A quality improvement initiative to reduce the time to initial maternal visit in the neonatal intensive care unit.

OBJECTIVE: We aimed to reduce the time interval between an infant's admission to the Neonatal Intensive Care Unit (NICU) and first maternal interaction. METHODS: We identified three key drivers: 1. Collaboration with Labor and Delivery, 2. Education of staff and parents, and 3. Improved documentation of maternal presence. We measured the time interval from NICU admission to the initial maternal presence. We followed length of stay as a balancing measure to assay whether use of remote televisitation impeded efficient parental teaching and delayed discharge. RESULTS: We reduced the time interval from an average of 19.7 h in February 2020 to 12.3 h in June 2021. We expanded an already existing televisitation program as a surrogate to in-person interaction during COVID-19 pandemic. Televisitation did not affect in-person parental presence or LOS. CONCLUSION: Our multidisciplinary efforts resulted in a significantly accelerated time to initial maternal presence and did not prolong LOS.

Seasonal Shifts in Reproduction Depend on Prey Availability for an Income Breeder.

The evolution of reproductive strategies depends on local environmental conditions. When environments are seasonal, selection favors individuals that align changes in key reproductive traits with seasonal shifts in habitat quality. Offspring habitat quality can decline through the season, and increased maternal provisioning to late-produced offspring may compensate. This shift, however, may depend on environmental factors that influence reproduction and are, themselves, subject to temporal changes (e.g., food abundance). We studied the brown anole lizard (Anolis sagrei) to demonstrate how prey abundance modifies seasonal changes in key reproductive traits. We bred lizards in controlled laboratory conditions across the reproductive season and manipulated the availability of food by providing some breeding pairs high prey availability and some low. Halfway through the season, we switched half of the breeding pairs to the opposite treatment. We measured growth of male and female lizards as well as latency to oviposit, fecundity, egg size, egg content (yolk, water, shell mass), and egg quality (steroid hormones, yolk caloric content) over this period. Higher prey availability enhanced lizard growth and some key reproductive traits (egg size, fecundity) but not others (egg content and quality). Moreover, we found that seasonal patterns of reproduction were modified by prey treatment in ways that have consequences for offspring survival. Our results demonstrate that seasonal changes in reproduction are dependent on fluctuations in local environmental conditions. Moreover, researchers must account for seasonal shifts in environmental factors and reproductive traits (and their interactions) when designing experiments and drawing conclusions about how the environment influences reproduction.