Orientador: Antonio Celso Fonseca de Arruda / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Engenharia Mecânica / Made available in DSpace on 2018-08-28T00:07:21Z (GMT). No. of bitstreams: 1 RondonCachopo_CindyJanneth_M.pdf: 14082441 bytes, checksum: 57cfd2f3a77c65d3289114fe7207bfa4 (MD5) Previous issue date: 2015 / Resumo: Mediante uma abordagem de Design Centrado no Humano (HCD), foram desenvolvidos dois dispositivos para o transporte após da alta hospitalar de "recém-nascidos de baixo peso" (RNBP) com massas entre 1600 g e 2500 g. Um dispositivo foi projetado para uso em automóveis particulares e o outro para uso em veículos coletivos. Buscaram-se dispositivos capazes de minimizar os riscos no transporte de recém-nascidos de baixo peso e tornar mais confortável o transporte destas crianças. O processo de design abarcou 4 etapas: (1) especificar o contexto de uso, (2) especificar os requisitos, (3) produzir soluções de design e (4) avaliar o design. Inicialmente, foram necessários estudos para estabelecer o estado da arte dos produtos existentes no mercado bem como para caracterizar o público-alvo e conhecer o ambiente de uso. Estes estudos permitiram identificar as necessidades de conforto e de segurança dos usuários, as quais definiram os parâmetros dos projetos. As soluções desenvolvidas foram avaliadas iterativamente por meio de uma série de entrevistas com pessoas membros da Faculdade de Engenharia Mecânica, membros do pessoal de saúde da área de neonatologia e mães de Recém Nascidos de Baixo Peso, seguida de testes de usabilidade. A abordagem por meio do Design Centrado no Humano envolveu três grupos de usuários: o recém-nascido, os familiares do neonato e o pessoal de enfermaria. Estes três grupos participaram em todo o processo de design, o que possibilitou identificar e conhecer os aspectos importantes para a realização dos projetos e para atingir a aceitação dos usuários / Abstract: The low birth weight infants must be transported under special conditions after hospital discharge. These special conditions are associated with physiological immaturity and low weight state that encourage the need of differentiated retention devices of conventionally existing products. A human-centered design approach was used to develop two solutions for the low birth weight infant transportation, a solution for usage in particular vehicles and another for usage in collective vehicles. The design process embraced 4 phases: (1) specific the context of use (understanding the current conditions of "low birth weight infants" transport and the needs of the users), (2) specify the requirements (translate the needs of the users to requirements that the solutions must meet), (3) produce design solutions, (4) evaluate the designs. Previous studies were necessary to establish the context of use; these have enabled researchers to recognize the most important users¿ needs, which defined the parameters of the projects. The solutions developed were evaluated through a series of interviews, with groups of health staff from Neonatal Area and mothers of low birth weight infants, followed by usability tests. The human-centered design approach embraced three user groups: neonates, family members and health staff. These three groups were involved around the design process, this enabled to meet important aspects for the solutions realization and to achieve user acceptance / Mestrado / Materiais e Processos de Fabricação / Mestra em Engenharia Mecânica

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The aim of this study was to explore temperament, psychopathology and quality of life (QOL) in adolescents born at extremely low birth weight (ELBW), i.e., < 1000g. ELBW adolescents (N = 15) completed the Revised Cheek and Buss Scale and Mini International Neuropsychiatric Interview 5.0.0 (M.I.N.I.), while their legal guardians completed a biographical questionnaire and the Short Form 12 version 2. The median age of the sample was 13 SD = 2.526 years (60% male) and all participants spoke English. ELBW adolescents with social phobia (n = 6) were more shy (p = .041) and had poorer mental health-related QOL (p = .041) than those without such symptoms. The results suggest that ELBW could be a predisposing factor for increased shyness and psychological disorders including social phobia. Planning of interventions for ELBW individuals should therefore include strategies to prevent or mitigate the effects of these factors in adolescence / Psychology / M. A. (Clinical Psychology)

京都大学 / 新制・課程博士 / 博士(医学) / 甲第23078号 / 医博第4705号 / 新制||医||1049(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 稲垣 暢也, 教授 万代 昌紀, 教授 小杉 眞司 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

