Sprachverstehen erfordert ein Zusammenspiel verschiedener mentaler Prozesse. Zuerst muss der kontinuierliche akustische Sprachstrom in einzelne Einheiten (z.B. Wörter) unterteilt werden. Segmentale und suprasegmentale linguistische Information unterstützt den Segmentierungsprozess. Wissen über die neuronalen Mechanismen dieser Prozesse ist wesentlich um Sprachverarbeitungs- und Sprachentwicklungsprozesse zu verstehen. Ziel der Dissertation ist die Charakterisierung neuronale Korrelate der Verarbeitung sprachrelevanter akustischer Information bei Erwachsenen und Säuglingen mittels kombinierter Nahinfrarot-Spektroskopie- und Elektroenzephalographie-Messungen. Studie I untersucht zeitliche und topographische Aspekte der phonotaktischen Verarbeitung bei Erwachsenen. Die Ergebnisse zeigen, dass phonotaktische Information links-hemisphärisch verarbeitet wird. Ob diese Lateralisierung auf die linguistischen oder akustischen Eigenschaften der Reize zurückzuführen ist bleibt unklar. Erwachsenen-Studien zeigen, dass die lateralisierte Verarbeitung von Sprache aus der Spezialisierung des auditorischen Kortex für bestimmte zeitliche akustische Variationen im Sprachsignal resultiert. Studie II und III untersuchen, ob diese Asymmetrie bereits bei Säuglingen vorliegt. Dafür werden zeitlich variierte nicht-sprachliche akustische Reize präsentiert. Die zeitlichen Variationen entsprechen kritischen Modulationen im Sprachsignal. Studie II zeigt, dass bei Neugeborenen die zeitlichen Modulationen zu differenzierten und lateralisierten Verarbeitungsmustern führen, die über die ersten Lebensmonate konstant bleiben (Studie III). Die Ergebnisse unterstützen die Annahme, dass die lateralisierte Verarbeitung von Sprache mit einer Spezialisierung des auditorischen Kortex für bestimmte zeitliche Frequenzen zusammenhängt. Das Gehirn ist von Geburt auf die Wahrnehmung zeitlicher akustischen Variationen spezialisiert, die für die Entschlüsselung des Sprachsignals relevant sind. / The comprehension of spoken language requires the segmentation of the continuous acoustic speech stream into smaller units (e.g., words). Segmental and suprasegmental linguistic information guide the segmentation process. Investigating the underlying neuronal mechanisms is crucial for understanding the general nature of language perception, and language acquisition in infancy. This dissertation aimed to determine neuronal mechanisms underlying the perception of basic auditory cues relevant for the segmentation of speech in adults and infants using concurrent recordings of near-infrared spectroscopy and electroencephalography. Study I assessed temporal and topographic characteristics of phonotactic processing in adults, thus forming the basis for future studies in infants. The results show that phonotactic processing recruits a left hemispheric network. Whether these asymmetries are a function of linguistic attributes or of basic temporal signal properties is under debate. Studies in adults link hemispheric specialization for speech perception to an asymmetry in cortical tuning and reveal that the auditory cortices are differentially sensitive to temporal features of speech. Whether this asymmetry is already established in infancy is addressed by study II and III. These studies used acoustic non-linguistic sounds that vary in their temporal structure, thus sharing critical temporal features with language. Study II reveals that newborns process temporally varying stimuli in a differential and lateralized fashion. Study III indicates that this lateralization pattern remains constant over the first months of life. The findings support the notion that the lateralization of language functions might result from a specialization for different acoustic properties. The data provide further evidence that language acquisition is linked to basic capacities in auditory processing, and reveal that from birth the brain is tuned to critical temporal properties of linguistic signals.

