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Purpose: The purpose of this study was to describe system-level and personal factors influencing parent presence in the neonatal intensive care unit (NICU) and identify differences in factors by sociodemographic characteristics. Study Design and Methods: In a cross-sectional national survey study using social media recruitment, participants rated the frequency of 13 potential barriers and 12 potential facilitators using a 5-point Likert scale. Experiences of discrimination and parent–staff engagement were also measured. Results: Valid responses were analyzed from 152 participants. Uncomfortable facilities and home responsibilities were the most highly reported system-level and personal barriers, respectively. Encouragement to participate in caregiving and social support were the most highly reported system-level and personal facilitators, respectively. Participants reported low to moderate levels of discrimination and moderate levels of parent–staff engagement. Latent class analysis revealed three sociodemographic clusters. Differences in barriers, facilitators, discrimination, and engagement were found among clusters. Clinical Implications: NICU facilities are uncomfortable and may discourage parent presence. Allowing support persons to accompany parents, providing comfortable facilities, and engaging parents in caregiving may promote greater parent presence and improved parent and child outcomes. Studies of potential bias toward parents with lower education and income and effects on parent presence and infant outcomes are needed. Parental presence in the neonatal intensive care unit has benefits for babies and parents. In this study, parents were recruited from social media to participate in a survey about their experiences in the neonatal intensive care unit. They identified multiple barriers as well as many facilitators of being able to be at the bedside of their hospitalized newborn. Nurses in neonatal nursing units can take a leadership role in making their unit as hospitable as possible and ensuring that the neonatal health care team is encouraging parents' presence and participation in care. [ABSTRACT FROM AUTHOR]

Background: Stress exposure in the neonatal intensive care unit (NICU) is associated with poor outcomes in preterm infants. However, factors predicting subsequent NICU stress exposure have not been identified. Purpose: To characterize NICU stressors experienced by preterm infants during the first 2 weeks of life and identify demographic, perinatal, and institutional variables associated with stress exposure. Methods: A secondary analysis of data from a nonexperimental, prospective study was conducted using data from 60 very preterm infants born 28 to 31 weeks gestational age. Stress exposures during the first 2 weeks of life, operationalized as number of invasive procedures, were characterized by type and quantity for each infant using data extracted from electronic health records. Associations between number of invasive procedures and demographic, perinatal, or institutional variables were analyzed using linear regressions with robust standard errors. Results: Preterm infants experienced, on average, 98 (SD = 41.8) invasive procedures. Of these invasive procedures, nasal and/or oral suctioning episodes (58.1%), followed by skin-breaking procedures (32.6%), were most frequent. Differences in the number of invasive procedures were found for maternal race; infants born to Black mothers experienced fewer total invasive procedures than infants born to White mothers. The number of invasive procedures also varied across NICUs. Implications for Practice and Research: Preterm infant stress exposure differed by maternal race and NICU, consistent with research findings of differential treatment of diverse infants. Further research is needed to understand the reasons for these differences and to identify best practices to standardize neonatal care. [ABSTRACT FROM AUTHOR]

Background: The Maternal Infant Responsiveness Instrument (MIRI) was developed in 2002 to measure a critical aspect of maternal-infant health. The objective of this analysis was to examine use, results, and continued relevance of the MIRI 20 years after its creation. Methods: For the completion of this narrative review, 5 electronic databases were accessed using key search terms. Inclusion criteria were English-language, peer-reviewed research using the MIRI. Hand searches of reference lists were conducted. Five authors performed screening, data extraction, appraisal, and summarized findings. Results: Fifteen studies were included. All studies reported an internal consistency of α > 0.70 for the MIRI. Positive correlations were reported with self-efficacy, infant temperament, and life satisfaction. Inverse relationships were reported with stress, depression, and experiential avoidance. Depressive symptomatology, life satisfaction, self-esteem, self-efficacy, and previous childcare experience were predictors of maternal responsiveness. Discussion: Maternal well-being (postpartum depression and stress) can affect maternal responsiveness. Given the pervasive disparities in maternal health and well-being, it is important to have reliable measures of the effects of those disparities. The MIRI, a valid and reliable measure, may be useful for assessing the effectiveness of interventions designed to improve infant and maternal well-being. [ABSTRACT FROM AUTHOR]

The article discusses changes in scientific communication norms, emphasizing the need for more inclusive science communication (ISC).

