving), infant group membership, and presence of intraventricular hemorrhage (IVH) in the infant. There were no significant differences between the two groups in any of the developmental outcomes or interactive variables, and the presence of IVH had no effect on these variables. Maternal positive attention and the home environment were correlated with mental development, and mother negative affect was related to adaptive behavior for both groups. Differences in developmental and interactive behaviors between infants with BPD and other prematurely born infants found in other studies appear to be a result of chronic health problems and, thus, are not unique to infants with BPD.

Bronchopulmonary Dysplasia↗
PubMed2000

Feeding and non-feeding interactions of mothers and prematures.

The interactions between mothers and premature infants during feeding and nonfeeding periods were explored. Twenty-nine premature infants and their mothers were observed interacting for 1 hour in their homes at 6 months corrected for prematurity. Mothers were more likely to engage in the following behaviors involving close contact during feeding: looking at the infant, holding the infant, having body contact, and rocking their infants. They interacted with their infants 96% of feeding time. During nonfeeding periods, they were more likely to engage in more distal behaviors (e.g., gesturing, touching, and playing with the infant) and spent only 67% of the time interacting with the infant. Infants were more likely to be alert, vocalize, play with objects, express negative affect, and locomote during nonfeeding, and they were more likely to be drowsy or asleep during feeding. Therefore, a complete understanding of interactions between mothers and prematures can only come from examining both feeding and nonfeeding periods.

Adult↗
PubMed2000

Mothers' stories about their experiences in the neonatal intensive care unit.

The purpose of this article is to let mothers tell the stories of their neonatal intensive care unit (NICU) experiences and to determine how well these experiences fit the Preterm Parental Distress Model. Interviews were conducted with 31 mothers when their infants were six months of age corrected for prematurity and were analyzed using the conceptual model as a framework. The analysis verified the presence in the data of the six major sources of stress indicated in the Preterm Parental Distress Model: (1) pre-existing and concurrent personal and family factors, (2) prenatal and perinatal experiences, (3) infant illness, treatments, and appearance in the NICU, (4) concerns about the infant's outcomes, (5) loss of the parental role, and (6) health care providers. The study indicates that health care providers, and especially nurses, can have a major role in reducing parental distress by maintaining ongoing communication with parents and providing competent care for their infants.

Adult↗
PubMed1999

The nurse parent support tool.

This report describes the development of an instrument, the Nurse-Parent Support Tool (NPST) designed to measure parents' perception of nursing support during their child's hospitalization. The NPST was based on the Nurse Parent Support Model developed from House's conceptualizations of four domains of support. Thus, the 21-item NPST assesses four dimensions of support: (1) supportive communication and provision of information related to the child's illness, treatments, care, and related issues; (2) parental esteem support focused on respecting, enhancing, and supporting the parental role; (3) emotional support to help the parents cope with their own emotional responses and needs related to the child's illness; and (4) caregiving support involving the quality of care provided to the child. Strong support for the content validity of the NPST derives from the steps used in constructing the instrument. This includes use of a conceptual framework, generating items from the literature, using data from interviews with parents of hospitalized children, and pilot testing with parents and experts. Factor analysis provides support for the underlying construct and significant correlations with another instrument measuring a similar construct provides support for the concurrent validity. The internal consistency reliability is very high. The NPST holds promise for use in nursing research and quality improvement programs in pediatric and neonatal in-patient settings.

Adult↗
PubMed1999

African American mothers' responses to hospitalization of an infant with serious health problems.

PURPOSE: To describe African American mothers' experiences related to the hospitalization of an infant with serious health problems. DESIGN: Retrospective descriptive. SAMPLE: 19 African American mothers with premature and term infants who were hospitalized at birth for serious health problems related to sequelae of prematurity or birth defect. MAIN OUTCOME VARIABLE: African American mothers' recollections about the hospitalization of their seriously ill infant. RESULTS: The mothers worried primarily about when the baby could go home. Their greatest source of stress was separation from the infant. Seeing their sick infant was also stressful and evoked shock, fear, denial, guilt, and helplessness. Mothers sought hope by seeking information and cues from the infant and by praying to God. Mothers established a relationship with their infant by visiting regularly and by learning how to care for him. Some mothers feared getting attached to an infant who might die. Mothers' highest source of satisfaction was support from the health care team.

