PubMed · 7335838
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F Weil-Halpern, D Rapoport, C Griscelli. 1981. [Bubble babies].. https://pubmed.ncbi.nlm.nih.gov/7335838/
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CONTEXT: Interest in home-visitation services as a way of improving maternal and child outcomes has grown out of the favorable results of a trial in semirural New York. The findings have not been replicated in other populations. OBJECTIVE: To test the effect of prenatal and infancy home visits by nurses on pregnancy-induced hypertension, preterm delivery, and low birth weight; on children's injuries, immunizations, mental development, and behavioral problems; and on maternal life course. DESIGN: Randomized controlled trial. SETTING: Public system of obstetric care in Memphis, Tenn. PARTICIPANTS: A total of 1139 primarily African-American women at less than 29 weeks' gestation, with no previous live births, and with at least 2 sociodemographic risk characteristics (unmarried, <12 years of education, unemployed). INTERVENTION: Nurses made an average of 7 (range, 0-18) home visits during pregnancy and 26 (range, 0-71) visits from birth to the children's second birthdays. MAIN OUTCOME MEASURES: Pregnancy-induced hypertension, preterm delivery, low birth weight, children's injuries, ingestions, and immunizations abstracted from medical records; mothers' reports of children's behavioral problems; tests of children's mental development; mothers' reports of subsequent pregnancy, educational achievement, and labor-force participation; and use of welfare derived from state records. MAIN RESULTS: In contrast to counterparts assigned to the comparison condition, fewer women visited by nurses during pregnancy had pregnancy-induced hypertension (13% vs 20%; P=.009). During the first 2 years after delivery, women visited by nurses during pregnancy and the first 2 years of the child's life had fewer health care encounters for children in which injuries or ingestions were detected (0.43 vs 0.55; P=.05); days that children were hospitalized with injuries or ingestions (0.03 vs 0.16; P<.001); and second pregnancies (36% vs 47%; P=.006). There were no program effects on preterm delivery or low birth weight; children's immunization rates, mental development, or behavioral problems; or mothers' education and employment. CONCLUSION: This program of home visitation by nurses can reduce pregnancy-induced hypertension, childhood injuries, and subsequent pregnancies among low-income women with no previous live births.
OBJECTIVE: To evaluate whether sleeping in the supine position resulted in changes in gross or fine motor developmental milestones observed at routinely scheduled well-child checkups at 4 or 6 months of age. DESIGN: A retrospective chart review. SETTING: One private pediatric practice involving 2 full-time and 2 part-time board-eligible or board-certified pediatricians. SUBJECTS: The study included 343 full-term infants whose weights were appropriate or large for gestational age, had no history of hospitalization other than for normal newborn care, and were examined in the office for their 4-month well-child checkup within 2 weeks of being 4 months old. METHODS: The Denver Developmental Screening Test-Revised was administrated at the 4- and 6-month well-child checkups. The primary sleep positions of the infants were determined by telephone survey, office interview, or letter after the 6-month checkup was completed. Background data collected from the mother for each mother-infant pair included maternal age at the time of birth, parity, and marital status, Medicaid status and ethnicity of the infant, and whether the infant was breast-fed. RESULTS: Infants who slept in the side or supine position were less likely to roll over at the 4-month checkup than infants who slept primarily in the prone position (P < .001). No significant differences were found when comparison by maternal age, parity, or marital status, Medicaid status or ethnicity of the infant, or the use of breast-feeding were considered. Other motor milestones screened did not show statistically significant changes. CONCLUSIONS: Sleep position significantly influences the age of achieving the gross motor developmental milestone of rolling over; infants who sleep in the side or supine position roll over later than infants who sleep in the prone position.
There has been recent interest in the idea that principles governing learning in connectionist networks can form the basis for an alternative understanding of developmental processes (Elman, Bates, Karmiloff-Smith, Johnson, Parisi, & Plunkett, 1996). The present paper can be viewed as a case example of the usefulness (and limitations) of connectionist modeling for the study of infant cognition. Specifically, the paper reports on a series of connectionist models designed to analyze the factors responsible for the emergence of global-level and basic-level category representations in young infants. The models (1) simulated the formation of global-level and basic-level representations, (2) revealed a global-to-basic order of category emergence, (3) uncovered the formation of two distinct global-level representations-an initial "self-organizing" perceptual global level and a subsequently "trained" arbitrary (i.e., nonperceptual) global level, and (4) displayed a gradual transition from perceptual global-level to perceptual basic-level representation with increasing exposure to training stimuli. Hypotheses for empirical investigations of category development in infants that follow from the modeling efforts are discussed.