Thesis (M.A. (Population and Reproductive Health Research))--Mahidol University, 2006. / LICL has E-Thesis 0016 ; please contact computer services.

Thesis (Ph. D.)--School of Nursing. University of Missouri--Kansas City, 2008. / "A dissertation in nursing." Advisor: Peggy Ward-Smith. Typescript. Vita. Title from "catalog record" of the print edition Description based on contents viewed Sept. 12, 2008. Includes bibliographical references (leaves 84-96). Online version of the print edition.

Made available in DSpace on 2014-06-11T19:28:01Z (GMT). No. of bitstreams: 0 Previous issue date: 2006-05-08Bitstream added on 2014-06-13T19:15:51Z : No. of bitstreams: 1 tutes_er_me_botfm.pdf: 2501133 bytes, checksum: b9d523ae3c2d7179240486569c5878e6 (MD5) / Analisar os resultados iniciais da triagem auditiva neonatal, obtidos na maternidade antes da alta hospitalar, em recém-nascidos de dois hospitais públicos de Campo Grande, MS. Método: estudo de coorte transversal com 20044 recém-nascidos de dois hospitais no período de janeiro de 2002 a dezembro de 2005. Foram utilizadas as Emissões Otoacústicas Evocadas Transientes (EOAETs) e a Pesquisa do Reflexo Cócleo-palpebral (RCP). Os resultados dos testes foram classificados em passa e falha para as EOAETs e em presente ou ausente para o RCP. Foram analisados em relação ao(s): local de nascimento, tempo de vida no momento da avaliação, peso ao nascimento, sexo, tipo de parto, valores de Apgar, convênio assistencial e risco para deficiência auditiva segundo o Joint Committee Infant Hearing (JCIH). Resultados: Foram testados 95,96% dos recém-nascidos dos dois hospitais; nesta amostra 87,52% de recém-nascidos foram de baixo risco e 12,48% de alto risco para a deficiência auditiva. Houve predominância de respostas passa nas EOAETs para o sexo feminino e para o parto normal. Também foi observada relação de aumento de peso e aumento das respostas passa. Na população de baixo risco auditivo, conforme aumentava o tempo de vida no momento da avaliação, os resultados de passa também aumentavam; já na população de alto risco auditivo esta relação não foi observada. Conclusão: Este programa pode ser considerado como válido de acordo com as recomendações do JCIH. / To analyze the initial results of the neonatal hearing sreening, gotten in the maternity before the discharge hospital, in newborns of two public hospitals of Campo Grande, MS. Method: transversal study of coorte with 20044 newborns of two hospitals in the period of January of 2002 the December of 2005. The Transient Evoked Otoacoustic Emissions (TEOAEs) and the cochleo-palpebral refex (CPR) had been used. The results of the tests had been classified in pass and fail for the TEOAEs and in present or absent for the CPR . They had been analyzed in relation the: place of birth, time of life at the moment of the evaluation, weight to the birth, sex, type of childbirth, values of Apgar, assistencial accord and risk for hearing impairment according to Joint Committee Infant Hearing (JCIH). Results: 95.96% of the newborns of the two hospitals had been tested; in this sample 87.52% of newborns had been of low risk and 12.48% of high risk for the hearing loss. It had predominance of answers pass in the TEOAEs for the feminine sex and the normal childbirth. Also relation of weight increase was observed and increased of the answers pass. In the population of low auditory risk, as it increased the time of life at the moment of the evaluation, the results pass increased; already in the population of high auditory risk this relation was not observed. Conclusion: This program can be considered as valid in accordance with the recommendations of the JCIH.

No description available.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2005. / Härtill 5 uppsatser.