Adaptation, Psychological↗
PubMed1997

Parenting the prematurely born child: pathways of influence.

Recognizing the importance of parents in the lives of preterm infants, investigators and clinicians have increasingly focused on the needs of parents during the period when their infant is hospitalized in a neonatal intensive care unit and the impact of this experience on their subsequent parenting. The purpose of this report is to summarize research findings from over two decades of research, present a framework for understanding the various influences on parents of prematurely-born children, and suggest clinical interventions that are important in helping parents both in the hospital and after discharge.

Affective Symptoms↗
PubMed1997

Coping and support effects on mothers' stress responses to their child's hematopoietic stem cell transplantation.

A hematopoietic stem cell transplantation (HSCT) is used as a treatment for cancer or nonmalignant hematological disorders in children. Little information is known about how an HSCT affects the mothers of these patients. The purposes of this repeated measures study were to examine the stress responses of mothers at four times during their child's hospitalization for an HSCT and to determine the relationships among mothers' stress responses and the resources for coping and social support. Maternal anxiety mean scores decreased significantly over time although a majority of the mothers had moderately high anxiety scores at all times. Mean scores of mothers' depressive symptomatologies decreased significantly over time. A majority of the mothers had depressive symptomatology scores above the cut-off score that indicates being at-risk for developing depression. At each of four data collection times, a specific coping style (defined as active reviewing of feelings or information associated with the situation) significantly explained the variance in mothers' scores for anxiety, depressive symptomatology, somatic complaints, and sleep behavior. Social support significantly explained differences in depressive symptomatology scores only at data collection times 1 and 3. Health care providers need to assess mothers for stress responses and assist them in dealing with their feelings and in understanding the information associated with an HSCT.

Adaptation, Psychological↗
PubMed1997

Maternal recall of the neonatal intensive care unit.

This study examined how mothers of prematurely born three-year-old children retrospectively recall their responses to their infant's hospitalization in the neonatal intensive care unit (NICU). Forty-four mothers of three-year-old prematurely born children were interviewed as part of a longitudinal study. Data from maternal interviews were analyzed using the analytic inductive method. Findings support the hypotheses that were based on the Parental Stress in the ICU model. Three years after the birth of their premature infants, mothers reported vivid memories of stress related to the appearance and behavior of their infants, the pain and procedures the infants endured, alterations in their role as parents, and stress related to the infant's illness severity and uncertainty about infant outcomes. Prenatal problems, such as high-risk pregnancy or birth, infant loss, and disturbances in family support, were also recalled as sources of stress. Findings have implications for family-centered nursing care in NICUs.

Adult↗
PubMed1997

Parenting the prematurely born child.

The purpose of this chapter is to summarize the findings of the nursing research on parenting the prematurely born child. This research focused on eight general areas: impact of the home environment on infant development status, the relationship between premature infants and their mothers during the first 2 years, parenting during hospitalization, maternal concerns about infant discharge, fathering, subpopulations of premature infants, parenting after the first 2 years, and interventions to improve parenting. There is a need to strengthen the design and conceptualization of these studies, to move toward more intervention research, and to do research that is more culturally sensitive, especially toward fathers, ethnic and cultural minority groups, and the poor.

Child↗
PubMed1996

Sources of support reported by mothers and fathers of infants hospitalized in a neonatal intensive care unit.

