human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background . Based on the general bonding hypothesis , it is suggested that kangaroo mother care ( KMC ) creates a climate in the family whereby parents become prone to sensitive caregiving . The general hypothesis is that skin-to-skin contact in the KMC group will build up a positive perception in the mothers and a state of readiness to detect and respond to infant 's cues . Method . The r and omized controlled trial was conducted on a set of 488 infants weighing < 2001 g , with 246 in the KMC group and 242 in the traditional care ( TC ) group . The design allows precise observation of the timing and duration of mother – infant contact , and takes into account the infant 's health status at birth and the socioeconomic status of the parents . Bonding Assessment . Two series of outcomes are assessed as manifestations of a mother 's attachment behavior . The first is the mother 's feelings and perceptions of her premature birth experience , including her sense of competence , feelings of worry and stress , and perception of social support . The second outcome is derived from observations of the mother and child 's responsivity to each other during breastfeeding at 41 weeks of gestational age . Interventions . KMC has three components . The first is the kangaroo position . Once the premature infant has adapted to extrauterine life and is able to breastfeed , he is positioned on the mother 's chest , in a upright position , with direct skin-to-skin contact . The second component is kangaroo nutrition . Although breastfeeding is the prime source of nutrition , infants also may receive preterm formula whenever necessary and vitamin supplements . The third component is the clinical control ; infants are monitored on a regular basis , daily until they are gaining at least 20 g per day . Afterward , weekly clinic visits are scheduled until term , which constitutes the ambulatory minimal neonatal care . In the TC group , infants are kept in incubators until they are able to self-regulate their temperature and are thriving ( ie , have an appropriate weight gain ) . Infants are discharged according to current hospital practice , usually not before their weight is ∼1700 g. Afterward , as with the KMC group , weekly clinic visits are scheduled until term . Results . We observed a change in the mothers ' perception of her child , attributable to the skin-to-skin contact in the kangaroo-carrying position . This effect is related to a subjective “ bonding effect ” that may be understood readily by the empowering nature of the KMC intervention . Moreover , in stressful situations when the infant has to remain in the hospital longer , mothers practicing KMC feel more competent than do mothers in the TC group . This is what we call a resilience effect . In these stressful situations we also found a negative effect on the feelings of received support of mothers practicing KMC . We interpret this as an isolation effect . To thwart this deleterious effect , we would suggest adding social support as an integral component of KMC . The observations of the mothers ' sensitive behavior did not show a definite bonding effect , but rather a resilience effect . This is attributable to the KMC intervention ; mothers practicing KMC were more responsive to an at-risk infant whose development has been threatened by a longer hospital stay . Otherwise , we observed that the mothers ( in both the KMC group and the TC group ) had behavioral patterns that were adapted to the child 's at-risk health status and to the precarious condition of some premature infants requiring intensive care . We conclude that the infant 's health status may be a more prominent factor in explaining a mother 's more sensitive behavior , which overshadows the kangaroo-carrying effect . Conclusion . These results suggest that KMC should be promoted actively and that mothers should be encouraged to use it as soon as possible during the intensive care period up to the 40 weeks of gestational age . Thus , KMC should be viewed as a means of humanizing the process of giving birth in a context of prematurity . This finding confirms the conclusions of the 1996 Trieste workshop suggesting that KMC should be promoted both in hospitals and after early discharge Abstract This study aims at assessing the effects of an early occupational therapy intervention on the cognitive development and the development of attachment patterns in ELBW infants . The intervention , given weekly at home from six months to 12 months , aim ed at supporting parent-child interaction and enhancing motor control and coordination . The study population consisted of 100 ELBW infants matched in pairs in accordance to their pre-perinatal risk scores and allocated successively to intervention or non-intervention groups .  