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Background/Objectives: Preterm infants are at a high risk of neurodevelopmental impairments due to immature brain development and the stressors of the neonatal intensive care unit (NICU) environment. To improve outcomes, incorporating a neuropromotion strategy by promoting nurturing encounters (NEs) is essential. Methods: In this 48-bed tertiary perinatal care center, an informal survey showed that staff lacked consistent knowledge about sensory neurodevelopment, while parents expressed a need for clearer guidance. This paper describes the development and implementation of the Sensory Developmental Care Map (SDCM) as part of a larger quality-improvement initiative. The SDCM is an educational tool designed to guide NICU staff and families in providing neuroprotective and neuropromotive care, based on the infant’s gestational age (GA). The SDCM was created by integrating evidence on sensory development across GAs and providing practical strategies to promote positive sensory input while protecting the developing brain. The map visually indicates when to protect or stimulate each sense, offering clear, developmentally appropriate guidance. Printed and digital versions of the map were made accessible to families and staff, with bedside copies and a poster displayed in the unit. Results: A post-implementation evaluation is ongoing, but preliminary feedback suggests that the SDCM improved the family understanding of sensory developmental care. The SDCM serves as a valuable resource for promoting appropriate sensory input for preterm infants and further enhancing developmentally supportive care within the NICU.

Background The General Movements Assessment is a non-invasive and cost-effective tool with demonstrated reliability for identifying infants at risk for cerebral palsy. Early detection of cerebral palsy allows for the implementation of early intervention and is associated with better functional outcomes. No review to date has summarized the utility of the General Movements Assessment to predict cerebral palsy in term and late-preterm infants diagnosed with neonatal encephalopathy. Methods We conducted a scoping review involving infants born greater than or equal to 34 weeks gestational age to identify all available evidence and delineate research gaps. We extracted data on sensitivity, specificity, and positive and negative predictive values and described the strengths and limitations of the results. We searched five databases (MEDLINE, Embase, PsychINFO, Scopus, and CINAHL) and the General Movements Trust website. Two reviewers conducted all screening and data extraction independently. The articles were categorized according to key findings, and a critical appraisal was performed. Results Only three studies, a cohort and two case series, met all of the inclusion criteria. The total number of participants was 118. None of the final eligible studies included late-preterm neonates. All three studies reported on sensitivity, specificity, and positive predictive and negative predictive values. An abnormal General Movement Assessment at 3–5 months has a high specificity (84.6–98%) for cerebral palsy with a similarly high negative predictive value (84.6–98%) when it was normal. Absent fidgety movements, in particular, are highly specific (96%) for moderate to severe cerebral palsy and carry a high negative predictive value (98%) when normal. In the time period between term and 4–5 months post-term, any cramped synchronized movements had results of 100% sensitivity and variable results for specificity, positive predictive value, and negative predictive value. Conclusions A normal General Movements Assessment at 3 months in a term high-risk infant is likely associated with a low risk for moderate/severe cerebral palsy. The finding of cramped synchronized General Movements is a strong predictor for the diagnosis of cerebral palsy by 2 years of age in the term population with neonatal encephalopathy. The deficit of high-quality research limits the applicability, and so the General Movements Assessment should not be used in isolation when assessing this population. Systematic review registration Title registration with Joanna Briggs Institute. URL: http://joannabriggswebdev.org/research/registered_titles.aspx .

The General Movements Assessment requires extensive training. As an alternative, a novel automated movement analysis was developed and validated in preterm infants. Infants < 31 weeks’ gestational age or birthweight ≤ 1500 g evaluated at 3–5 months using the general movements assessment were included in this ambispective cohort study. The C-statistic, sensitivity, specificity, positive predictive value, and negative predictive value were calculated for a predictive model. A total of 252 participants were included. The median gestational age and birthweight were 274/7 weeks (range 256/7–292/7 weeks) and 960 g (range 769–1215 g), respectively. There were 29 cases of cerebral palsy (11.5%) at 18–24 months, the majority of which (n = 22) were from the retrospective cohort. Mean velocity in the vertical direction, median, standard deviation, and minimum quantity of motion constituted the multivariable model used to predict cerebral palsy. Sensitivity, specificity, positive, and negative predictive values were 55%, 80%, 26%, and 93%, respectively. C-statistic indicated good fit (C = 0.74). A cluster of four variables describing quantity of motion and variability of motion was able to predict cerebral palsy with high specificity and negative predictive value. This technology may be useful for screening purposes in very preterm infants; although, the technology likely requires further validation in preterm and high-risk term populations.