Made available in DSpace on 2016-04-27T18:12:44Z (GMT). No. of bitstreams: 1 Monique Kelly Duarte Lopes.pdf: 450811 bytes, checksum: 0b819395982a5d4d5a8a377e0891fa64 (MD5) Previous issue date: 2010-02-10 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Introduction: the data submitted by the Surveillance Epidemiological Center of the State of São Paulo, Brazil, pointed out that the number of children, particularly with infectious diseases increases each year. Some of these diseases are considered as indicators of risk for hearing. To know their occurrence is important in order to support official programs for hearing loss prevention and hearing conservation. Objective: to analyze and compare the occurrence of risk indicators for hearing in a period of 10 years (1995-2005) in a public maternity of São Paulo, Brazil. Method: It is a retrospective and quantitative study, based on collected data of newborn records of a public maternity of São Paulo. Records of babies born between January and December of 1995 and 2005 and that presented deafness risk indicators, such as: prematurity, low weight and asphyxia, and/or, have suspected or confirmed diagnosis of TORSCH-A group infection (toxoplasmosis, congenital rubella, syphilis, cytomegalovirus, Herpes and HIV+) were included. Results: from all the babies records, were considered 565 children born in 1995, and 1047 in 2005. Among the risk indicators for deafness analyzed in two years, it was observed that there was significant difference for the indicator prematurity, being the largest percentage of premature children in 1995 (p<0,001); there was no significant difference between the percentages of low weight indicator occurrence in 1995 and 2005 (p =-0,209), and there was significant difference between the percentages of children with asphyxia in two years (p = 0,027). The higher percentage of occurrence was in 1995. The risk indicators: prematurity, low weight and asphyxia were more frequent than toxoplasmosis, syphilis and HIV. The compared analysis of concurrency of these 3 risk factors has been reviewed and compared, in 1995, 1.2% of children did not present any of 3 risk indicators, while, in 2005, that percentage was 9.1%. In 1995, we observed the largest percentage of children with prematurity and low weight (28.9%), while in 2005 it was only low-weight (31.1%). It was also noted that in 1995 there was simultaneous occurrence of 3 risk factors in 7.3% of children, while that in 2005 the percentage was 3.2%. There is no significant difference between the associated percentages for prematurity, low weight and asphyxia in two years (p<0,001). In two years, the largest number of indicators observed in one child was 3. Most of the babies presented at least one risk indicator (57.1% in 1995 and 69.4% in 2005). Conclusion: Children born in 1995 tended to have a greater number of indicators of risk than those born in 2005 (p<0,001) / Os dados apresentados pelo Centro de Vigilância Epidemiológica do Estado de São Paulo apontam que o número de crianças, acometidas por doenças infecto-contagiosas, aumenta a cada ano. Algumas destas doenças são consideradas de risco para a audição. Conhecer sua ocorrência é importante para fundamentar ações de prevenção e de promoção de saúde auditiva. Objetivo: verificar e comparar a ocorrência de indicadores de risco para Deficiência Auditiva em um intervalo de 10 anos (1995 e 2005) em uma maternidade municipal de São Paulo. Método: é um estudo de caráter quantitativo e retrospectivo, realizado a partir do levantamento e análise de dados dos registros fornecidos por uma Maternidade da cidade de São Paulo. Foram incluídos na pesquisa, os registros dos bebês que nasceram entre janeiro a dezembro dos anos de 1995 e 2005, e que apresentassem indicadores de risco para surdez, como: prematuridade, baixo peso e asfixia, além de, possuir diagnóstico confirmado ou suspeita de doenças infecto-contagiosas do grupo TORSCH-A. Resultados: Foram considerados os prontuários de 565 crianças nascidas em 1995, e 1047 em 2005. Dentre os Indicadores de Risco para surdez analisados nos dois anos, observou-se que houve diferença significativa para o indicador