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Peter A. Gorski

Bio: Peter A. Gorski is an academic researcher from Northwestern University. The author has contributed to research in topics: Intensive care unit & Developmental Diagnostic. The author has an hindex of 4, co-authored 6 publications receiving 77 citations.

Papers
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Journal ArticleDOI
TL;DR: Findings suggest that medical or "developmental" tactile stimulation presented when the infant was already physiologically compromised (with low pO2) may potentiate an underlying vulnerability to bradycardia.

41 citations

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TL;DR: In this article, the authors review and critique historical and contemporary research and practice on neonatal developmental intervention and provide theoretic and empiric rationales for understanding and planning clinical programs on behalf of infant and family recovery from high-risk birth.

16 citations

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TL;DR: The need for measures that are more predictive based on infant behavior is highlighted and a discussion of a number of experimental techniques that seem to hold great promise for developmental prediction and clinical application are discussed.
Abstract: Recognizing the impressive range of behavioral capacities of newborn infants, clinicians and researchers have long searched for valid assessment instruments to help evaluate infant behavior. Behavioral assessments with high predictive validity would aid the goals of developmental diagnostic, prognostic, and treatment programs for infants born at risk from biological or environmental circumstances. The failure of current assessments to predict developmental outcome based on infant behavior may be due to the limited information about higher central nervous system (CNS) functioning obtained from available measures, or to the very dynamic nature of CNS organization in young infants. We begin our review by discussing some major functional characteristics of neonates and then proceed to describe critically the commonly used methods of neurological and behavioral assessment. Noting the need for measures that are more predictive, we turn next to a discussion of a number of experimental techniques that seem to hold great promise for developmental prediction and clinical application. J Dev Behav Pediatr 8:39–50, 1987. Index terms: neonatal assessment, newborn behavior, developmental prediction.

11 citations

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TL;DR: The cause and nature of change in infant status is reviewed and the increasing demand for supporting stages of neuromaturation and social-emotional development during hospitalization is attempted to reconcile with current limited understanding of how fragile infants process and respond to interventions.
Abstract: Contempary neonatal intensive care units treat infants with very different medical conditions from those of a decade ago Approaches to ensuring optimal outcome following highrisk birth must reflect the changing conditions and needs of these infants This paper will review the cause and nature of change in infant status and attempt to reconcile the increasing demand for supporting stages of neuromaturation and social-emotional development during hospitalization with our current limited understanding of how fragile infants process and respond to interventions Special cautions will be directed to well-meaning caregivers who may unwittingly jeopardize infant health and development by implementing new clinical models without empirical support Opportunities for integrating psychosocial and medical care of these infants will also be highlighted.

6 citations


Cited by
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Journal ArticleDOI
01 Mar 1994-Pain
TL;DR: Children who had been extremely premature, and thereby experienced prolonged hospitalization and repeated medical intervention in infancy, had clinically high somatization scores on the Personality Inventory for Children, and the importance of maternal factors in relation to somatized was confirmed.
Abstract: In a prospective study of 36 children who were extremely low birthweight (ELBW: < 1000 g) preterm infants and 36 matched full-term controls, differences were found in somatization at age 4 1/2 years. Only children who had been extremely premature, and thereby experienced prolonged hospitalization and repeated medical intervention in infancy, had clinically high somatization scores on the Personality Inventory for Children. The combination of family relations at age 4 1/2 years, neonatal intensive care experience, poor maternal sensitivity to child cues in mother-child interaction observed at age 3 years, and child avoidance of touch or holding at age 3, predicted somatization scores, prior to school entry. Due to the known higher incidence of actual medical problems among children with a history of extreme prematurity, the high somatization ELBW children were compared with the normal somatization ELBW children. There were no differences in prevalence of actual medical problems between the 2 ELBW groups, and the importance of maternal factors in relation to somatization was confirmed. Child temperament at age 3, but not personality at 4 1/2, was related to somatization. The etiology of recurrent physical complaints of no known medical cause appears to be a multi-dimensional problem. Non-optimal parenting may contribute to the development of inappropriate strategies for coping with common pains of childhood, or of chronic pain patterns, in some children who have experienced prolonged or repeated pain as neonates.