Currently, the care of premature newborn infants and their parents is mainly focused on the so-called Newborn Individualized Developmental Care and Assessment Program (NIDCAP) that is aimed at protection of the developing central nervous system of a premature child.The aim of nursing care is to help premature child to cope with the premature delivery. To adjust the environment and the way of care so it suits the individual needs of every child. The support of the parental role and the efforts to involve parents in the care of a newborn infant as early as possible are stressed. The following objectives were defined in the diploma thesis. To process experience with introducing new forms of the developmental care of excessively or extremely premature newborn infants from the point of view of nursing. To characterize current provision of individualized developmental care of newborn infants born before week 32 of gestation. To map the role of the nurse in delivering individualized developmental care and to find out how parents perceive the developmental care of excessively and extremely premature newborn infants. 4 research questions were raised on the basis of the objectives of the thesis. Which forms of the individualized developmental care are used in care of a newborn infant born before week 32 of gestation most? Which problems do nurses have to cope when employing individualized developmental care in the day-to-day care of newborn infants born before week 32 of gestation with and which roles of nurses are applied most when providing care? How do parents of newborn infants born before week 32 of gestation perceive the care of their child included in the individualized developmental care? The theoretical part of the thesis deals with the issue of excessively and extremely premature newborn babies, characteristics of the individualized developmental care and the nursing strategies, the role of a nurse and the role of parents. The practical part is focused on the qualitative research. The results of the research suggest the nurses have included the individualized developmental care into the nursing care of premature newborn infants at the Department of Neonatal Medicine in the Hospital in České Budějovice, however, not in its full extent. The parents perceive the included aspects of this care positively,the nursing staff is important. The research has identified problems nurses have to cope with when they implement this care and what the reserves in the implementation are. A map of the individualized developmental care that can be used by nurses in practice is the result of the research.

<p>Obesity is a major health problem in the Western world. Mean birth weight has increased during the last 25 years. One explanation is that the proportion of large for gestational age (LGA) infants has increased. Such infants risk developing obesity, cardiovascular disease and diabetes later in life. Despite the risk of neonatal hypoglycemia, their postnatal metabolic adaptation has not been investigated. Our data, obtained with stable isotope labeled compounds, demonstrate that newborn LGA infants have increased lipolysis and decreased insulin sensitivity. After administration of glucagon, the plasma levels of glucose and the rate of glucose production increased. The simultaneous increase in insulin correlated with the decrease in lipolysis, indicating an antilipolytic effect of insulin in these infants.</p><p>We also demonstrated an intergenerational effect of being born LGA, since women born LGA, were at higher risk of giving birth to LGA infants than women not born LGA. Further, the LGA infants formed three subgroups: born long only, born heavy only, and born both long and heavy. Infants born LGA of women with high birth weight or adult obesity were at higher risk of being LGA concerning weight alone, predisposing to overweight and obesity at childbearing age. In addition we found that pregnant women with gestational diabetes were at increased risk of giving birth to infants that were heavy alone. This could explain the risk of both perinatal complications and later metabolic disease in infants of this group of women.</p><p>To identify determinants of fetal growth, 20 pregnant women with a wide range of fetal weights were investigated at 36 weeks of gestation. Maternal fat mass was strongly associated with insulin resistance. Insulin resistance was related to glucose production, which correlated positively with fetal size. The variation in resting energy expenditure, which was closely related to fetal weight, was largely explained by BMI, insulin resistance, and glucose production. Lipolysis was not rate limiting for fetal growth in this group of women. Consequently, high maternal glucose production due to a high fat mass may result in excessive fetal growth.</p>