prematuridade, sendo a porcentagem de crianças prematuras maior em 1995 (p<0,001), não houve diferença significativa entre as porcentagens de ocorrência do indicador baixo peso em 1995 e 2005 (p=0,209), e houve diferença significativa entre as porcentagens de crianças com asfixia nos dois anos (p=0,027), sendo a porcentagem de ocorrência maior em 1995. Os indicadores de risco: prematuridade, baixo peso e asfixia, foram mais freqüentes do que a Toxoplasmose, a Sífilis e o HIV+. A análise comparada da simultaneidade desses 3 fatores de risco foi analisada e comparada, em 1995, 1,2% das crianças não apresentaram nenhum dos 3 indicadores de risco, enquanto que, em 2005, essa porcentagem foi de 9,1%. Em 1995, a maior porcentagem observada foi a de crianças com prematuridade e baixo peso (28,9%), enquanto que em 2005 foi somente de baixo peso (31,1%). Notou-se ainda que em 1995 houve a ocorrência simultânea dos 3 indicadores de risco em 7,3% das crianças, enquanto que em 2005 a porcentagem foi de 3,2%. Há diferença significativa entre as distribuições de porcentagens conjunta de prematuridade, baixo peso e asfixia nos dois anos (p<0,001). Assim, nos dois anos, o maior número de indicadores observados em uma mesma criança foi 3. A maioria destas apresentou pelo menos um indicador de risco (57,1% em 1995 e 69,4% em 2005). Conclusão: pode-se concluir que, as crianças nascidas em 1995 tenderam a ter um maior número de indicadores de risco do que as nascidas em 2005 (p<0,001)

Submitted by Marlene Santos (marlene.bc.ufg@gmail.com) on 2014-10-14T20:24:00Z No. of bitstreams: 2 Dissertação - Ellia Christinne de Lima França - 2013.pdf: 2174155 bytes, checksum: 514acbbd5493b1455db408ce9110387f (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Approved for entry into archive by Jaqueline Silva (jtas29@gmail.com) on 2014-10-16T18:00:36Z (GMT) No. of bitstreams: 2 Dissertação - Ellia Christinne de Lima França - 2013.pdf: 2174155 bytes, checksum: 514acbbd5493b1455db408ce9110387f (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Made available in DSpace on 2014-10-16T18:00:36Z (GMT). No. of bitstreams: 2 Dissertação - Ellia Christinne de Lima França - 2013.pdf: 2174155 bytes, checksum: 514acbbd5493b1455db408ce9110387f (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2013-12-02 / The literature on orofacial muscle activity in infant feeding with the use of alternative methods for breastfeeding is scarce. When breastfeeding is difficult or impossible during the neonatal period, an analysis of muscle activity can help determine the best method for substituting it to promote the child’s development. The aim of this study was to analyze the electrical activity of the masseter muscle using surface electromyography during suction in term newborns by comparing breastfeeding, bottle and cup feeding. We conducted an observational, cross-sectional analytical study, in the rooming in care at the Materno Infantil Hospital of Goiânia-Goiás. Was carried out on healthy, clinically stable term infants. Muscle activity was analyzed using surface electromyography during breastfeeding, bottle and cup feeding. Root mean square averages (RMS) recorded in microvolts were transformed into percentages (normalization) of the reference value. The three groups were compared by ANOVA; the “stepwise” method of the multiple linear regression analysis tested the model which best defined the activity of the masseter muscle in the sample at a significance level of 5%. Participants were 81 newborns aging 1.4±0.8 days of life,equally distributed among the three groups. RMS values were lower in the bottle (44.2±14.1%) than in the breast feeding (58.3±12.7%) (p=0.003, ANOVA); cup feeding (52.5±18.2%) did not differ (p>0.05). For one gram increase in weight, RMS would increase by 0.010 units. Bottle/cup feeding would reduce RMS by 10.392 units, comparing to breastfeeding. Masseter activity was significantly higher in breastfed newborns, compared to bottle-fed newborns, which presented the lowest RMS values. Masseter activity during cup-feeding stayed in-between breast and bottle feeding, and did not significantly differ from both groups. Cup/bottle feeding significantly