Over the past two decades, awareness of the importance of social support for individuals faced with a major life transition or a stressful event has increased. The purpose of this study was to identify the perceptions of mothers and fathers of critically ill infants about the helpfulness of support provided to them by family, health care professionals, and other when their infants were in a neonatal intensive care unit (NICU). Social support in this study is conceptualized as the interpersonal transactions that parents of preterm infants perceive as helpful in reducing their stress and coping with their child's illness. Data were collected using the Illness Support Scale, on which subjects rated the helpfulness of support from individuals across their network. Findings indicate that these parents experienced a moderately high level of support and perceived NICU nurses as very helpful. Nurses need to continue to develop their role in helping families by identifying specific supportive interventions.

Adaptation, Psychological↗
PubMed1995

Melatonin rhythms in Atlantic salmon (Salmo salar) maintained under natural and out-of-phase photoperiods.

Diel changes in circulating melatonin were measured in juvenile Atlantic salmon, Salmo salar, maintained under natural and out-of-phase seasonal photocycles. Under natural daylengths of autumn, winter, spring, and summer circulating melatonin levels were inversely related to light intensity, with levels low during the day and high at night. The duration of the nocturnal increase in circulating melatonin was related to the duration of darkness, i.e., longer in winter than in summer. Under simulated seasonal photocycles circulating melatonin concentrations measured in August, October, and December were also elevated for the duration of darkness, irrespective of whether the photoperiods were synchronized or 6 months out-of-phase with the natural light and temperature cycles. Circulating melatonin also provided an accurate representation of the prevailing photoperiod in fish initially maintained on simulated natural photocycles, either synchronized or 6 months out-of-phase with the natural light cycle, and then held for 3 months on daylengths approximating the summer and winter solstices. Well-defined melatonin rhythms were always present, irrespective of time of year, photoperiod, and temperature. The amplitude of the nocturnal increase in circulating melatonin was similar in groups of fish maintained under simulated seasonal photoperiods 6 months out-of-phase with each other, but otherwise identical conditions, indicating that daylength per se did not influence the amplitude of the melatonin rhythm. The amplitude of the melatonin rhythm was slightly higher during the summer months, suggesting that temperature may modify circulating melatonin levels. These results demonstrate that circulating melatonin profiles always reflect the prevailing daylength and hence have the potential to provide the Atlantic salmon with accurate information on daily and calendar time, which could be utilised to time daily and seasonal events.

Animals↗
PubMed1995

A longitudinal study of the role of sociodemographic factors and childhood aggression on adolescent injury and "close calls".

PURPOSE: This study examined the: (1) relationships among gender, race, and socioeconomic status and the incidence of adolescent injury and "close calls" (near accidents); (2) ability of childhood aggression to predict injury and "close calls" during adolescence; and (3) characteristics of injury and "close-call" events, including contributing mechanisms and risk-taking behaviors. METHODS: Subjects were a subsample (N = 271) of the Carolina Longitudinal Study who reported an injury (48%) or "close-call" (52%) during a 9th, 10th, or 11th grade interview (mean age 16.3 years); 52% were female and 23% African American. They were recruited beginning at grade 4 and grade 7 and were interviewed annually. RESULTS: More males than females reported an injury (chi 2 = 4.97, p < .05); motor vehicles and sports were major contributors. Caucasian females reported more injuries (chi 2 = 3.90, p < .05) and "close calls" (X2 = 4.13, p < .05) than African American females. More males than females reported risk-taking behaviors associated with injuries (chi 2 = 4.35, p < .05) and "close calls" (X2 = 4.29, p < .05), especially Caucasians. Logistic regression demonstrated that childhood aggression was a robust predictor of adolescent injury and "close calls." CONCLUSIONS: Reports of "close calls" by a majority of the sample suggest that mortality and morbidity statistics in this age group may underestimate the vulnerability of youth to serious injury. These results further add risk for physical injury in adolescence to the sequalae of childhood aggression. These findings suggest the need for the incorporation of injury prevention into school curriculum and activities of all children, but especially for children assessed as aggressive.