Purpose: To identify factors associated with parental participation in the feeding care of hospitalized preterm infants and determine associations between parental participation in feeding and infant neurobehavioral outcomes. Study Design and Methods: Secondary analysis of data collected during a larger study of preterm infants. Parental participation in gavage and oral feeding was measured as a proportion of all feeding opportunities. Neurobehavioral outcomes were measured using a neurobehavioral assessment and feeding milestones. Other data were collected from the electronic health record. Results: Parental participation in feeding was low. There were associations between parental participation in gavage feeding and infant sex, insurance type, maternal race, infant gestational age at birth, and birthweight. There were associations between parental participation in oral feeding and infant sex, insurance type, maternal race, and study group. Greater parental participation in feeding was associated with earlier achievement of some feeding milestones. Clinical Implications: Parental participation in feeding can decrease the time required for infants to achieve feeding milestones, possibly leading to decreased length of hospitalization. Nurses should encourage parents to participate in caregiving for their preterm infants. Interventions are needed to remove barriers to parental participation in caregiving. In this secondary data analysis of 87 preterm infants using data from a randomized controlled trial of patterned tactile experience provided during gavage and oral feeding on infant neurobehavior and clinical outcomes, parental involvement in infant feeding in the neonatal intensive care unit was low. Parental participation in feeding can decrease the time required for infants to achieve feeding milestones, possibly leading to decreased length of hospitalization. Nurses should encourage parents to participate in caregiving for their preterm infants. Interventions are needed to remove barriers to parental participation in caregiving. [ABSTRACT FROM AUTHOR]

Supplemental Digital Content is Available in the Text. Positive tactile experiences in the newborn period are critical to normal sensory development. Universal gloving in the neonatal intensive care unit has become a controversial issue in neonatal nursing practice. Intended to prevent infection among neonatal patients, universal gloving also hinders the provision of human touch. The purpose of this survey study was to (1) describe gloving policies in neonatal intensive care units, and (2) describe the gloving and touch practices of neonatal nurses and identify associations between these practices and demographic characteristics. The investigators developed a 19-question, anonymous survey. The survey link was distributed through the National Association of Neonatal Nurses' social media and newsletter. Of the 137 responses, only 22.1% of nurses reported unit policy requiring universal gloving. While nurses reported some ambiguity about gloving policies, surveyed nurses commonly used gloves when performing general care activities. Institutional gloving policies varied in this geographically diverse sample, but routine, bare-handed touch was an uncommon practice among neonatal nurses. Research evidence is needed to guide nursing practice and inform policy decisions regarding glove use in the neonatal intensive care unit. [ABSTRACT FROM AUTHOR]

The article discusses the concerning shortage of nursing scientists and the low enrollment in PhD programs in nursing, It emphasizes the importance of nursing scientists in advancing the discipline, contributing to evidence-based practice, and improving health and well-being.

Supplemental digital content is available in the text. Background: Neonatal exposure and subsequent withdrawal from maternal substance use disorder are a growing problem and consequence of the current opioid epidemic. Neonatal abstinence syndrome (NAS) is defined by a specified cluster of symptoms with treatment guided by the expression and severity of these symptoms. The mechanisms or pathophysiology contributing to the development of NAS symptoms are not well known, but one factor that may influence NAS symptoms is the gut microbiota. Objectives: The purpose of this integrative review was to examine evidence that might show if and how the gut microbiota influence expression and severity of symptoms similar to those seen in NAS. Methods: Using published guidelines, a review of research studies that focused on the gut microbiome and symptoms similar to those seen in NAS was conducted, using the Cochrane, EMBASE, and Scopus databases, from 2009 through 2019. Results: The review results included findings of aberrant microbial diversity, differences in microbial communities between study groups, and associations between specific taxa and symptoms. In studies involving interventions, there were reports of improved microbial diversity, community structure, and symptoms. Discussion: The review findings provide evidence that the gut microbiota may play a role in modifying variability in the expression and severity of symptoms associated with NAS. Future research should focus on examining the gut microbiota in infants with and without the syndrome as well as exploring the relationship between symptom expression and aberrant gut microbiota colonization in infants with NAS. [ABSTRACT FROM AUTHOR]