predicted a decreased in RMS, compared to breastfeeding. / A literatura sobre a atividade da musculatura orofacial na alimentação de bebês com o uso de métodos alternativos ao aleitamento materno é escassa. A análise da atividade muscular pode ajudar a definir o melhor método substituto do aleitamento materno quando este está dificultado ou impedido no período neonatal, visando beneficiar o desenvolvimento da criança. O objetivo deste trabalho foi analisar a atividade elétrica do músculo masseter por meio da eletromiografia de superfície durante sucção nos recém-nascidos a termo comparando aleitamento materno, mamadeira e copo. Realizou-se um estudo observacional, analítico transversal, no Alojamento Conjunto do Hospital Materno Infantil de Goiânia-Goiás. Incluiuse recém-nascidos saudáveis, a termo, clinicamente estáveis. Avaliou-se a atividade muscular por meio de eletromiografia de superfície durante aleitamento materno, alimentação com mamadeira ou com copo. As médias de root meant square (RMS) registradas em µV foram transformadas em valores percentuais (normalização) do valor de referência. Os três grupos foram comparados por ANOVA; análise de regressão linear múltipla, método “stepwise”, testou o modelo que melhor definisse a atividade do músculo masseter na amostra estudada; observou-se nível de significância de 5%. Participaram 81 recém-nascidos 1,4 ± 0,8 dias de vida, distribuídos igualmente entre os três grupos. Os valores encontrados da atividade do músculo masseter em RMS foram menores em alimentação por mamadeiras (44,2 ± 14,1%) do que no aleitamento materno (58,3 ± 12,7%) (p = 0,003, ANOVA); a alimentação por copo (52,5 ± 18,2%) não diferiu (p> 0,05). Para um aumento de peso em gramas, o valor de RMS aumentaria 0.010 unidades. Alimentação por mamadeira / copo reduziria RMS por 10,392 unidades, em comparação com a amamentação. A maior média percentual da atividade do músculo masseter foi significativamente maior nos recémnascidos amamentados, em comparação com recém-nascidos alimentados por mamadeira, que apresentou os menores valores de RMS. A média percentual da atividade do músculo masseter durante a alimentação por copo ficou entre as médias encontradas no aleitamento materno e na mamadeira, e não diferiu significativamente entre os dois grupos. Copo / mamadeira predisseram significativamente a diminuição da atividade do músculo, em comparação com a amamentação.

Drug and alcohol addiction in pregnant women is a significant public health issue. The purpose of this study was to assess drug and alcohol addiction in pregnant women and the setting in which they sought service or treatment to determine whether U.S. census regions and race data could predict the type of addiction service or treatment that pregnant addicts chose. The theories of self-efficacy, cognitive behavioral therapy, and rational emotive behavioral therapy were used as the theoretical framework for this study. The research questions were used to examine whether there was a relationship between the source of addiction treatment referral and the type of addiction service or treatment setting for pregnant addicts that reside in the United States at the time of their initial admission for treatment. This quantitative study used archival data from the 2012 Treatment Episode Dataset – Admission from the Substance Abuse and Mental Health Services Administration. Data analysis included the Chi square (χ2) test of independence and a multinomial regression. There was a significant relationship (p < .001) between the source of treatment program referral and type of service/treatment setting for pregnant women who were diagnosed with only an alcohol addiction and both an alcohol and illicit drug addiction. U.S. census region and race did predict the type of addiction service/treatment setting for pregnant addicts diagnosed with an alcohol addiction, as well as those diagnosed with a drug addiction, at the time of treatment admission. Results from this study can be used to address an under researched area of addiction treatment and could aid in changing the behaviors of pregnant addicts, thereby potentially promoting positive social change.

