Made available in DSpace on 2016-08-10T10:53:45Z (GMT). No. of bitstreams: 1 GABRIELA CARDOSO MOREIRA MARQUES.pdf: 1903683 bytes, checksum: 6c486d333c5cf2306942aa9b630124c6 (MD5) Previous issue date: 2013-03-05 / Breastfeeding is recognized as a priority of public health policy in reducing perinatal and infant mortality. However, despite programs encourage breastfeeding, its implementation occurs in Brazil substandard. It´s a descriptive qualitative study with phenomenological approach and aims at understanding the meaning of the use of exclusive breastfeeding to mothers who had their babies admitted to the Neonatal Intensive Care Unit. Data were collected from July 2011 to July 2012, through semistructured interviews with mothers. Observation was used to achieve or seek further the essence of the information regarding the phenomenon. In discourse analysis, four categories emerged: maternal instinct and common sense in breastfeeding, breastfeeding important act of love; Motivation to continue or abandon breastfeeding; Influences of (mis) understanding of information regarding breastfeeding. Results: The study revealed the suffering, the pain, the anguish and the frustration, feelings that can be minimized with rethinking the actions of health education individually recognizing the knowledge of the other, the world experienced by the other and from there build together a true education. Thus, making our effective work for an exclusive breastfeeding; decrease early weaning. From this understanding about the process of breastfeeding, some proposals have been drawn up in order to minimize the difficulties and increase the rate of exclusive breastfeeding. / O aleitamento materno é reconhecido como prioridade da política pública de saúde na redução da mortalidade perinatal e infantil. Entretanto apesar dos programas de incentivo ao aleitamento materno, sua implementação ocorre, no Brasil, em padrões inferiores ao preconizado. Estudo descritivo qualitativo com abordagem fenomenológica e tem por objetivo, compreender o significado do uso do aleitamento materno exclusivo na visão de mães que tiveram seus bebês internados em Unidade de Terapia Intensiva Neonatal. Os dados foram coletados no período de julho de 2011 a julho de 2012, por meio de entrevistas semi-estruturadas com mães. Utilizei da observação como forma de buscar aprofundar ou alcançar a essência das informações referentes ao fenômeno. Na análise dos discursos emergiram quatro categorias: Instinto materno e senso comum no aleitar; Aleitamento materno importante ato de amor; Motivação para continuidade ou abandono do amamentar; Influências do (des)conhecimento das informações referentes à amamentação. Resultados: o estudo revelou o sofrimento, a dor, a angústia, a frustração, sentimentos que podem ser minimizados com repensar das ações de educação em saúde de forma individualizada reconhecendo o saber do outro; o mundo vivido do outro e a partir daí construir junto um verdadeiro educar. Tornando assim nosso trabalho eficaz para um aleitamento materno exclusivo; diminuir o desmame precoce. A partir dessa compreensão quanto ao processo de aleitamento materno, algumas propostas foram elaboradas com o intuito de minimizar as dificuldades e aumentar o índice de aleitamento materno exclusivo.

