Publications by authors named "Karen A Thomas"

Article Synopsis
  • The study investigates how parents perceive and experience seeking help for infant sleep issues.
  • Parents often face uncertainty about infant sleep and may feel their concerns are manageable, leading to delays or reluctance in seeking professional help.
  • The research highlights that inadequate information and unsatisfactory healthcare experiences can deter parents from pursuing medical advice for their infant's sleep problems.
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The influence of light and maternal activity on early infant activity rhythm were studied in 43 healthy, maternal-infant pairs. Aims included description of infant and maternal circadian rhythm of environmental light, assessing relations among of activity and light circadian rhythm parameters, and exploring the influence of light on infant activity independent of maternal activity. Three-day light and activity records were obtained using actigraphy monitors at infant ages 4, 8, and 12 weeks.

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Purpose: To study the relation of infant characteristics and home environment on maternal sleep, depression, and fatigue in late postpartum.

Study Design And Methods: Forty-two healthy mother-infant dyads completed a home-based study at infant age 32 weeks. Maternal measures included Patient Reported Outcomes Measurement Information System (PROMIS) sleep and wake disturbance, depression, and fatigue scales.

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The study of infant and mother circadian rhythm entails choice of instruments appropriate for use in the home environment as well as selection of analytic approach that characterizes circadian rhythm. While actigraphy monitoring suits the needs of home study, limited studies have examined mother and infant rhythm derived from actigraphy. Among this existing research a variety of analyses have been employed to characterize 24-h rhythm, reducing ability to evaluate and synthesize findings.

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Background: Mutual circadian rhythm is an early and essential component in the development of maternal-infant physiological synchrony.

Aims: The aim of this to examine the longitudinal pattern of maternal-infant circadian rhythm and rhythm synchrony as measured by rhythm parameters.

Study Design: In-home dyadic actigraphy monitoring at infant age 4, 8, and 12 weeks.

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Article Synopsis
  • Amplitude-integrated EEG (aEEG) is being used more frequently in research involving premature infants, but there's a need for clearer methods to interpret the data effectively.
  • The study aimed to develop operational measures to assess the brain function of neonates by focusing on continuity and discontinuity in aEEG recordings obtained in a NICU setting.
  • Results showed specific measures like bandwidth, peak counts, and signal amplitudes, which offer new ways to quantify aEEG data, potentially enhancing the understanding and application of this technology in both research and clinical environments.
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Background Parents' stress resulting from hospitalization of their infant in the neonatal intensive care unit (NICU) produces emotional and behavioral responses. The National Institutes of Health-sponsored Patient Reported Outcomes Measurement Information System (PROMIS) offers a valid and efficient means of assessing parents' responses. Objective To examine the relationship of stress to anxiety, depression, fatigue, and sleep disruption among parents of infants hospitalized in the NICU.

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In this pilot study we examined the relationship between objective and subjective sleep disturbances and depressive symptoms in 22 healthy primiparous postpartum women within 3 months after delivery. We found that none of the women in our study had clinically significant depression scores on the Edinburgh Postnatal Depression Scale; nonetheless, a variable duration of night-time sleep from night to night during the 7-day monitoring period and reported awakening too early were significantly correlated with increased depressive symptoms. Results suggest that first-time mothers who complain of irregular night-time sleep duration and waking up too early should be screened and evaluated for potential postpartum depressive symptoms.

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Objectives: To examine the association among nighttime sleep and daytime napping behaviors, depressive symptoms, and perception of fatigue in pregnant women.

Design: A prospective descriptive study with within-subject design.

Setting: A university-affiliated hospital and participants' home environments.

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Aim: This article is a report of an exploratory study of the relation between light exposure and circadian rest-activity patterns in infants.

Background: Ambient light is a major environmental stimulus for regulation of circadian rhythm of sleep and wake in adults, but few studies have been conducted to examine environmental light exposure in relation to rest-activity circadian rhythm parameters of infants.

Methods: An intensive within-subject design was used with a convenience sample of 22 infants (mean postnatal age 49·8 days) who wore a combined light and activity monitoring device for seven consecutive days at home.