Background: Although the survival rate of very preterm infants has improved, rates of subsequent neurobehavioral disabilities remain high. One factor implicated in poor neurobehavioral and developmental outcomes is hospitalization and inconsistent caregiving patterns in the neonatal intensive care unit. Although much underlying brain damage occurs in utero or shortly after birth, neuroprotective strategies may stop progression of damage, particularly when these strategies are used during the most sensitive periods of neural plasticity 2-3 months before term age. Objective: The purpose of this analysis was to test the effect of a patterned feeding experience involving a tactile component (touch and/or holding) provided during feedings on preterm infants' clinical outcomes, measured by oral feeding progress, as an early indicator of neurodevelopment. Methods: We used an experimental, longitudinal, two-group random assignment design. Preterm infants (n = 120) were enrolled within the first week of life and randomized to an experimental group receiving a patterned feeding experience or to a control group receiving usual feeding care. Results: Analysis of data from 91 infants showed that infants receiving touch at more than 25% of early gavage feedings achieved full oral feeding more quickly; as touch exposure increased, time from first oral to full oral feeding decreased. There was no association between holding during early gavage feedings or touch during transition feedings and time to full oral feeding. Discussion: Neurological expectation during critical periods of development is important for infants. However, a preterm infant's environment is not predictable: Caregivers change regularly, medical procedures dictate touch and holding, and care provision based on infant cues is limited. Current knowledge supports caregiving that occurs with a naturally occurring sensation (i.e., hunger), is provided in a manner that is congruent with the expectation of the neurological system, and occurs with enough regularity to enhance neuronal and synaptic development. In this study, we modeled an experience infants would "expect" if they were not in the neonatal intensive care unit and demonstrated a shorter time from first oral feeding to full oral feeding, an important clinical outcome with neurodevelopmental implications. We recommend further research to determine the effect of patterned caregiving experiences on other areas of neurodevelopment, particularly those that may occur later in life. [ABSTRACT FROM AUTHOR]

The article discusses the potential threat to scientific integrity posed by artificial intelligence (AI) in the form of software that can generate written content, highlighting the positive aspects and capabilities of AI-based writing tools while emphasizing the need for careful evaluation.

An introduction is presented in which the editor discusses articles in the issue on topics including, interventions that can reduce health disparities and achieve health equity; and understanding of the conduct of equitable and inclusive science in recruitment and retention.

An editorial is presented on shaping and developing nursing science. Topics include created by the lack of discussion opportunities, scientific work progressing slowed, and ideas for moving forward in those areas important to the profession; and research important to the practice of nursing, the primary goal of nursing science necessary in achieving the mission of improving health and well-being.

An editorial is presented on classic example mostly about skipping important information. Topics include examining the existing knowledge base for evaluating the truthfulness or adequacy of new information; and deliberating evaluation with thoughtful consideration of the accuracy of the information reducing the misinformation uptake.

An editorial is presented on the individual scientist and the challenges associated with sustaining an established, productive research program during scientific shifts. It expresses the view that resources needed to obtain, produce, and deliver goods from start to finish. An overview of recent phenomenon that may enhance the supply chain for nursing science is the increased interest of young people in nursing as a profession is presented.