Leveduras da mucosa oral, de cateter e de sangue de neonatos internados na UTIN (Unidade de Terapia Intensiva Neonatal) por período de 9 meses, foram avaliadas quanto ao perfil molecular pela técnica de PFGE. Dos 125 neonatos internados, 23 (18,4%) apresentaram leveduras na mucosa oral, sangue e cateter. Destes pacientes, obtivemos 54 amostras de leveduras, sendo 36 (66,7%) isoladas da colonização oral; 12 (22,2%) de sangue, seis (11,1%) de cateter. C. albicans foi a mais freqüente dentre as amostras isoladas da mucosa oral e sepse. C. parapsilosis foi a mais isolada dentre as amostras de cateter. Todas as amostras foram consideradas sensíveis aos antifúngicos. Estas amostras apresentaram atividade de pelo menos uma exoenzima. Dentre os 12 casos de sepse, 83,4% (10/12) foram causadas por espécies de Candida, sendo que, destas 10 candidemias, 60% (6/10) estiveram associadas com colonização oral prévia pela mesma espécie e perfil genotípico. A mortalidade devido a infecção sistêmica (septicemia) por leveduras,no período do estudo, foi de 91.6% . / Yeasts isolated from the oral mucosa, catheter and blood of neonates in na NICU (neonatal intensive care unit) over a period of 9 months, were were evaluated in regard to the molecular profile by PFGE technique. Of the 125 neonates studied, 23 (18.4%) presented yeast in their oral mucosa, blood, or catheter. From these 23 neonates, 54 samples of yeast were obtained; 36 (63.7%) from oral colonization, 12 (22.2%) from the blood, and 6 (11.1%) from the catheter. The most frequently encountered species among the samples isolated from the oral mucosa and blood was C. albicans; while C. parapsilosis was the species found most frequently among the samples obtained from catheters. All the samples were considered susceptible to antifungal agents tested. The samples presented activity of at least one exoenzyme. Among the 12 cases of sepsis, 10 (83.4%) were caused by species of Candida, and of these 10 cases, 6 (60%) were associated with previous oral colonization by the same species and genotypic profile. The mortality rate due to septicemia by yeasts was 91.6%.

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No. of bitstreams: 2 Dissertação - Nádia Ferreira Gonçalves - 2013.pdf: 1051840 bytes, checksum: 75498ee692a1a652339e16003a0de36c (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2013-10-21 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Compliance with preventive measures by health professionals is a large challenge, and it is believed that in the intensive care unit, especially those classified as neonatal and pediatric, contamination of goods, equipment, and environmental surfaces contribute significantly to the increased epidemiology of healthcare associated infections (HAIs). The objective of this study was to analyze the epidemiological and microbiological profiles of tools, equipment, and ambient surfaces contaminated with antimicrobial resistant Staphylococcus spp. in neonatal and pediatric intensive care units. It is a cross-sectional epidemiological study carried out from August 2011 to September 2012, in a neonatal and pediatric intensive care unit specializing in maternal and child health of the public health system in GoiâniaGoiás, Brazil. Samples were collected using sterile swabs moistened with saline solution 0.9%, which were subjected to microbiological processing consisting of isolation, identification and antimicrobial susceptibility testing. Analysis and interpretation of results followed. Of the 137 samples, 1 02 were identified as Staphylococcus spp. and, in six of the 12 incubators, different strains of these microorganisms were isolated, totaling 108 isolates. Among the isolates, only four were identified as Staphylococcus aureus, and the remaining 104 were coagulasenegative Staphylococcus. During the processing of isolates it was revealed that 74.5% of the tools, surfaces and equipment were infected by Staphylococcus spp., and of these, more than 80% were resistant to antimicrobials. In four, MLSB phenotype was detected. As for oxacillin-resistant isolates, 82.3 % had resistance confirmed by Etest®. Upon completion of the analysis, it became clear that the tools, surfaces and equipment used in pediatric neonatal intensive care units are reservoirs of bacteria. This immediately highlights an important contributor to the epidemiology of HAIs: compliance with procedure for the safety of infants and healthcare workers, since these findings signal gaps in the work process and therefore in the processing of these items. Therefore, it is believed that the perception of the professionals who work in health facilities (related to the risks of cross-contamination) is of unique value to understanding the need to adopt safe work practices. It is hoped, that