O Streptococcus do Grupo B (EGB) é um dos principais agentes de infecção no período neonatal, sendo responsável por altos índices de morbimortalidade materno-fetal. Este estudo tem por objetivo avaliar a passagem transplacentária de anticorpos anti-Streptococcus B e imunoglobulina G em recém-nascidos de termo e pré-termo, bem como comparar seus níveis séricos. Foi realizado estudo transversal incluindo 44 recém-nascidos (18 pré-termo e 26 de termo) do Berçário Anexo à Maternidade do Hospital das Clínicas da FMUSP no período de dezembro de 2006 a julho de 2007. Após consentimento esclarecido, foram obtidas amostras de sangue das mães e do cordão umbilical de seus respectivos recém-nascidos, realizadas dosagens de IgG total por nefelometria e de anticorpos anti-EGB através do ensaio imunoenzimático (ELISA). Observou-se que nos dois grupos de mães da casuística, compostos por 16 mães de RN pré-termo e 26 mães de RN de termo, não houve diferença significativa em relação aos níveis séricos de anticorpos anti-EGB. O nível sérico médio de anticorpos maternos anti-EGB foi de 1697,98, com variação de 456 a 5200 (em títulos). O nível sérico médio de anticorpos anti-EGB das mães de RNPT foi de 1570,72, com variação de 588 a 3829 (em títulos), enquanto nas mães de RNT o nível médio foi de 1786,08, com variação de 456 a 5200. Os níveis séricos de anticorpos anti-Streptococcus do grupo B dos recém-nascidos foram significantemente mais baixos nos RN pré-termo em relação aos RN de termo. O nível sérico médio de anticorpos anti-EGB dos RNPT foi de 1059,22, com variação de 416 a 3924 (em títulos), enquanto nos RNT foi 2025,50, com variação de 542 a 5476. Houve correlação positiva entre os níveis de imunoglobulina G e de anticorpos anti-Streptococcus B com a idade gestacional, demonstrando correlação entre prematuridade e baixos níveis séricos de anticorpos anti-EGB. A associação entre idade gestacional inferior a 37 semanas e diminuição dos níveis de anticorpos anti-EGB concorda com a maior vulnerabilidade dos neonatos pré-termo à infecção por esta bactéria. Os autores concluem que houve passagem transplacentária de imunoglobulina G e anticorpos anti-Streptococcus B nos RN de termo e pré-termo, sendo, porém, os níveis séricos significantemente mais baixos nos RNPT, tanto em relação às suas mães quanto em relação aos níveis observados nos RN de termo. Os recém-nascidos de termo apresentaram níveis séricos de anticorpos anti-Streptococcus B semelhantes aos maternos, devido ao incremento da transferência transplacentária no final da gestação. Houve correlação positiva entre os níveis de imunoglobulina G e de anticorpos anti-Streptococcus B com a idade gestacional, enfatizando a importância da prematuridade como fator determinante das baixas concentrações séricas destes componentes imunológicos. Não houve diferença significante entre as mães dos recém-nascidos de termo e pré-termo em relação aos níveis séricos de anticorpos anti-Streptococcus B. / Group B Streptococcus (GBS) is one of the leading causes of infections in mothers and newborn babies, and it is responsible for high mortality rates. The purpose of this study was to evaluate the transplacental transfer of anti-Streptococcus B antibodies and immunoglobulin G in term and preterm newborns and compare the serum levels between these two groups. A transversal study was conducted with 44 newborns (18 preterm and 26 term infants) admitted to the Nursery next to FMUSP Hospital das Clínicas Maternity in the period of December 2006 to July 2007. After they gave their informed consent, blood and umbilical cord samples were collected from the mothers and from their respective newborn babies. Total IgG measurements were performed using nephelometry and the presence of antibodies anti-GBS was evaluated by the immunoenzimatic test (ELISA). In both groups of mothers (16 preterm`s mothers and 26 term`s mothers) the serum levels of anti-Streptococcus B antibodies were similar and there was no statistical significance between them. The mean serum levels of anti-GBS antibodies in mothers was 1697,98, ranging from 456 to 5200 (in titles). The mean serum levels of anti-GBS antibodies in mothers of preterm babies was 1570,72, ranging from 588 to 3829 (in titles), while in term`s mothers the mean level was 1786,08, ranging from 456 to 5200. Anti-Streptococcus B antibodies in the newborns demonstrated significantly lower levels in preterm newborn compared to the levels of the term newborns. The mean serum levels of anti-GBS antibodies in preterm newborns was 1059,22, ranging from 416 to 3924 (in titles), while in term newborns the mean level was 2025,50, ranging from 542 to 5476. There was a positive correlation between the levels of immunoglobulin G and anti-Streptococcus B antibodies and the gestational age which shows the correlation between prematurity and low levels of anti-Streptococcus B antibodies. The association between gestational age less than 37 weeks and reduction of anti-GBS antibody levels corroborates with the fact that preterm neonates are more vulnerable to the infection by this bacteria. The authors have come to the conclusion that transplacental transfer of immunoglobulin G and anti-Streptococcus B antibodies have been proved in term and preterm newborns. The transfer of immunoglobulin and antibodies was less effective in preterm newborns, whose serum levels were significantly lower compared to the levels of their mothers and the term newborns. Term newborns showed levels of anti-Streptococcus B antibodies similar to their mothers due to the increase of transplacental transfer of antibodies during the end of gestation. The positive correlation between the levels of immunoglobulin G and anti-Streptococcus B antibodies with gestational age, proves the importance of prematurity as a determining factor of the low serum concentrations in the components of this newborn\'s immunological repertoire. There was no significant difference between the levels of anti-Streptococcus B antibodies in mothers of term and preterm newborns.