Background: The use of functional connectivity magnetic resonance imaging (fcMRI) in research involving preterm infants is relatively new, and its feasibility in this population is not fully established. However, fcMRI images reveal functional neural connections that may be useful in establishing the mechanisms of neuroprotective interventions in preterm infants. Objective: The aim of this study was to determine the feasibility of using fcMRI to measure differences in functional neural connections in nursing intervention studies. Methods: A pilot study was conducted as part of a longitudinal, randomized controlled trial (RCT) testing the effect of a feeding intervention on neurodevelopmental and clinical outcomes of preterm infants randomly assigned to one of two groups: a patterned feeding experience (PFE) group and a usual feeding care (UFC) group. The fcMRIs were done at term-equivalent age. Visual, motor, and default mode networks were analyzed. Results: Seven infants were studied (four were in the PFE group, and three were in the UFC group). Participants were selected sequentially from the parent RCT. Clear images were obtained from all participants. Differences were noted among PFE and UFC infants: Infants receiving PFE were hyperconnective in the default mode (caudate, anterior cingulate cortex, and precuneus) and motor networks (middle temporal and middle occipital areas) and hypoconnective in others areas of the default mode (hippocampal and lingual regions) and motor networks (precentral and superior frontal cortices) relative to UFC infants. No differences were noted in visual networks. Discussion:The feasibility of using fcMRI at term-equivalent age in preterm infants who participated in an RCT on the effect of a nursing intervention was shown. Differences in connectivity among infants by group were detected. Further research is needed to show the benefit of fcMRI in studies of preterm infants given the costs of the procedure as well as the uncertain relationship of this early outcome measure to long-term neurodevelopment. [ABSTRACT FROM AUTHOR]

The author reflects on questionable research practice (QRP) in nursing, which is a serious research wrongdoings that could include plagiarism and data falsification or fabrication.

An editorial is presented on sustainability being important to equitable health and healthcare delivery. Topics include applying scientific knowledge to the development of interventions meeting health needs and improving quality of life; and maintaining the well-established programs of research for continuing advancing in nursing science, train emerging scientists, and meeting standards of quality and integrity.

By incorporating focused feedback from families and other stakeholders a multidisciplinary team redesigned a single nurse home visit to improve transitions to home for pediatric patients following short-stay, acute care hospitalizations. Refinements to the nurse-led transitional home visit included standardization of teaching focused on condition- and medication-specific concerns, the use of red flags or warning signs to prompt caregiver action, and the provision of reassurance [ABSTRACT FROM AUTHOR]

An editorial is presented on goals of inclusive nursing science improving health for all. Topics include interpreting the results of studies within disciplinary theories and continuing in building and developing theoretical knowledge in defining the discipline and field; and wellness promotion in diverse communities, management of illness conditions and troubling symptoms, development and implementation of technology for addressing health problems.

The article informs about nursing research papers, which include research has been used to legitimize nursing as a profession, education; and research has been on the agenda and the influential bodies involved, only a moderate proportion of nurses use research as a basis for practice.

An editorial is presented on the Confronting Racism Through Nursing Science. The article discusses that Racism is a public health crisis affecting mental, spiritual, and physical health; and the National Commission to Address Racism in Nursing, established in January 2021 by the American Nurses Association, the National Black Nurses Association, and the National Association of Hispanic Nurses, will examine the issue of racism within nursing.

An editorial is presented on Nursing Research has rejected 58% of submissions to the journal before review and desk rejection is almost a standard practice in publishing and using desk rejection allows us to send to reviewers only those papers that have a possible chance of being accepted.