contributing to the development of other studies, with the goal of identifying possible gaps, involving both the management of the service and standard operating procedures for the cleaning and disinfection of ambient surfaces, tools and equipment in compliance with guidelines. / A adesão às medias preventivas pelos profissionais de saúde é um amplo desafio e, acredita-se que na unidade de terapia intensiva, em especial nas de caráter neonatal e pediátrico, a contaminação de artigos, superfícies ambientais e equipamentos contribua expressivamente para o avanço da cadeia epidemiológica das Infecções Reacionadas à Assistência à Saúde (IrAS). Objetivou-se neste estudo analisar os aspectos epidemiológicos e microbiológicos de artigos, superfícies ambientais e equipamentos contaminados por Staphylococcus spp. resistentes aos antimicrobianos em unidades de terapia intensiva neonatal e pediátrica. Trata-se de um estudo epidemiológico tipo transversal desenvolvido de agosto de 2011 a setembro de 201 2, nas unidades de terapia intensiva neonatal e pediátrica de uma instituição especializada em saúde materna e infantil do Sistema Único de Saúde de Goiânia-Goiás, Brasil. Os dados foram obtidos por meio de swab, coletou-se amostras biológicas dos artigos, superfícies ambientais e equipamentos existentes nas unidades selecionadas para estudo. Realizou-se fricção bidirecional com swab estéril umedecido em solução salina a 0,9%; em seguida foi feito o processamento laboratorial dos espécimes, com isolamento, identificação e teste de suscetibilidade dos micro-organismos aos antimicrobianos; por fim, a análise e interpretação dos resultados. Das 1 37 amostras, em 1 02 foram identificados Staphylococcus spp. sendo que, em seis das 12 incubadoras foram isoladas diferentes cepas desses micro-organismos, totalizando 1 08 isolados. Dentre os isolados, apenas quatro foram identificados como Staphylococcus aureus, e os 104 restantes de Stafilococos coagulase negativo. Durante o processamento dos isolados, verificou-se que 74,5% dos artigos, superfícies e equipamentos se encontravam contaminados por Staphylococcus spp., destes mais de 80%, resistentes aos antimicrobianos testados. Mas em apenas quatro foi detectado o fenótipo resistente a macrolídeos, lincosamidas e estreptogramina B (MLSB). Quanto aos isolados resistentes à oxacilina, 82,3% tiveram a resistência confirmada pelo Epsilometer Test (Etest®). Ao concluir as análises, evidenciou-se que artigos, superfícies e equipamentos de unidades de terapia intensiva neonatal e pediátrica, são reservatórios de bactérias. Logo, representam importante papel na cadeia epidemiológica das IrAS, o que configura inconformidades com a segurança do recém nascido e do trabalhador, uma vez que, esses achados sinalizam falhas no processo de trabalho e consequentemente no processamento desses artefatos. Nessa direção, acreditase que a percepção dos profissionais que laboram em estabelecimentos de saúde relacionada aos riscos de contaminação cruzada é de singular valor para compreenderem a necessidade de adotarem atitudes seguras no ato laboral. Espera-se ainda, contribuir com o desenvolvimento de outros estudos, com o objetivo de compreender as possíveis falhas envolvendo o tanto a gestão do serviço, quanto aos processos de trabalho e de limpeza e desinfecção das superfícies ambientais, artigos e equipamentos em conformidade com as diretrizes.

O objetivo desta dissertação foi descrever a investigação de um surto de Klebsiella pneumoniae em uma unidade de terapia intensiva neonatal cujo elo entre os casos foi a mão, persistentemente colonizada pelo agente, de uma técnica de enfermagem que apresentava onicomicose em primeiro quirodáctilo esquerdo. Revisou-se a história da aplicação do método epidemiológico na investigação de surtos de infecção relacionada à assistência à saúde. Foi revisada também a literatura pertinente à investigação de surtos na busca de situações semelhantes. Embora seja bem conhecido o papel das mãos de profissional de saúde na transmissão cruzada de agentes causadores de infecção nosocomial, poucos surtos foram publicados em que estes profissionais atuaram como fonte comum e persistente de infecção. É mais freqüente Gram-positivos envolvidos, havendo cinco relatos de Gram-negativos neste contexto. A contribuição desta dissertação é alertar para o risco que profissionais de saúde com alterações tróficas em mãos e anexos podem representar quando atuam em unidades críticas de assistência, assim como durante investigações de surto em que a evidências apontam para uma fonte comum, a busca de profissional com tais alterações deve ser considerada / The aim of this study was to describe the investigation of an outbreak of Klebsiella pneumoniae at a neonatal intensive care unit, associated with the