Cognitive development was assessed with the Bayley Scales at age two and with the WPPSI at age four . Attachment to primary caregiver was assessed with the Preschool Assessment of Attachment ( PAA ) . Cognitive performance was within age norms in both groups at both ages . Intervention did not show any effect on cognitive performance at the age of two years . At the age of four years , cognitive level was overall , and most notably for verbal performance , higher in the intervention group than in the control group . There was an over-representation of the so-called atypical attachment patterns ( those not fitting the normative A , B , or C categories ) in the control group . The results are discussed in terms of finding more global ways to support the development of at risk pre-term children A recent federal law has exp and ed the eligibility for multidisciplinary evaluation and assessment of infants suspected of developmental delay . At the same time , modern neonatal care has increased infant survival . These two developments have created a need for family education regarding the need for health and developmental intervention , as well as counseling to maintain family participation in these services . This study compares the education and counseling services of a hospital-based case management team with the traditional discharge and follow-up services of a neonatal intensive care unit ( NICU ) .  Subjects were the 10 % most medically severe infants discharged from a neonatal intensive care unit over a 16-month period . Preliminary data suggests a significantly greater number of families accessed community-based , coordinated , comprehensive health and developmental services when they received case management services . The data suggest that hospital professionals generally refer the most medically severe 3 % of this group for services under a traditional model . However , the additional 7 % referred under the transition model showed greater developmental benefits from the services during the first 6 months of life . These data support current federal initiatives for early intervention services which are family-centered , community-based and coordinated This prospect i ve longitudinal study was design ed to evaluate the effects of a multidisciplinary infant development program ( IDP )  on the mental and physical development of low birth weight infants ( less than 1,800 g ) . Infants in the neonatal intensive care were r and omly assigned to the IDP or to traditional care ( control group ) . IDP infants received developmental interventions in the hospital and at home through the first 2 years of life . Counseling and parenting education were provided to their parents during this same period . The control group received all the postnatal care and referrals customarily given in traditional care . Both IDP and control infants were enrolled in an independent follow-up program , which used the Bayley Scales of Infant Development in a blind evaluation design . The IDP group had a significantly lower incidence of developmental delay ( P less than .05 ) and scored significantly higher than the control group ( P less than .05 ) on mean mental and physical indices at 12 and 24 months of adjusted age CONTEXT Most studies of the long-term effects of early childhood educational interventions are of demonstration programs rather than large-scale public programs . Previous studies of one of the oldest federally funded preschool programs have reported positive effects on school performance , but effects on educational attainment and crime are unknown . OBJECTIVE To determine the long-term effectiveness of a federal center-based preschool and school-based intervention program for urban low-income children . DESIGN , SETTING , AND PARTICIPANTS Fifteen-year follow-up of a nonr and omized , matched-group cohort of 1539 low-income , mostly black children born in 1980 and enrolled in alternative early childhood programs in 25 sites in Chicago , Ill. INTERVENTIONS The  Chicago Child-Parent Center ( CPC ) Program ( n = 989 children ) provides comprehensive education , family , and health services and includes half-day preschool at ages 3 to 4 years , half- or full-day kindergarten , and school-age services in linked elementary schools at ages 6 to 9 years . The comparison group ( n = 550 ) consisted of children who participated in alternative early childhood programs ( full-day kindergarten ) : 374 in the preschool comparison group from 5 r and omly selected schools plus 2 others that provided full-day kindergarten and additional instructional re sources and 176 who attended full-day kindergartens in 6 CPCs without preschool participation . MAIN OUTCOME MEASURES Rates of high school completion and school dropout by age 20 years , juvenile arrests for violent and nonviolent offenses , and grade retention and special education