Made available in DSpace on 2016-07-27T14:20:49Z (GMT). No. of bitstreams: 1 Ocania da Costa Vale.pdf: 463237 bytes, checksum: 5b5deb15061b023bdcbbca6a38187bb9 (MD5) Previous issue date: 2006-06-19 / This research intended to verify is the behavior of the newborn indicates recognition of motherese maternal. Subjects were twenty normal newborn babies (seven female and thirteen male) with average weight of 3,300Kg and Apgar score of nine on the first and fifth minutes of life. The experiment used a multiple ABA or reversion design, alternating between periods of base-line and periods of verbal stimulation. Behavioral data were obtained through direct observation using behavioral sampling with fixed time interval. Recorded behaviors were: Orientation, Attention, Body movements, Crying, Vocalization and Non-nutritional suction. In this study, the variation of Orientation, through out the session, suggests that habituation occurred for female Motherese in general, especially for the maternal voice. Body movements indicate relation between the stimulus and the expectation of successive events, indicating recognition of maternal motherese. Cry response indicates a tendency to discriminate the infantilization of the maternal voice and also hold a singular relation with maternal verbal behavior during gestation. The occurrence Vocalizations in response to motherese might be related to the development of the emotional processing the language. The occurrence of Non-nutritional suction demonstrates the ability of the newborn to associate environmental stimulus to the received cares. / Esta pesquisa pretendeu identificar os comportamentos do recém-nascido, indicadores de discriminação da infantilização da voz materna. Participaram deste estudo vinte recém-nascidos ouvintes normais, sendo sete do sexo feminino e treze do sexo masculino com idade média de 26h36min de vida, peso médio de 3,300 Kg e escore de Apgar 9 no primeiro e 10 no quinto minuto de vida. O experimento foi desenhado segundo o delineamento ABA múltiplo ou de reversão, alternando entre períodos de linhas de base e períodos de estimulação verbal. Os dados comportamentais foram obtidos por meio da observação direta usando o método de amostragem com intervalo de tempo. Os comportamentais registrados foram: Orientação, Atenção, Movimentos corporais, Choro, Vocalização e Sucção não-nutritiva. Neste estudo, a variação de Orientação, ao longo da sessão, sugere que a habituação ocorreu, em geral, diante da infantilização das vozes femininas, especialmente diante da voz materna. Os Movimentos corporais indicam a relação entre o estímulo percebido e a expectativa dos eventos sucessivos indicando o reconhecimento da infantilização da voz materna. A resposta do Choro indicou a tendência de discriminação da infantilização da voz materna e, também, apresentou uma singular relação com a conduta verbal da mãe durante a gestação. A ocorrência da Vocalização diante das vozes infantilizadas pode associar-se ao desenvolvimento do processamento emocional da linguagem. A produção de Sucção não-nutritiva demonstra a habilidade do recém-nascido de associar estímulos ambientais aos cuidados recebidos.

O Streptococcus do Grupo B (EGB) é um dos principais agentes de infecção no período neonatal, sendo responsável por altos índices de morbimortalidade materno-fetal. Este estudo tem por objetivo avaliar a passagem transplacentária de anticorpos anti-Streptococcus B e imunoglobulina G em recém-nascidos de termo e pré-termo, bem como comparar seus níveis séricos. Foi realizado estudo transversal incluindo 44 recém-nascidos (18 pré-termo e 26 de termo) do Berçário Anexo à Maternidade do Hospital das Clínicas da FMUSP no período de dezembro de 2006 a julho de 2007. Após consentimento esclarecido, foram obtidas amostras de sangue das mães e do cordão umbilical de seus respectivos recém-nascidos, realizadas dosagens de IgG total por nefelometria e de anticorpos anti-EGB através do ensaio imunoenzimático (ELISA). Observou-se que nos dois grupos de mães da casuística, compostos por 16 mães de RN pré-termo e 26 mães de RN de termo, não houve diferença significativa em relação aos níveis séricos de anticorpos anti-EGB. O nível sérico médio de anticorpos maternos anti-EGB foi de 1697,98, com variação de 456 a 5200 (em títulos). O nível sérico médio de anticorpos anti-EGB das mães de RNPT foi de 1570,72, com variação de 588 a 3829 (em títulos), enquanto nas mães de RNT o nível médio foi de 1786,08, com variação de 456 a 5200. Os níveis séricos de anticorpos anti-Streptococcus do grupo B dos recém-nascidos foram significantemente