Tyrimo tikslas. Išanalizuoti Neonatologijos klinikoje gydomų naujagimių tėvų poreikius. Tyrimo uždaviniai: 1. Nustatyti Neonatologijos klinikoje gydomų naujagimių tėvų svarbiausius poreikius. 2. Išanalizuoti Neonatologijos klinikoje gydomų naujagimių tėvų poreikių tenkinimą. 3. Nustatyti personalo vaidmenį tenkinant Neonatologijos klinikoje gydomų naujagimių tėvų poreikius. Tyrimo metodika. Tyrimas buvo vykdomas 2010 balandžio – liepos mėnesiais LSMUL Kauno klinikų Neonatologijos klinikoje. Tyrime dalyvavo 455 respondentai (iš jų 365 NLS ir 90 NITS). Tyrimo metu informacijai rinkti buvo naudojamas Gudrun Kristijandottir „Tėvų poreikių vaikų intensyviosios terapijos skyriuje“ vertinimo įrankis. Statistinei duomenų analizei naudota SPSS 17.0 kompiuterinė programa. Atlikta aprašomoji statistika, vertinta požymių priklausomybė, lyginti neparametrinių kintamųjų vidurkiai bei proporcijų lygybė, ryšio stiprumas. Skirtumai laikyti statistiškai reikšmingais, kai reikšmingumo lygmuo p≤0,05. Išvados. 1. Analizuojant Neonatologijos klinikoje gydomų naujagimių tėvų pasitikėjimo, užtikrintumo, informacinių, skatinimo, tėvų fizinių poreikių, mokymo, tėvų visų poreikių, paramos, kuri užtikrintų tėvų gerovę, paramos, susijusios su kitais šeimos nariais, finansinės konsultacijos poreikių svarbos vertinimus statistiškai reikšmingų skirtumų tarp poreikių poskalių vertinimų nustatyta nebuvo, todėl iškelta hipotezė, kad Neonatologijos klinikoje gydomų naujagimių tėvams svarbiausi yra... [toliau žr. visą tekstą] / The aim of the study. To analyze the needs of parents of hospitalized newborns in the Neonatal Clinic. Objectives: 1. To establish the most important needs of parents of hospitalized newborns in the Neonatal Clinic. 2. To analyze the meeting of needs of parents of hospitalized newborns in the Neonatal Clinic. 3. To identify the role of personnel in meeting the needs of parents of hospitalized newborns in the Neonatal Clinic. Methodology. The study was conducted in April – July of 2010 at the Neonatal Clinic of Lithuanian University of Health Sciences Hospital (LSMUL). This study included 455 parents (365 at Newborns Care Unit (NCU) and 90 at Neonatal Intensive Care Unit (NICU)). Data was collected using „NPQ – Needs of Parents Questionnaire“ developed by Gudrun Kristijandottir. Statistical data analysis was performed using SPSS 17.0 software program. Performed descriptive statistics, evaluated the signs of addiction, compared means nonparametric variables’ and equality of proportions, the connection strength. The differences were statistically significant at the significance level of p ≤ 0.05. Conclusions. 1. Analyzing importance of parental needs in Neonatal Clinic: trust, assurance, information, encouragement, guidance, support ensuring welfare of parents, support related to other family members, financial consultation, physical and other parental needs statistically significant differences were not found. Therefore, hypothesis, that informational needs are the most... [to full text]

The peripheral venipuncture in premature newborns (RNPT) and the challenges for nursing care and patient safety are the subject of this study, which has as its guiding questions: How the practice of nursing care with peripheral venipuncture in preterm infants? What are the challenges experienced in nursing care considering patient safety and promoting comfort and minimizing pain? Aimed to comprehend the practice of nursing care with peripheral venipuncture form on RNPT and its challenges to promote comfort and minimize pain with a view to patient safety. Specifically: 1) To describe the profile of respondents;" 2) characterize the peripheral venipuncture procedure in preterm infants, while care practice performed by the nursing team; 3) identify the knowledge of professionals about this care practice; 4) relate aimed at professional attention to manifestations of preterm infants before, during and after the procedure with a view to patient safety; 5) verify the measures to promote comfort and minimize pain in relation to peripheral venipuncture in preterm infants. Descriptive and qualitative study, developed in the neonatal unit of the Universitary Hospital Professor Alberto Antunes (HUPAA / UFAL), Maceió/AL, between April and September 2014, after approval by the Ethics Committee of the Federal University of Alagoas, in the opinion under No. 608,622. The population was made up of 42 professionals of the nursing staff of this unit being applied semi-structured interview, plus a daily non-participant observation. The recorded data were transcribed and validated by each professional. There was use of the