persistently colonized hands of a nurse who had onychomycosis on her left thumb. We reviewed the use of the epidemiological method for investigating healthcare related outbreaks of infections. We also reviewed the literature concerning the hands of health care personnel. Although the hands of healthcare workers (HCW) play a role in the cross-transmission of nosocomial pathogens, there are few reports in which the persistently colonized hands act as a common source perpetuating an outbreak. In this setting, Gram-positive outbreaks are frequently reported and five Gramnegative outbreaks were reported. By means of this work, we have sought to draw attention to the role of the healthcare professional with chronic lesions on the hand skin and/or fingernails. They may pose a risk of persistent transmission of nosocomial pathogens, especially for critical patients with invasive devices. During healthcare infection outbreaks, examination of the hands of HCW should be included in the investigation

Made available in DSpace on 2016-04-27T13:10:26Z (GMT). No. of bitstreams: 1 Adriana Ayres de Oliveira Franca.pdf: 1639083 bytes, checksum: 8d2d93bef33289602cdea8c2d0a63b89 (MD5) Previous issue date: 2015-03-24 / The hospital Discharge in a NITU must be planned and evaluated by all the staff evolved in the child and the mother care, who, after coming to the conclusion that they are prepared, determine the hospital discharge date. Professionals working in the NITU need to be prepared for dialogue with family, always looking for a horizontal dialogic practice between work and family. Health education appears as a tool to transform professional practice, giving the assistance and care characteristics of critical and creative activity. Therefore, this study aimed to describe how the multidisciplinary team working in direct care with preterm infants in the neonatal intensive care unit of Hospital Santa Lucinda, Sorocaba (SP) performs the hospital discharge guidelines. It is, then, an exploratory, descriptive study of qualitative-quantitative approach. The study included 36 professionals who answered a self-administered instrument developed by the researcher, with open and closed questions, composed of 22 items divided into three dimensions on educational activities for hospital discharge: characterization of professionals; educational actions and perceptions. In general, participants use dialogue and demonstration, the most used feature is the vaccination card and the most discussed topics are breastfeeding, hygiene, vaccination and follow-up. The most cited facilitating factors were: maternal presence in the NITU, maternal involvement, use of folder and booklets, bond with the family, the multidisciplinary team performance and personal improvement. The most frequently mentioned hindering aspects were not participatory mother, mother of cognitive difficulty, lack of staff training, standardization of guidelines and educational material the need for educational materials, the mother's resistance to participate in the care, the lack of preparation. Most of the team believes that mothers come prepared to care for the newborn in the household, and these are also satisfied with the guidelines they perform. The guidelines are performed mechanical way into the work process, are segmented and there is no consensus among professionals on the subject, content, strategy and evaluation. Although education is embedded in the daily activities within the NITU, this is reproduced as a service task without the questioning of those who do and those who receive it. Thus, there is the need of education for the multidisciplinary team, seeking the preparation and greater integration between professionals beyond the availability of funds for such practices / A alta do recém-nascidos pré-termo (RNPT) deve ser planejada e avaliada por toda a equipe envolvida no cuidado da criança e da mãe, que, após concluir que ambos estão preparados, determinar a data da saída do hospital. Os profissionais que atuam na UTIN precisam estar preparados para o diálogo com a família, buscando sempre uma prática dialógica horizontal entre profissionais e familiares. A educação em saúde aparece como um instrumento capaz de transformar a prática profissional, conferindo à assistência e ao cuidado características de uma atividade crítica e criativa. Para isto, este trabalho buscou descrever como a equipe multiprofissional que atua na assistência direta com o RNPT na UTI Neonatal do Hospital Santa Lucinda, Sorocaba (SP) realiza as orientações de alta hospitalar. Trata-se, então, de um estudo exploratório, descritivo, de abordagem qualiquantitativa. Participaram do estudo 36 profissionais que responderam um instrumento autoaplicável, desenvolvido pela pesquisadora, com perguntas abertas e fechadas, composto