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Advances in neonatology have led to increased numbers of high-risk neonates surviving and intensified interest in the developmental outcomes of this population. In the South African context prematurity and low birth weight are the most common causes of death in the perinatal period and the same risk factors that contribute to infant mortality also contribute to the surviving infants’ increased risk for developmental delays. As a result of the interacting biological and environmental risk factors of prematurity, low birth weight, poverty and HIV and AIDS in the South African context Kangaroo Mother Care (KMC) has been developed as best practice to promote infant survival and to facilitate mother-infant attachment. Mother-infant attachment may lead to synchronous interaction patterns between the mother and infant which forms the basis of early communication development. Early communication intervention (ECI) services are recommended as early as possible as high-risk infants are especially at risk for feeding difficulties and communication developmental delays. It is, however, not clear what the content of an ECI programme should be and how it should be implemented according to the changing communication and feeding developmental needs of the infant while receiving KMC. There appears to be a dearth of research on the earliest stages of communication development in high-risk neonates, which should form the foundation of such a programme. A descriptive survey was conducted to describe the development of 25 high-risk infants and their mothers’ changing needs from admission to discharge from a KMC unit. Each participant and mother dyad was followed up over an average of 11 days of data collection with three to four data collection sessions. Data was collected by means of direct observation during routine care-giving activities. The different developmental subsystems of the participants’ feeding, communication, neuro-behavioural organization and mother-neonate interaction were described. The results demonstrated that subtle, but definite changes could be observed in the participants’ development. Development in all the different areas occurred over time as the participants progressed through the three developmental states of the in-turned state, coming-out state and reciprocity state. As the participants progressed during the 11 days of data collection and were increasingly able to attend to their environment, they also developed the ability to regulate and organize their own behaviour in order to develop more complex communication, feeding and interaction skills with their mothers. The functioning of the participants’ sensory systems developed in a specific order namely tactile, auditory and then visual. Although the participants developed consistently throughout their stay in the KMC unit, mother-neonate interaction never reached optimal levels. The importance of an individualized training programme for each mother is reflected in the finding that the neonate’s developmental level and progress needs to be considered when implementing the ECI programme. The need for speech-language therapy involvement in KMC is emphasized in the light of a shortage of practicing speech-language therapists in South Africa. It is therefore imperative that the prevention of communication delays and feeding difficulties in high-risk neonates as well as parent training assume priority. / Dissertation (MCommunication Pathology)--University of Pretoria, 2008. / Speech-Language Pathology and Audiology / unrestricted

Objective: This study sought to determine the association between periodontal disease in pregnancy and the delivery of low birth weight newborns in a rural population of South African women. Methods: This case-control study involved 348 new mothers. All subjects were recruited post-delivery from three public hospitals in the rural Eastern Cape of South Africa. The cases (n=119) were mothers who delivered through normal delivery and whose babies at the time of delivery weighed <2.5 kg. Age-matched controls (n=229) were mothers who delivered ≥2.5 kg babies. Potential risk factors for periodontal disease and low birth weight were collected by means of a structured questionnaire and maternity record review. Using the WHO's community periodontal index, a trained dental clinician blinded to participants' birth-outcomes recorded the periodontal health status of each participant (intraexaminer reliability; kappa = 0.95). Mothers who presented with a probing depth ≥4 mm on more than four index teeth without the presence of gingival overgrowth were deemed to present with periodontal disease. Data analysis included conditional logistic regression analysis. Results: Periodontal disease was diagnosed in 37.9%> (n=45) of the case group and 9.2°/o (n=21) of the control group. Low birth weight was also significantly more common among those who were unemployed, those who reported fewer than three antenatal visits and drinking on five or more days per week during pregnancy. After controlling for potential confounders, mothers presenting with a probing depth ≥ 4 mm on four teeth (OR = 4.12; 95°/o Cl = 1. 78 - 9.50) or more than four teeth (OR = 4.95; 95%> Cl: 1.52 - 15.81) were found to be significantly more likely to have low birth weight babies. Conclusions: The study findings suggest that there is a significant dose-dependent positive association between periodontal disease and low birth weight, independent of other risk factors measured in this study. / Dissertation (MSc)--University of Pretoria, 2013. / Community Dentistry / unrestricted