Content Analysis, proposed by Laurence Bardin, resulting in the following categorization: 1) Professional Practice in Neonatology and care peripheral venipuncture; 2) humanizing aspects and promotion of comfort by the team in RNPT. The results showed: the sensitivity of professionals, nursing care in trans peripheral venipuncture period; appreciation of humanization of such care; scientific knowledge associated with professional practice; leveling the knowledge reported in the same professional category; applicability of non-pharmacological techniques for pain relief; attention to manifestations of assisted RN; interest and appreciation of the professional development; consistency between reported and care the product of observation made. The study revealed the sensitivity of the participants in order to promote comfort and ease the pain of RNPT subjected to a peripheral venipuncture. Regardless of the busy and institutional link position, characterized individualized and humanized care by interest whether transpose the difficulties encountered, whether related to RN or provided by the dynamics of service. It identified the expansion of nursing practice dimension, bringing the academic and healthcare faces, resulting in identification of interest for the provision of nursing care quality coated, not limited to the activities of compliance. / A venopunção periférica em recém-nascidos prematuros (RNPT) e os desafios para o cuidado de enfermagem e a segurança do paciente constituem o objeto deste estudo, que traz como questões norteadoras: Como ocorre a prática do cuidado de enfermagem com a venopunção periférica em RNPT? Quais os desafios vivenciados no cuidado de enfermagem considerando-se a segurança do paciente e a promoção de conforto e minimização da dor? Objetivou-se compreender a prática do cuidado de enfermagem com a venopunção periférica em recém-nascidos prematuros, seus desafios para a promoção do conforto e minimização da dor com vistas à segurança do paciente. Especificamente: 1) descrever o perfil dos participantes da pesquisa; 2) caracterizar o procedimento de venopunção periférica em RNPT, enquanto prática de cuidado executada pela equipe de enfermagem; 3) identificar o conhecimento dos profissionais acerca deste cuidado; 4) relacionar a atenção voltada pelo profissional às manifestações do RNPT, antes, durante e após o procedimento, na perspectiva da segurança do paciente; 5) verificar as medidas de promoção do conforto e minimização da dor em relação à venopunção periférica em RNPT. Estudo descritivo, qualitativo, desenvolvido na unidade neonatal do Hospital Universitário Professor Alberto Antunes (HUPAA/UFAL), Maceió/AL, entre abril e setembro de 2014, após aprovação do Comitê de Ética em Pesquisa da Universidade Federal de Alagoas, segundo o parecer sob nº 608.622. A população compôs-se por 42 profissionais da equipe de enfermagem desta unidade, sendo aplicada entrevista semi-estruturada, acrescida por diários de observação não-participante. Os dados gravados foram transcritos e validados, por cada profissional. Fez-se uso da Análise de Conteúdo, proposta por Laurence Bardin, resultando na seguinte categorização: 1) Prática profissional em Neonatologia e cuidados com a venopunção periférica; 2) Aspectos de humanização e promoção do conforto pela equipe diante da venopunção periférica em RNPT. Os resultados demonstraram: sensibilidade dos profissionais, aos cuidados de enfermagem, no período de transvenopunção periférica; valorização da humanização destes cuidados; conhecimento científico associado à prática profissional; nivelamento do conhecimento relatado, em uma mesma categoria profissional; aplicabilidade de técnicas não farmacológicas para alívio da dor; atenção às manifestações do RN assistido; interesse e valorização do aprimoramento profissional; coerência entre os cuidados relatados e o produto da observação realizada, ou seja, os detalhes do cuidado que puderam ser, pela pesquisadora, visualizados. O estudo revelou a sensibilidade dos participantes, no intuito de se promover conforto e amenizar a dor do RNPT submetido a uma venopunção periférica. Independente do cargo ocupado e vínculo institucional, caracterizou-se uma assistência individualizada e humanizada, mediante interesse por se transpor as dificuldades encontradas, seja relacionadas ao RN ou proporcionadas pela dinâmica do serviço. Identificou-se a ampliação da dimensão da prática de enfermagem, aproximando as faces acadêmica e assistencial, com consequente reconhecimento do interesse pela prestação de cuidados de enfermagem revestidos de qualidade, não limitados ao cumprimento de atividades.