de 22 itens divididos em três dimensões sobre as ações educativas para alta hospitalar: caracterização dos profissionais; ações educativas e percepções. De forma geral, os participantes utilizam o diálogo e a demonstração, o recurso mais utilizado é a Carteira de Vacinação e os temas mais abordados são Aleitamento Materno, cuidados de higiene, vacinação e seguimento ambulatorial. Os aspectos facilitadores mais citados foram: a presença materna na UTIN, o comprometimento materno, uso de folder e cartilhas, vínculo com a família, atuação da equipe multiprofissional e o aprimoramento pessoal. Os aspectos dificultadores mais apontados foram: mãe não participativa, dificuldade cognitiva da mãe, falta de capacitação da equipe, padronização das orientações e material educativo a necessidade de materiais educativos, a resistência da mãe em participar do cuidado, a falta de preparo. A maior parte da equipe acredita que as mães saem preparadas para o cuidado com o RN no domicilio, e estes também estão satisfeitos com as orientações que realizam. As orientações são realizadas de maneira mecanizada dentro do processo de trabalho, são segmentadas e não há consenso entre os profissionais quanto ao tema, conteúdo, estratégia e avaliação. Embora a educação esteja incorporada no cotidiano das atividades dentro da UTIN, esta se reproduz como uma tarefa do serviço, sem a problematização daqueles que a fazem e para aqueles que a recebem. Assim, há a necessidade de intervenções educativas para a equipe multiprofissional, visando o preparo e maior integração entre os profissionais além da disponibilização de recursos para essas práticas

Even though initiation of breastfeeding among term and preterm infants has increased, the incidence and duration among preterm infants continues to lag because of the unique challenges of breastfeeding preterm infants. African American mothers have the lowest rates of breastfeeding initiation and duration, and their preterm infants are less likely to receive breast milk while in the neonatal intensive care unit. The objective of this cross-€sectional quantitative study was to evaluate the relationship between breastfeeding and maternal sociodemographic factors as well as medical and obstetrical conditions for infants born between 32-€37 weeks gestational age in South Carolina from 2009 to 2011. The health belief model provided the framework for this study. Secondary data from the South Carolina Pregnancy Risk Assessment Monitoring System included 1,752 preterm pregnancies. Results of binary logistic regression and multivariate logistic regression analysis indicated that mothers who were African American and those who had lower income, no Medicaid, and lower education level breastfed less frequently. Findings may be used to decrease neonatal, postnatal, and infant morbidity and mortality, and to increase breastfeeding knowledge and support to ensure successful breastfeeding of preterm infants beyond the hospital.

Cleft lip with or without cleft palate (CLP) is an ongoing public health issue across the globe, and in the United States. The estimated number of babies born each year in the United States with cleft palate (CP) is about 2,650, while CLP affects approximately 4,440 babies. The purpose of this quantitative cross-sectional study was to determine if there is a relationship between CLP and maternal characteristics such as reproductive history (advanced maternal age, maternal obesity, prenatal visits, month prenatal care began, number of pregnancies, gestational age at birth, assisted reproductive technology used, gestational diabetes, and hypertension), socioeconomic status of the mother (marital status, education, mother's race, payment source for delivery, and place where birth occurred), and admission to the Neonatal Intensive Care Unit (NICU) in U.S. hospitals from January 2016 to December 2016. The epidemiological triad theory served as the study's framework. A secondary dataset from the National Vital Statistics System was used for this study. Logistic regression was used to test the hypothesized associations. Results indicated that many maternal characteristics such as mother's age (p = .000), maternal obesity (p = .020), number of prenatal visits (p = .001), total birth order (p = .001), gestational age at birth (p = .000), gestational diabetes (p = .002), and gestational hypertension (p = .032), mother's education (p = .000), marital status (p = .018), race (p = .000), and admission to NICU (p = .000) were significantly associated with CLP. Results of this study may help health care professionals identify the determinants of the risk of CLP so as to design and implement effective CLP preventive measures among United States populations that are disproportionately affected by this condition.