Purpose: Although extensive research has been conducted on preterm infant oral feeding, few investigations have examined parents' experiences learning to feed orally their preterm infant while in the neonatal intensive care unit (NICU). As such, the aim of this study was to explore parental learning experiences to gain a better understanding of the process parents use in learning to feed their preterm infant.Subjects: Parents included in the investigation were 18 years of age or older with a medically stable preterm infant who was less than 36 weeks' gestational age at birth, free of congenital malformations, and feeding orally.Design: This investigation used phenomenology to explore the depth and richness of parental experience with the process of learning to feed orally their preterm infant.Methods: Participants were recruited from a university-affiliated women's hospital with a level III NICU. Purposive sampling was used to ensure that all participants were familiar with the experience of interest. Data collection consisted of personal interviews, which were conducted in a private consultation room located within the NICU. In instances where both the infant's mother and father chose to participate, the interviews were conducted separately on the same day.Main Outcome Measures: Twelve mothers and 8 fathers participated in semistructured interviews. For 8 mothers and 6 fathers, this was their first child. This was the first preterm infant for all participants. From the parental experience, the following 3 themes were identified: an emotional experience, learn as you go, and it is technical.Principal Results: Parents noted that feeding encompassed both positive and negative emotions, that learning was a process that nurses played an instrumental role in, and that feeding a preterm infant could be very technical, requiring extra skills for feeding success.Conclusions: Nurses can play a key role in helping parents learn by acknowledging both positive and negative feelings about the feeding process, recognizing parents' learning needs, and by teaching and demonstrating appropriate feeding techniques. [ABSTRACT FROM AUTHOR]

An editorial is presented on the Nursing Research which provides an opportunity for leading nurse scientists to explain new, interesting, and innovative research methods. The article discusses that the Recruiting participants to research can be challenging, particularly when target participants are very busy professionals; and social media can be useful to recruit samples in studies involving participants from many different demographic background.

An introduction is presented in which the editor discusses articles in the issue on topics including mechanistic work of science is about improving understanding of diseases processes, and systematically undertaken.

An editorial is presented on the need for institutional intervention work to increase crisis preparation and support health care staff predates the Covid-19 pandemic, and added benefit to research about institutional preparation is that health care systems can implement changes to patients care.

The purpose of this phenomenological study was to examine the experiences of mothers of preterm infants during the first 6 months at home following discharge from a neonatal intensive care unit (NICU). A purposeful sample of 8 mothers was gathered and interviews were conducted over a 4-month period. Each interview was audio recorded and took place in the study participant's home or another place of her choosing. Interviews were transcribed verbatim and analyzed independently with themes being identified and organized for each participant. From these analyses, the themes of fear, exhaustion, determination, and thankfulness were identified as being common to all study participants and became the basis for developing the essence of the phenomenon. The essence of this experience for these mothers was their resolve to do whatever was necessary to ensure the best possible outcomes for their infants. The data gathered from these personal interviews will serve to further inform our understanding of this important time from the perspective of those who experienced it, as well as aid in the design of interventions to address the specific needs of these mothers prior to NICU discharge. [ABSTRACT FROM AUTHOR]

An editorial is presented on the truth and science including the most of them involved serious thought about the nature of truth and the relationship of truth to scientific inquiry.

An editorial is presented on the social and traditional media have raised the question of what nurse scientists should be doing during the pandemic including the number of suggestions to help nurse scientists stay productive while research projects were on hold because of the COVID-19 pandemic.

The purpose of this article is to introduce a model of neurodevelopmental risk and protection that may explain some of the relationships among biobehavioral risks, environmental risks, and caregiving behaviors that potentially contribute to neurobehavioral and cognitive outcomes. Infants born before 30 weeks of gestation have the poorest developmental prognosis of all infants. These infants have lengthy hospitalization periods in the neonatal intensive care unit (NICU,) an environment that is not always supportive of brain development and long-term developmental needs. The model supports the premise that interventions focused on neuroprotection during the neonatal period have the potential to positively affect long-term developmental outcomes for vulnerable very preterm infants. Finding ways to better understand the complex relationships among NICU-based interventions and long-term outcomes are important to guiding caregiving practices in the NICU. [ABSTRACT FROM AUTHOR]

An editorial is presented on 200th anniversary of the birth of Florence Nightingale, and taking part in numerous in person as well as social media discussions and callouts about Florence Nightingale. Topics discussed include nursing is now a respected profession with educational programs generally based in university settings and using well-established educational practices; and Year of the Nurse and Midwife campaign, designed to correspond to the Nightingale 200th, to the COVID-19 crisis.

An editorial is presented that discussed advances and challenges in symptom science include descriptive studies of symptom manifestations in various disease conditions, symptom prevention and treatment interventions along with mechanism-based interventions for testing in clinical research.