Background Prediction of long-term neurodevelopmental outcomes remains an elusive goal for neonatology. Clinical and socioeconomic markers have not proven to be adequately reliable. The limitation in prognostication includes those term and late-preterm infants born with neonatal encephalopathy. The General Movements Assessment tool by Prechtl has demonstrated reliability for identifying infants at risk for neuromotor impairment. This tool is non-invasive and cost-effective. The purpose of this study is to identify the published literature on how this tool applies to the prediction of cerebral palsy in term and late-preterm infants diagnosed with neonatal encephalopathy and so detect the research gaps. Methods We will conduct a systematic scoping review for data on sensitivity, specificity, positive, and negative predictive value and describe the strengths and limitations of the results. This review will consider studies that included infants more than or equal to 34 + 0 weeks gestational age, diagnosed with neonatal encephalopathy, with a General Movements Assessment done between birth to six months of life and an assessment for cerebral palsy by at least 2 years of age. Experimental and quasi-experimental study designs including randomized controlled trials, non-randomized controlled trials, before and after studies, interrupted time-series studies and systematic reviews will be considered. Case reports, case series, case control, and cross-sectional studies will be included. Text, opinion papers, and animal studies will not be considered for inclusion in this scoping review as this is a highly specific and medical topic. Studies in the English language only will be considered. Studies published from at least 1970 will be included as this is around the time when the General Movements Assessment was first introduced in neonatology as a potential predictor of neuromotor outcomes. We will search five databases (MEDLINE, Embase, PsychINFO, Scopus, and CINAHL). Two reviewers will conduct all screening and data extraction independently. The articles will be categorized according to key findings and a critical appraisal performed. Discussion The results of this review will guide future research to improve early identification and timely intervention in infants with neonatal encephalopathy at risk of neuromotor impairment. Systematic review registration Title registration with Joanna Briggs Institute https://joannabriggs.org/ebp/systematic_review_register .

ObjectiveTo apply automated movement analysis to the general movements assessment (GMA) to build a predictive model for motor impairment (MI).Study designA retrospective cohort study including infants ≤306/7 weeks GA or BW ≤1500 g seen at 3–5 months was conducted. Automated video analysis was used to develop a multivariable model to identify MI, defined as Bayley motor composite score <85 or cerebral palsy (CP).ResultsOne hundred and fifty two videos were analyzed. Median GA and BW were 275/7 weeks and 955 g, respectively. MI and CP rates were 22% (N = 33) and 14% (N = 22). Minimum, mean, and mean vertical velocity of the infant’s silhouette correlated significantly with MI. Sensitivity, specificity, positive and negative predictive values, and accuracy of automated GMA were 79%, 63%, 37%, 91%, and 66%, respectively. C-statistic indicated good fit (C = 0.77).ConclusionsAutomated movement analysis predicts MI in preterm infants. Further refinement of this technology is required for clinical application.

ObjectiveTo assess the predictive value of trajectories and individual assessment of quality of general movements (AQGM) for identification of neurodevelopmental impairment (NDI) at 18–24 months corrected age (CA) in infants <30 weeks gestational age and/or birth weight <1500 g.MethodsIn this retrospective cohort study, AQGM at 6 weeks and 3 months CA were scored and categorized as normal (N) or abnormal (A). AQGM measures were compared with degree of NDI and Bayley Scales of Infant Development, Third Edition (BSID-III) composite motor and cognitive scores. ‘Persistently abnormal’ AQGM included both mildly abnormal (MA) and definitely abnormal (DA) assessments. A “modified AQGM” where MA assessments were considered normal variant/transient injury was used to conduct post-hoc analysis.ResultsAcross 244 cases, persistently abnormal AQGM trajectory predicted the level of NDI (OR 2.5, 95% CI 1.2, 5.1) compared to AQGM trajectory that normalized. However, using the “modified AQGM”, persistently DA trajectories were associated with significantly lower BSID-III composite motor and cognitive scores (p < 0.001 and p = 0.039, respectively).ConclusionCategorizing MA assessments as transient injury increased the predictive value of AQGM trajectories and significantly predicted lower cognitive and motor scores at 18–24 months CA.

Forty-four ELBW ($\\le$1000 grams) were enrolled in a study to examine the relationship of Bronchopulmonary Dysplasia (BPD) on outcome measures of cognitive, fine and gross motor development from 4 months to 2 years corrected age. There were no significant differences between those infants with BPD and those without BPD on the Movement Assessment of Infants, the Bayley Scales of Infant Development and the Peabody Developmental Motor Scales. Perinatal variables that significantly correlated with BPD were those which related to the length of hospitalization, the amount of time on oxygen and mechanical ventilation as well as an increased incidence of Retinopathy of Prematurity (ROP), Intraventricular Haemorrhage (IVH), and Periventricular Echogenicity (PVE). The MAI at 4 and 8 months was examined and found to be predictive of one year outcome. The overall corrected prediction rate of the MAI with the Bayley Scales and the PDMS Fine and Gross Motor was poor.