Professional research project (Au.D.)--University of South Florida, 2003. / Title from PDF of title page. / Document formatted into pages; contains 20 pages. / Includes bibliographical references. / Text (Electronic thesis) in PDF format. / ABSTRACT: The purpose of this study was to determine the effects of an atypical pattern of early acoustic stimulation on auditory development. Previous human research suggests that the acoustic environment of pre-term human infants in the Neonatal Intensive Care Unit (NICU) negatively affects some aspects of auditory development. Animal research suggests that premature auditory stimulation interrupts auditory development. Because mice are born before their auditory systems are developed, they make an excellent model for research on fetal and postnatal plasticity of the auditory system. The premature auditory state of newborn mice is similar to that of the NICU pre-term infant, albeit, natural for mice C57 mouse pups were exposed to an augmented acoustic environment (AAE) of a nightly 12-hour regiment of 70 dB SPL noise burst, beginning before age 12 days (onset of hearing) and lasting for one month. / ABSTRACT: The prepulse inhibition (PPI) of mice exposed to the AAE was compared to that of non-exposed mice to observe short-term and long-term effects. Results showed that the prepulse inhibition of the AAE exposed mice did not differ significantly from that of the non-exposed mice. However, it is possible that the measurement used, PPI, may not have been appropriate or that the AAE may not have been an appropriate simulation of the NICU environment. / System requirements: World Wide Web browser and PDF reader. / Mode of access: World Wide Web.

Bakgrund. Vård av döende barn kan vara psykiskt påfrestande för många sjuksköterskor som arbetar på neonatala intensivvårdsavdelningar. Internationella studier visar på att de främsta faktorerna är; brist på utbildning inom neonatal palliativ vård och brist på kommunikation. Syfte. Syftet med studien var att beskriva samband mellan sjuksköterskors attityder till att vårda döende barn på en neonatal intensivvårdsavdelning och arbetslivserfarenhet samt utbildningsnivå. Metod: Studien genomfördes med en webbaserad enkät på de neonatala intensivvårdsavdelningarna vid Norrlands Universitetssjukhus i Umeå samt Akademiska sjukhuset i Uppsala. Studien inkluderade 72 sjuksköterskor med erfarenhet av att vårda minst ett döende barn. Studien är en empirisk kvantitativ tvärsnittsstudie med deskriptiv design. Resultat. Alla sjuksköterskor med kort arbetslivserfarenhet ansåg att det var psykiskt påfrestande att vårda döende barn jämfört med 61% av de med lång erfarenhet. Mer än hälften (59%) av de utan vidareutbildning jämfört med de med vidareutbildning (16%) ville  undvika situationer där de behövde vårda döende barn. Av alla deltagarna önskade 85% mer utbildning än vad de fick i nuläget om vård av döende barn. Konklusion. Brist på vidareutbildning, kort arbetslivserfarenhet och hög tjänstgöringsgrad i konkret omvårdnadsarbete ökar risken för negativa attityder och uppfattningar bland sjuksköterskor i vården av döende barn. / Background. It can be a challenge for nurses to care for dying children in a neonatal intensive care unit. International studies show that the main factors are; lack of training in neonatal palliative care and lack of communication within the health care team. Objectives. The aim of this study was to describe the correlation between nurses' attitudes of caring for dying children in a neonatal intensive care unit and work experience and level of education. Method. The study was conducted using a web-based survey in the neonatal intensive care units at Norrland University Hospital in Umeå and Uppsala University Hospital. The study included 72 nurses with experience of caring for at least one dying child. The study is an empirical quantitative cross-sectional study with descriptive design. Results. All nurses with short work experience felt that it was psychologically stressful to care for dying children , compared with 61 % of those with long work experience. More than half (59%) of those without further education compared to those with further education ( 16%) wanted to avoid situations where they have to care for dying children. Of all the participants 85% wanted more education about caring for dying children. Conclusion. Lack of education, brief work experience and a high degree of service in the real nursing work increases the risk of negative attitudes and perception in the care of dying children among nurses.

Thesis (M.S.)--University of Texas Health Science Center at Houston, School of Public Health, 2008. / Source: Masters Abstracts International, Volume: 46-04, page: 2056. Adviser: Maureen Sanderson. Includes bibliographical references.