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Article Synopsis
  • Continuous real-time brain function monitoring in preterm infants is now possible using noninvasive hydrogel electrodes and amplitude-integrated electroencephalography (aEEG), which could enhance the evaluation of their neurological development.
  • The study involved 16 medically stable preterm infants and examined factors affecting aEEG accuracy, such as skin preparation and post-electrode placement skin condition.
  • Improvements were achieved in electrode placement, recording duration, and maintaining low skin impedance, demonstrating the effectiveness of aEEG as a reliable, noninvasive monitoring tool in neonatal care without causing skin irritation.
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Purpose: To create a thermal map of ambient air, radiant, and evaporative temperatures and humidity throughout the NICU nursery by season across a calendar year.

Subjects: Each cubicle of the 32-bed NICU, distributed across 5 rooms, in a level III nursery was measured.

Methods: Temperatures were recorded at a consistent time on one day during January, April, July, and October.

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Neonates in the neonatal intensive care nursery experience multiple, painful, tissue-damaging procedures daily. Pain among neonates is often underestimated and untreated, producing untoward consequences. A literature review established strong evidence supporting the use of sucrose as an analgesic for minor procedural pain among neonates.

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Objective: Entrainment to the day-night cycle is critical for infant sleep and social development. Synchronization of infant circadian systems with the social 24-hr day may require maternal activity signals as an entraining cue. This descriptive and exploratory research examines the activity level and circadian pattern in mothers and infants.

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Purpose: To create a thermal map of ambient air, radiant, and evaporative temperatures and humidity throughout the NICU nursery by season across a calendar year.

Subjects: Each cubicle of the 32-bed NICU, distributed across 5 rooms, in a level III nursery was measured.

Methods: Temperatures were recorded at a consistent time on one day during January, April, July, and October.

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Purpose: The purpose of the study was to determine the number of days of diary data collection needed to reliably measure mother and infant sleep-wake pattern.

Study Design And Methods: Twenty healthy adult mothers and their healthy term gestation infants age 4 to 10 weeks postnatal participated in a single group, cross-sectional design. Mothers completed a paper and pencil sleep-wake diary divided into 15-minute time periods.

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The purpose of this study was to assess feasibility and acceptability of using a diaper pad for collection of in-home infant urinary samples and to test the accuracy of diaper pad extraction for 6-sulfatoxymelatonin and creatinine, which was used to correct assay results for urinary volume. To assess feasibility and acceptability, urine samples from 20 infants were collected over a 24-hr day using a cotton pad inserted in the diaper. The accuracy of diaper pad extraction was evaluated in the laboratory using urine samples collected from 11 adult volunteers and assayed using enzyme immunosorbent assay (EIA).

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Neonatal ICU research poses unique concerns for infants and parents. Children are considered a vulnerable research population. Federal regulations specify special protections when children participate in research.

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Correspondence between infant actigraphy and mother-recorded diary differed significantly when receiver-operator function area under the curve, correlation, and logistic regression was calculated with and without excluding periods of external motion. External motion occurred in 40% of recording time and significantly changed activity count per epoch.

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Objective: To further understand state development of preterm infants throughout hospitalization and the effects of selected infant characteristics on state development.

Design: Secondary data analysis of a 2-group, experimental design study.

Setting: Two nurseries in a Northwest medical center.

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Background: Adequate light exposure is critical for entraining circadian rhythms, regulating sleep-wake cycles, and maintaining optimal mood. Yet, few studies have reported normative data on light exposure experiences in postpartum women and young infants; none has examined the two simultaneously.

Objectives: The objective of this pilot study was to document the 24-h light exposure experiences in postpartum women and their infants.

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Article Synopsis
  • The study examines how nursing care impacts sleep and wake states in preterm infants, comparing results by gender.
  • At 34 weeks postmenstrual age, there were no significant differences in sleep and wake states between male and female infants, but male infants showed a much higher rate of state change.
  • By discharge, male infants experienced nearly twice as much caregiving and had a greater response in state change to that caregiving compared to females, indicating potential gender differences that warrant further investigation.
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