Background Prediction of long-term neurodevelopmental outcomes remains an elusive goal for neonatology. Clinical and socioeconomic markers have not proven to be adequately reliable. The limitation in prognostication includes those term and late-preterm infants born with neonatal encephalopathy. The General Movements Assessment tool by Prechtl has demonstrated reliability for identifying infants at risk for neuromotor impairment. This tool is non-invasive and cost-effective. The purpose of this study is to identify the published literature on how this tool applies to the prediction of cerebral palsy in term and late-preterm infants diagnosed with neonatal encephalopathy and so detect the research gaps. Methods We will conduct a systematic scoping review for data on sensitivity, specificity, positive and negative predictive value and describe the strengths and limitations of the results. This review will consider studies that included infants more than or equal to 34+0 weeks gestational age, diagnosed with neonatal encephalopathy, with a General Movements Assessment done between birth to six months of life and an assessment for cerebral palsy by at least two years of age. Experimental and quasi-experimental study designs including randomized controlled trials, non-randomized controlled trials, before and after studies, interrupted time-series studies and systematic reviews will be considered. Case reports, case series, case control and cross-sectional studies will be included. Text, opinion papers and animal studies will not be considered for inclusion in this scoping review as this is a highly specific and medical topic. Studies in the English language only will be considered. Studies published from at least 1970 will be included as this is around the time when the General Movements Assessment was first introduced in neonatology as a potential predictor of neuromotor outcomes. We will search five databases (MEDLINE, Embase, PsychINFO, Scopus and CINAHL). Two reviewers will conduct all screening and data extraction independently. The articles will be categorized according key findings and a critical appraisal performed. Discussion The results of this review will guide future research to improve early identification and timely intervention in infants with neonatal encephalopathy at risk of neuromotor impairment.

In public opinion, social and digital media provide means for influence as well as sorting according to pre-existing values. Here we consider types of media usage versus opinion using new polling results in the former Soviet republics (FSRs) of Belarus, Ukraine, and Georgia. Over 1000 individuals in each country were asked about a news event (the January 6 riot at the U.S. Capitol) and about the long-term future of their country. We find that year of birth and country of residence, rather than self-reported media reliance, consistently predicted the respondents’ views, particularly on the future of their country. The timing of these differences suggests a cultural difference between generations growing up in the Soviet Union (likely more pro-Russian) versus afterward, in an FSR (more pro-Western). Whereas digital media choice is somewhat correlated with perceptions of a recent, international news event, the more predictive factors are longer-term cultural values and age cohorts within each nation.

IntroductionIn patients with advanced persistent atrial fibrillation the optimal ablation strategy during redo procedures is unknown. The utility of posterior wall isolation (PWI) in addition to pulmonary vein isolation (PVI) in these patients remains uncertain.Methods44 patients with PeAF or longstanding PeAF (mean age 63 ± 7.9 years, 77% male, median time since AF diagnosis 22.5 months, median indexed LA volume 36 ml/m2) were randomised to index radiofrequency PVI followed by protocol mandated redo at 2 months including PWI (PVI+PWI group) vs index cryoballoon PVI followed by protocol mandated redo without PWI (PVI-only group). Patients were followed-up with daily handheld ECG monitoring for 12 months, and quality of life (QOL) was assessed at baseline and 12 months using the EQ5D visual analogue scale (0 = worst, 100 = best).Results38 patients underwent both procedures (n=17 PVI-only, n=21 PVI+PWI). Over median 338 days of follow-up, there was no difference in arrhythmia recurrence between the groups (PVI+PWI 38.1% vs PVI-only 41.2%; HR 0.84 [95% CI 0.31–2.33]; p=0.743). QOL was similar at baseline (median 70 per group, p=0.383), improved to 83 with PVI-only (p=0.041 vs baseline) and 80 with PVI+PWI (p=0.046 vs baseline), and did not differ between arms (p=0.616). QOL improved significantly in those without arrhythmia recurrence (p=0.005), but not in those with recurrence (p=0.158).ConclusionPatients with advanced persistent atrial fibrillation have a high rate of arrhythmia recurrence following PVI, even with a repeat invasive procedure to ensure PVI durability. Addition of PWI does not appear to improve outcomes. QOL improvement may depend upon ablation success.Abstract 102 Figure 1Kaplan-Meier curves for PVI only vs PVI+PWIConflict of InterestNone