placement by age 18 years . RESULTS Relative to the preschool comparison group and adjusted for several covariates , children who participated in the preschool intervention for 1 or 2 years had a higher rate of high school completion ( 49.7 % vs 38.5 % ; P = .01 ) ; more years of completed education ( 10.6 vs 10.2 ; P = .03 ) ; and lower rates of juvenile arrest ( 16.9 % vs 25.1 % ; P = .003 ) , violent arrests ( 9.0 % vs 15.3 % ; P = .002 ) , and school dropout ( 46.7 % vs 55.0 % ; P = .047 ) . Both preschool and school-age participation were significantly associated with lower rates of grade retention and special education services . The effects of preschool participation  on educational attainment were greater for boys than girls , especially in reducing school dropout rates ( P = .03 ) . Relative to less extensive participation , children with extended program participation from preschool through second or third grade also experienced lower rates of grade retention ( 21.9 % vs 32.3 % ; P = .001 ) and special education ( 13.5 % vs 20.7 % ; P = .004 ) . CONCLUSIONS Participation in an established early childhood intervention for low-income children was associated with better educational and social outcomes up to age 20 years . These findings are among the strongest evidence that established programs administered through public schools can promote children 's long-term success BACKGROUND AND OBJECTIVE Care based on the Newborn Individualized Developmental Care and Assessment Program ( NIDCAP ) has been reported to exert a positive impact on the development of prematurely born infants . The aim of the present investigation was to determine the effect of such care on the 1-year development of infants born with a gestational age of less than 32 weeks . METHODS All surviving infants ( 11 in the NIDCAP group and 9 in the control group ) were assessed employing the Bayley Scales of Infant Development at 1 year of corrected age . RESULTS The Mental Developmental Index ( MDI ) of children who had received care according to NIDCAP was higher [ 88 ( 72 - 114 ) ] [ median ( range ) ] than the corresponding value for the control children [ 78 ( 50 - 82 ) ] ( p=0.01 ) . The odds ratio for being alive with an MDI>80 was 14 ( 95 % CI ; 1.4 - 141.5 ) in favour of the intervention group . However , the Psychomotor Developmental Indices ( PDI ) were not significantly different [ 85 ( 61 - 108 ) and 69 ( 50 - 114 ) , respectively ] ( p=0.23 ) . CONCLUSION Our findings indicate that care based on the NIDCAP might have a positive impact on the cognitive development of infants born very prematurely At a corrected age of 3 months , 80 low birth-weight infants were assigned to normal or at-risk groups on the basis of a neurodevelopmental assessment scale . Both groups were further divided into intervention and non-intervention sub-groups ( 20 infants in each ) . Intervention consisted of monthly hospital-based neurodevelopmental therapy in addition to a home exercise programme . Infants were re-assessed by a physiotherapist at 6 , 9 , and 12 months , and were tested at 12 months by an independent psychologist blinded for infant group . Mean birthweight and gestational age were similar for normal and at-risk groups . At-risk infants had higher mean neurodevelopmental scores throughout the study period and lower 1-year development quotients ( DQ ) than normals . In neither normal nor at-risk groups did neurodevelopmental therapy alter the pattern of development or the outcome Effects of high participation in the Infant Health and Development Program ( IHDP ) , an 8-site r and omized trial that targeted low-birth-weight ( LBW ) premature infants ( N=1,082 ) , were estimated . Children in the treatment group were offered high- quality center-based care in their 2nd and 3rd years of life ( full-day care , 50 weeks per year ) . High-dosage effects were estimated with a new methodology that found a matched comparison group within the follow-up group for those with high participation rates ; these estimates were compared with traditional intention-to-treat ( ITT ) estimates . At age 8 , effects on the Wechsler Intelligence Scale for Children Full and Verbal scales for children who attended > 400 days ranged from 7 to 10 points . For the heavier LBW infants ( 2,001 - 2,500 g ) , the effects were about 14 points for > 400 days ; for the lighter LBW infants ( < or = 2,000 g ) , the effects were about 8 points . These effects were all substantially higher than corresponding ITT effects . Similar but smaller effects were found for children who attended > 350 days Aims : To test the effectiveness of a home based developmental education intervention in improving outcome at 5 years for very preterm infants . Methods : The Avon Premature Inf 
    Output:
    
agent