287 citations

Journal ArticleDOI
TL;DR: Evidence that massage for preterm infants is of benefit for developmental outcomes is weak and does not warrant wider use of preterm infant massage, and serious concerns about the methodological quality of the included studies weaken credibility.
Abstract: Background It has been argued that infants in Neonatal Intensive Care Units are subject both to a highly stressful environment - continuous, high-intensity noise and bright light - and to a lack of the tactile stimulation that they would otherwise experience in the womb or in general mothering care. As massage seems to both decrease stress and provide tactile stimulation, it has been recommended as an intervention to promote growth and development of preterm and low-birth weight infants. Objectives To determine whether preterm and/or low birth-weight infants exposed to massage experience improved weight gain and earlier discharge compared to infants receiving standard care; to determine whether massage has any other beneficial or harmful effects on this population. Search methods The following databases were searched: the specialized register of the Cochrane Neonatal Review Group and that of the Cochrane Complementary Medicine Field. Searches were also undertaken of the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 3, 2003), MEDLINE, EMBASE, Psychlit, CINAHL and Dissertation Abstracts International (up to July 1, 2003). Further references were obtained by citation tracking, checking personal files and by correspondence with appropriate experts. Data provided in published reports was supplemented by information obtained by correspondence with authors. There were no language restrictions. Selection criteria Randomised trials in which infants with gestational age at birth <37 weeks or weight at birth <2500g received systematic tactile stimulation by human hands. At least one outcome assessing weight gain, length of stay, behaviour or development must be reported. Data collection and analysis Data extracted from each trial were baseline characteristics of sample, weight gain, length of stay and behavioural and developmental outcomes. Physiological and biochemical outcomes were not recorded. Data were extracted by three reviewers independently. Statistical analysis was conducted using the standard Cochrane Collaboration methods. Main results Massage interventions improved daily weight gain by 5.1g (95% CI 3.5, 6.7g). There is no evidence that gentle, still touch is of benefit (increase in daily weight gain 0.2g; 95% CI -1.2, 1.6g). Massage interventions also appeared to reduce length of stay by 4.5 days (95% CI 2.4, 6.5) though there are methodological concerns about the blinding of this outcome. There was also some evidence that massage interventions have a slight, positive effect on postnatal complications and weight at 4 - 6 months. However, serious concerns about the methodological quality of the included studies, particularly with respect to selective reporting of outcomes, weaken credibility in these findings. Authors' conclusions Evidence that massage for preterm infants is of benefit for developmental outcomes is weak and does not warrant wider use of preterm infant massage. Where massage is currently provided by nurses, consideration should be given as to whether this is a cost-effective use of time. Future research should assess the effects of massage interventions on clinical outcome measures, such as medical complications or length of stay, and on process-of-care outcomes, such as care-giver or parental satisfaction.

268 citations

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TL;DR: Calf lung surfactant extract instillation at birth appears to be an effective material and method of preventing hyaline membrane disease in extremely premature infants.

187 citations

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TL;DR: The NIDCAP approach seeks to support the infant's stabilization and organization of the autonomic, motor, and state systems at each level of maturation, while minimizing stressful events.

178 citations

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TL;DR: Kangaroo care satisfies in part the handling, self-consoling/soothing, nonnutritive sucking, and parenting interventions recommended by the National Association of Neonatal Nurses' Infant and Family Centered Developmental Care Guidelines.
Abstract: Kangaroo care (skin-to-skin holding) is an intervention that meets development care criteria by fostering neurobehavioral development. The five dimensions of neurobehavioral development are autonomic, motor, state, attention/interaction, and self-regulation. Kangaroo care promotes stability of heart and respiratory function, minimizes purposeless movements, improves behavioral state profiles, offers maternal proximity for attention/interaction episodes, and permits self-regulatory behavior expression. Kangaroo care satisfies in part the handling, self-consoling/soothing, nonnutritive sucking, and parenting interventions recommended by the National Association of Neonatal Nurses' Infant and Family-Centered Developmental Care Guidelines.

138 citations