mais baixos nos RN pré-termo em relação aos RN de termo. O nível sérico médio de anticorpos anti-EGB dos RNPT foi de 1059,22, com variação de 416 a 3924 (em títulos), enquanto nos RNT foi 2025,50, com variação de 542 a 5476. Houve correlação positiva entre os níveis de imunoglobulina G e de anticorpos anti-Streptococcus B com a idade gestacional, demonstrando correlação entre prematuridade e baixos níveis séricos de anticorpos anti-EGB. A associação entre idade gestacional inferior a 37 semanas e diminuição dos níveis de anticorpos anti-EGB concorda com a maior vulnerabilidade dos neonatos pré-termo à infecção por esta bactéria. Os autores concluem que houve passagem transplacentária de imunoglobulina G e anticorpos anti-Streptococcus B nos RN de termo e pré-termo, sendo, porém, os níveis séricos significantemente mais baixos nos RNPT, tanto em relação às suas mães quanto em relação aos níveis observados nos RN de termo. Os recém-nascidos de termo apresentaram níveis séricos de anticorpos anti-Streptococcus B semelhantes aos maternos, devido ao incremento da transferência transplacentária no final da gestação. Houve correlação positiva entre os níveis de imunoglobulina G e de anticorpos anti-Streptococcus B com a idade gestacional, enfatizando a importância da prematuridade como fator determinante das baixas concentrações séricas destes componentes imunológicos. Não houve diferença significante entre as mães dos recém-nascidos de termo e pré-termo em relação aos níveis séricos de anticorpos anti-Streptococcus B. / Group B Streptococcus (GBS) is one of the leading causes of infections in mothers and newborn babies, and it is responsible for high mortality rates. The purpose of this study was to evaluate the transplacental transfer of anti-Streptococcus B antibodies and immunoglobulin G in term and preterm newborns and compare the serum levels between these two groups. A transversal study was conducted with 44 newborns (18 preterm and 26 term infants) admitted to the Nursery next to FMUSP Hospital das Clínicas Maternity in the period of December 2006 to July 2007. After they gave their informed consent, blood and umbilical cord samples were collected from the mothers and from their respective newborn babies. Total IgG measurements were performed using nephelometry and the presence of antibodies anti-GBS was evaluated by the immunoenzimatic test (ELISA). In both groups of mothers (16 preterm`s mothers and 26 term`s mothers) the serum levels of anti-Streptococcus B antibodies were similar and there was no statistical significance between them. The mean serum levels of anti-GBS antibodies in mothers was 1697,98, ranging from 456 to 5200 (in titles). The mean serum levels of anti-GBS antibodies in mothers of preterm babies was 1570,72, ranging from 588 to 3829 (in titles), while in term`s mothers the mean level was 1786,08, ranging from 456 to 5200. Anti-Streptococcus B antibodies in the newborns demonstrated significantly lower levels in preterm newborn compared to the levels of the term newborns. The mean serum levels of anti-GBS antibodies in preterm newborns was 1059,22, ranging from 416 to 3924 (in titles), while in term newborns the mean level was 2025,50, ranging from 542 to 5476. There was a positive correlation between the levels of immunoglobulin G and anti-Streptococcus B antibodies and the gestational age which shows the correlation between prematurity and low levels of anti-Streptococcus B antibodies. The association between gestational age less than 37 weeks and reduction of anti-GBS antibody levels corroborates with the fact that preterm neonates are more vulnerable to the infection by this bacteria. The authors have come to the conclusion that transplacental transfer of immunoglobulin G and anti-Streptococcus B antibodies have been proved in term and preterm newborns. The transfer of immunoglobulin and antibodies was less effective in preterm newborns, whose serum levels were significantly lower compared to the levels of their mothers and the term newborns. Term newborns showed levels of anti-Streptococcus B antibodies similar to their mothers due to the increase of transplacental transfer of antibodies during the end of gestation. The positive correlation between the levels of immunoglobulin G and anti-Streptococcus B antibodies with gestational age, proves the importance of prematurity as a determining factor of the low serum concentrations in the components of this newborn\'s immunological repertoire. There was no significant difference between the levels of anti-Streptococcus B antibodies in mothers of term and preterm newborns.