Accidents, Traffic↗
PubMed1995

Compensatory parenting: how mothers describe parenting their 3-year-old, prematurely born children.

Premature infants and their mothers experience difficulties in establishing their relationships. The effect of these early problems on later parenting is not known. This study explored whether mothers' recollections surrounding the birth and hospitalization of a preterm infant affected their perceptions and their parenting of these children at 3 years of age. Twenty-seven primary caregivers of 30 prematurely born children completed three questionnaires on their perceptions of their children and were interviewed about parenting experiences. The core concept identified in analysis was compensatory parenting, a parenting style in which mothers provided special experiences and avoided others in an attempt to compensate the children for their neonatal experiences. Compensatory parenting was influenced by the view of these prematurely born children as both special and normal and by salient prenatal, labor, and delivery experiences; memories of the neonatal intensive care unit experience; the sequelae of emotional responses to these experiences; and subsequent health problems after discharge. Prospective research is needed to further study compensatory parenting and to develop interventions.

Adaptation, Psychological↗
PubMed1994

Caring for gravely ill children.

BACKGROUND: Much has been written about the care of the hopelessly ill adult, but there is little guidance for pediatric health care professionals in the management of children who are critically or terminally ill. METHODS: Through a 3-day meeting in Tarrytown, NY, attended by a group of pediatricians and others directly involved in these issues, a principled approach was developed for the treatment of, and health care decision-making for, children who are gravely ill. RESULTS: The group agreed that the needs and interests of the child must be the central focus of any treatment plan and that the child should be involved to as great extent possible, consistent with developmental maturity, in the decision-making process. Quality of future life should be viewed as being relevant in all decisions. Parents are believed to be the natural guardians of children and ought to have great latitude in making decisions for them. However, parental discretion is not absolute and professionals must maintain an independent obligation to protect the child's interests. CONCLUSIONS: Decision-making should be collaborative among patient, parents, and professionals. When conflict arises, consultation and ethics committees may assist in resolution. When cure or restoration of function is no longer possible, or reasonable, promotion of comfort becomes the primary goal of management. Optimal use of pain medication and compassionate concern for the physical, psychological, and spiritual well-being of the child and family should be the primary focus of the professionals caring for the dying child.

Adolescent↗
PubMed1994

Maternal perception of illness severity in premature infants.

This study examines relationships between the actual severity of the premature infant's medical condition, maternal perception of the severity of the infant's illness, the infant's birth weight, and maternal anxiety levels. Subjects for this study were 44 mothers who were part of a larger study of parental stress in neonatal intensive care units (NICUs). The premature infants of these mothers were hospitalized in the NICU of a large southeastern university medical center at the time of data collection. Mothers completed a severity perception scale and the State-Trait Anxiety Inventory. Data about actual severity of each infant's illness and about the infant's characteristics were collected from the medical chart. The findings indicate that maternal perceptions regarding the severity of their premature infants' illness are complex and are influenced by different factors at different points in time. A significant relationship was not found between the mother's recollection of infant severity at NICU admission and maternal perceptions at the time of the interview, two to five days after admission. Although maternal recall of the severity of the infant's illness on admission is not related to anxiety, perceptions of severity at the time of the interview (two to five days after admission) are related to anxiety scores.

Adolescent↗
PubMed1992

The stress response of mothers and fathers of preterm infants.

Differences in neonatal intensive care unit (NICU) environmental stress, uncertainty, and anxiety of 23 mothers and fathers (couples) whose premature infants were hospitalized in an NICU were explored. Alterations in the parental role were found to be stressful for both mothers and fathers, with mothers reporting significantly greater stress in this area than did fathers. Stress and uncertainty decreased significantly over time. Mothers and fathers did not differ in level of anxiety. Findings suggest that both mothers and fathers are distressed by the admission of a premature to an NICU; however, mothers may be more distressed by certain aspects of the experience.

Adolescent↗