Conclusion : Positive clinical ly meaningful effects ( > 5 points ) are seen to an age of 36 months , but are no longer present at 5 years
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background . Based on the general bonding hypothesis , it is suggested that kangaroo mother care ( KMC ) creates a climate in the family whereby parents become prone to sensitive caregiving . The general hypothesis is that skin-to-skin contact in the KMC group will build up a positive perception in the mothers and a state of readiness to detect and respond to infant 's cues . Method . The r and omized controlled trial was conducted on a set of 488 infants weighing < 2001 g , with 246 in the KMC group and 242 in the traditional care ( TC ) group . The design allows precise observation of the timing and duration of mother – infant contact , and takes into account the infant 's health status at birth and the socioeconomic status of the parents . Bonding Assessment . Two series of outcomes are assessed as manifestations of a mother 's attachment behavior . The first is the mother 's feelings and perceptions of her premature birth experience , including her sense of competence , feelings of worry and stress , and perception of social support . The second outcome is derived from observations of the mother and child 's responsivity to each other during breastfeeding at 41 weeks of gestational age . Interventions . KMC has three components . The first is the kangaroo position . Once the premature infant has adapted to extrauterine life and is able to breastfeed , he is positioned on the mother 's chest , in a upright position , with direct skin-to-skin contact . The second component is kangaroo nutrition . Although breastfeeding is the prime source of nutrition , infants also may receive preterm formula whenever necessary and vitamin supplements . The third component is the clinical control ; infants are monitored on a regular basis , daily until they are gaining at least 20 g per day . Afterward , weekly clinic visits are scheduled until term , which constitutes the ambulatory minimal neonatal care . In the TC group , infants are kept in incubators until they are able to self-regulate their temperature and are thriving ( ie , have an appropriate weight gain ) . Infants are discharged according to current hospital practice , usually not before their weight is ∼1700 g. Afterward , as with the KMC group , weekly clinic visits are scheduled until term . Results . We observed a change in the mothers ' perception of her child , attributable to the skin-to-skin contact in the kangaroo-carrying position . This effect is related to a subjective “ bonding effect ” that may be understood readily by the empowering nature of the KMC intervention . Moreover , in stressful situations when the infant has to remain in the hospital longer , mothers practicing KMC feel more competent than do mothers in the TC group . This is what we call a resilience effect . In these stressful situations we also found a negative effect on the feelings of received support of mothers practicing KMC . We interpret this as an isolation effect . To thwart this deleterious effect , we would suggest adding social support as an integral component of KMC . The observations of the mothers ' sensitive behavior did not show a definite bonding effect , but rather a resilience effect . This is attributable to the KMC intervention ; mothers practicing KMC were more responsive to an at-risk infant whose development has been threatened by a longer hospital stay . Otherwise , we observed that the mothers ( in both the KMC group and the TC group ) had behavioral patterns that were adapted to the child 's at-risk health status and to the precarious condition of some premature infants requiring intensive care . We conclude that the infant 's health status may be a more prominent factor in explaining a mother 's more sensitive behavior , which overshadows the kangaroo-carrying effect . Conclusion . These results suggest that KMC should be promoted actively and that mothers should be encouraged to use it as soon as possible during the intensive care period up to the 40 weeks of gestational age . Thus , KMC should be viewed as a means of humanizing the process of giving birth in a context of prematurity . This finding confirms the conclusions of the 1996 Trieste workshop suggesting that KMC should be promoted both in hospitals and after early discharge Abstract This study aims at assessing the effects of an early occupational therapy intervention on the cognitive development and the development of attachment patterns in ELBW infants . The intervention , given weekly at home from six months to 12 months , aim ed at supporting parent-child interaction and enhancing motor control and coordination . The study population consisted of 100 ELBW infants matched in pairs in accordance to their pre-perinatal risk scores and allocated successively to intervention or non-intervention groups .  