Abstract It is estimated that about 22% of all births in Pakistan are low birth weight (&lt;2500g), representing approximately 198,000 births per year. One of the major causes of low birth weight is maternal anemia. In Pakistan approximately 52% of pregnant women are anemic and one of the most common cause of maternal anemia is soil-transmitted helminthic infection. Soil-transmitted helminthiasis is endemic in Pakistan carries the highest burden of infection in Eastern Mediterranean region. Despite the recommendations deworming the mother during pregnancy is not being commonly practiced in routine antenatal care. We hypothesized that there is an association between deworming during pregnancy and low birth weight. For this study, cross sectional analysis of secondary data from the latest Pakistan Demographic Health Survey (PDHS conducted in 2017-18 and released in 2019) was done. Total N=1403 mother and child were included, logistic regression was used to determine the association between deworming during pregnancy and low birth weight after adjusting for potential confounders.  We found no statistically significant association [aOR 0.63, 95% CI (0.21-1.83)] between deworming during pregnancy and low birth weight. Moreover the mothers who belonged to higher socioeconomic status [aOR 0.41, 95% CI (0.22- .76)] and attained higher education [aOR 0.55, 95% CI (0.34- .87)] had reduced odds of having a new born with low birth weight compared to newborn of the women from low socioeconomic status and had no education, respectively. Further research is needed to explore effectiveness of deworming during pregnancy at population level.

Thesis (M.Med. (Paediatrics and Child Health)) -- University of Limpopo, 2019 / Objectives To determine the prevalence and survival rate; and to assess the maternal risk factors as well as complications of prematurity, associated with the mortality of very low and extremely low birth weight infants in the Neonatal Intensive Care Unit (NICU) of Mankweng Hospital. Materials and Methods A retrospective descriptive study was conducted at the NICU of Mankweng Hospital for a 7-month period from 1st January to 31st July 2015. The patient medical records and the Perinatal Problem Identification Programme (PPIP) data were used for the study. Results Prevalence of prematurity was 23%, Infants weighing between 500g-1499g represented 6.3% of the total live births and 25% of the admissions to the NICU; of which 4.9% were classified as extremely low birth weight (ELBW). Overall 77% of the study population survived until discharge. From the medical records, the survival to discharge of infants with weight 500g - 999g was 52%; and 84% for those with weight 1000g-1499g. Multivariable analysis found that improved survival was associated with an increase in gestational age (p <0.001), as well as birth weight (p <0.001) and prolonged length of stay. Variables associated with poor survival were spontaneous preterm labour (p = 0.031), low Apgar score at 1 and 5 minutes (p <0.001), sepsis (p = 0.001), respiratory distress syndrome (p <0.001), pulmonary hemorrhage (p <0.001), hypothermia (P = 0.005), resuscitation at birth (p = 0.002) and necrotising enterocolitis (p =0.044). Antenatal steroids were not associated with survival (p =0.111), however this was not documented in 53%(134/252) of the records, so the non-significance to outcome in this study may not be a true reflection. The use of NCPAP or SiPAP only was associated with improved survival of up to 69% and high mortality rates were recorded in babies who required invasive ventilator support. Multi-organ immaturity was found to be the most common cause of death, followed by sepsis. Conclusion: The prevalence and survival rates of very low and extremely low birth weight, found in this study are comparable to those found in other tertiary hospitals in South Africa. The survival rate of ELBW babies is low and must be improved. Reliable data and further research should address effective steps to prevent preterm labour, extreme prematurity and hypothermia. The documentation and provision of antenatal steroids is encouraged. KEY CONCEPTS: Prematurity, Extremely low and Very low birth weight, Risk factors, Prevalence, Survival, Neonatal mortality rate.

This article focuses on a systems biology approach to studying the pathophysiology of cigarette smoking during pregnancy. Particular emphasis is given to the damaging role of oxidative stress. Cigarette smoking exerts multiple adverse affects but abundant evidence, mostly in adults, suggests that oxidative stress and free radical damage is a major pathophysiological factor. Smoking during pregnancy is known to contribute to numerous poor birth outcomes, such as low birth weight, preterm birth as well as life-long health and developmental problems. It is clinically important to know the separate contributions that cigarette derived-nicotine and smoking-induced free oxidative stress make to these poor outcomes. Surprisingly, the extent to which smoking dependent oxidative stress contributes to these poor outcomes is not well studied but the application of redox proteomics should be useful. Considerable biochemical evidence suggests that antioxidants, such as tocopherols and ascorbate, could be useful in minimizing oxidative stress induced pathology to the developing fetus in those women who, despite medical advice, continue to smoke. Nevertheless, this suggestion has yet to be tested in well-designed clinical studies.