Cognitive development was assessed with the Bayley Scales at age two and with the WPPSI at age four . Attachment to primary caregiver was assessed with the Preschool Assessment of Attachment ( PAA ) . Cognitive performance was within age norms in both groups at both ages . Intervention did not show any effect on cognitive performance at the age of two years . At the age of four years , cognitive level was overall , and most notably for verbal performance , higher in the intervention group than in the control group . There was an over-representation of the so-called atypical attachment patterns ( those not fitting the normative A , B , or C categories ) in the control group . The results are discussed in terms of finding more global ways to support the development of at risk pre-term children A recent federal law has exp and ed the eligibility for multidisciplinary evaluation and assessment of infants suspected of developmental delay . At the same time , modern neonatal care has increased infant survival . These two developments have created a need for family education regarding the need for health and developmental intervention , as well as counseling to maintain family participation in these services . This study compares the education and counseling services of a hospital-based case management team with the traditional discharge and follow-up services of a neonatal intensive care unit ( NICU ) .  Subjects were the 10 % most medically severe infants discharged from a neonatal intensive care unit over a 16-month period . Preliminary data suggests a significantly greater number of families accessed community-based , coordinated , comprehensive health and developmental services when they received case management services . The data suggest that hospital professionals generally refer the most medically severe 3 % of this group for services under a traditional model . However , the additional 7 % referred under the transition model showed greater developmental benefits from the services during the first 6 months of life . These data support current federal initiatives for early intervention services which are family-centered , community-based and coordinated This prospect i ve longitudinal study was design ed to evaluate the effects of a multidisciplinary infant development program ( IDP )  on the mental and physical development of low birth weight infants ( less than 1,800 g ) . Infants in the neonatal intensive care were r and omly assigned to the IDP or to traditional care ( control group ) . IDP infants received developmental interventions in the hospital and at home through the first 2 years of life . Counseling and parenting education were provided to their parents during this same period . The control group received all the postnatal care and referrals customarily given in traditional care . Both IDP and control infants were enrolled in an independent follow-up program , which used the Bayley Scales of Infant Development in a blind evaluation design . The IDP group had a significantly lower incidence of developmental delay ( P less than .05 ) and scored significantly higher than the control group ( P less than .05 ) on mean mental and physical indices at 12 and 24 months of adjusted age CONTEXT Most studies of the long-term effects of early childhood educational interventions are of demonstration programs rather than large-scale public programs . Previous studies of one of the oldest federally funded preschool programs have reported positive effects on school performance , but effects on educational attainment and crime are unknown . OBJECTIVE To determine the long-term effectiveness of a federal center-based preschool and school-based intervention program for urban low-income children . DESIGN , SETTING , AND PARTICIPANTS Fifteen-year follow-up of a nonr and omized , matched-group cohort of 1539 low-income , mostly black children born in 1980 and enrolled in alternative early childhood programs in 25 sites in Chicago , Ill. INTERVENTIONS The  Chicago Child-Parent Center ( CPC ) Program ( n = 989 children ) provides comprehensive education , family , and health services and includes half-day preschool at ages 3 to 4 years , half- or full-day kindergarten , and school-age services in linked elementary schools at ages 6 to 9 years . The comparison group ( n = 550 ) consisted of children who participated in alternative early childhood programs ( full-day kindergarten ) : 374 in the preschool comparison group from 5 r and omly selected schools plus 2 others that provided full-day kindergarten and additional instructional re sources and 176 who attended full-day kindergartens in 6 CPCs without preschool participation . MAIN OUTCOME MEASURES Rates of high school completion and school dropout by age 20 years , juvenile arrests for violent and nonviolent offenses , and grade retention and special education placement by age 18 years . RESULTS Relative to the preschool comparison group and adjusted for several covariates , children who participated in the preschool intervention for 1 or 2 years had a higher rate of high school completion ( 49.7 % vs 38.5 % ; P = .01 ) ; more years of completed education ( 10.6 vs 10.2 ; P = .03 ) ; and lower rates of juvenile arrest ( 16.9 % vs 25.1 % ; P = .003 ) , violent arrests ( 9.0 % vs 15.3 % ; P = .002 ) , and school dropout ( 46.7 % vs 55.0 % ; P = .047 ) . Both preschool and school-age participation were significantly associated with lower rates of grade retention and special education services . The effects of preschool participation  on educational attainment were greater for boys than girls , especially in reducing school dropout rates ( P = .03 ) . Relative to less extensive participation , children with extended program participation from preschool through second or third grade also experienced lower rates of grade retention ( 21.9 % vs 32.3 % ; P = .001 ) and special education ( 13.5 % vs 20.7 % ; P = .004 ) . CONCLUSIONS Participation in an established early childhood intervention for low-income children was associated with better educational and social outcomes up to age 20 years . These findings are among the strongest evidence that established programs administered through public schools can promote children 's long-term success BACKGROUND AND OBJECTIVE Care based on the Newborn Individualized Developmental Care and Assessment Program ( NIDCAP ) has been reported to exert a positive impact on the development of prematurely born infants . The aim of the present investigation was to determine the effect of such care on the 1-year development of infants born with a gestational age of less than 32 weeks . METHODS All surviving infants ( 11 in the NIDCAP group and 9 in the control group ) were assessed employing the Bayley Scales of Infant Development at 1 year of corrected age . RESULTS The Mental Developmental Index ( MDI ) of children who had received care according to NIDCAP was higher [ 88 ( 72 - 114 ) ] [ median ( range ) ] than the corresponding value for the control children [ 78 ( 50 - 82 ) ] ( p=0.01 ) . The odds ratio for being alive with an MDI>80 was 14 ( 95 % CI ; 1.4 - 141.5 ) in favour of the intervention group . However , the Psychomotor Developmental Indices ( PDI ) were not significantly different [ 85 ( 61 - 108 ) and 69 ( 50 - 114 ) , respectively ] ( p=0.23 ) . CONCLUSION Our findings indicate that care based on the NIDCAP might have a positive impact on the cognitive development of infants born very prematurely At a corrected age of 3 months , 80 low birth-weight infants were assigned to normal or at-risk groups on the basis of a neurodevelopmental assessment scale . Both groups were further divided into intervention and non-intervention sub-groups ( 20 infants in each ) . Intervention consisted of monthly hospital-based neurodevelopmental therapy in addition to a home exercise programme . Infants were re-assessed by a physiotherapist at 6 , 9 , and 12 months , and were tested at 12 months by an independent psychologist blinded for infant group . Mean birthweight and gestational age were similar for normal and at-risk groups . At-risk infants had higher mean neurodevelopmental scores throughout the study period and lower 1-year development quotients ( DQ ) than normals . In neither normal nor at-risk groups did neurodevelopmental therapy alter the pattern of development or the outcome Effects of high participation in the Infant Health and Development Program ( IHDP ) , an 8-site r and omized trial that targeted low-birth-weight ( LBW ) premature infants ( N=1,082 ) , were estimated . Children in the treatment group were offered high- quality center-based care in their 2nd and 3rd years of life ( full-day care , 50 weeks per year ) . High-dosage effects were estimated with a new methodology that found a matched comparison group within the follow-up group for those with high participation rates ; these estimates were compared with traditional intention-to-treat ( ITT ) estimates . At age 8 , effects on the Wechsler Intelligence Scale for Children Full and Verbal scales for children who attended > 400 days ranged from 7 to 10 points . For the heavier LBW infants ( 2,001 - 2,500 g ) , the effects were about 14 points for > 400 days ; for the lighter LBW infants ( < or = 2,000 g ) , the effects were about 8 points . These effects were all substantially higher than corresponding ITT effects . Similar but smaller effects were found for children who attended > 350 days Aims : To test the effectiveness of a home based developmental education intervention in improving outcome at 5 years for very preterm infants . Methods : The Avon Premature Inf 
    Output:
    