The use of wraps in the care of newborns and infants. The thesis deals with the use of wraps suitable for newborns and infants. Wraps are used particulary to calm down children. Because swaddling of a child imitates the strength and tightness of their mother's womb, children are mostly feeling calmly and safely. There are many wraps on the market, like blankets, classic lace-wraps, cocoons and wraps specially developed for restless and teary children. The goal of the thesis was to find out what knowledge have parents of children about swaddling, which wraps do they use and effect of swaddling on children. We have tried to verify the effects of swaddling in practice. In this thesis, we used a combination of qualitative and quantitative methods, interview techniques, and action research. The qualitative part of the research took the form of an unstructured interview. The sample for this interview was 33 mothers who had to answer open questions. The results of the interview were manually written to the printed record sheets. The interviewed responders were individually asked in their homes, in cafes and children's clubs. At first was completed the basic respondents information like their age, education level, place of residence and number of children and their age during their first pregnancy. Then we proceeded to talk about swaddling children to varienty types of wraps. We asked questions related to the type used wraps, swaddling style, usage time of wraps. We also asked about what for effect had swaddling on a child, whether the child calmed down, slept or remained teary. The collected personal information we processed statistically to help us to determine the answer to our hypothesis. Action research was applied on 4 children and one pair of twins in their home environment. Prior to that, their parents agreed with the research. We agreed that during the research will be present at least one parent. Parents received a record sheet on which they could write down when the child had trouble sleeping, or falling asleep and how much did the child cry. Based on their statements and notes we have devised a way to help the child to fall asleep or calm down. Parents got recommended specialized literature on swaddling, which they could later study. For swaddling we had the opportunity to use more types of wraps, according to the wish of parents, especially with best regards for the child, because each individual requires a specific type of swaddling and different wraps. Together with parents, we chose a wrap for the day or night and we wrapped the baby up and observed how it goes. Parents then following days wrapped up the children themselves and told us about how the child behaves during swaddling and whether was there a desired effect. After a month, we met parents again and personally summarized the effects of wraps on their baby and the changes that occurred after swaddling. Results: In the qualitative survey, we found out that most parents use wraps to calm down and soothe the child. Most mothers reported using quick wraps, classic lace wraps or a combination of both. Half of the surveyed mothers said that after using wraps were their children calmer. The remaining third of the mothers said that swaddling helped to let their children to sleep better. Children of the remaining respondents did not feel well during swaddling and they were more teary and restless. Questions regarding age, education and place of residence showed that more than half of respondents have completed education with graduation, a third of mothers have an university degree. The youngest mother was at the time of our research 21 years old, the oldest was aged 38 years, the average age of mothers was 28.2 years. In the question regarding the residence, we found out that 19 of the interviewed mothers were living in a town and the remaining number, 14, were living in the smaller village.

Made available in DSpace on 2014-07-29T15:04:43Z (GMT). No. of bitstreams: 1 Viviane Rodrigues Tavares.pdf: 523579 bytes, checksum: f7e610c824be82add025856d7ddd8925 (MD5) Previous issue date: 2009-03-03 / Hepatitis B vaccination is the major mode of hepatitis B prevention. To evaluate the immunogenicity and reactogenicity of the Brazilian hepatitis B vaccine (Butang®) in newborns in Goiania-GO, 294 infants born in the east of Goiânia, Goiás, were recruited. All of them received the first vaccine dose in the first 12 hours of life. The second and third doses were applied 30 and 150 days after, respectively. About 45 days after the last dose, blood samples were collected from 250 children in order to detect quantitative anti-HBs, using the enzyme immunoassay of microparticles (MEIA). All participants were evaluated 48-72 hours after each dose to investigate local and systemic reactions. Mothers of newborns were screened for anti-HBs and anti-HBc by enzyme immunoassay. Of 250 newborns who completed the study, 97.6% (95% CI: 94.8-99.1) developed anti-HBs protector titers, being most of them higher than 100 mIU/mL (90,8%). The anti-HBs geometric mean titer was equal to 572 mIU/mL (95% CI: 471.1 - 694.6), and no difference was observed between female and male newborns. Low responders NB (10-99 mIU/ml) were more frequent in male infants (58,8% vs 41,2%). Maternal anti-HBs and/or anti-HBc-positivity did not interfere in the newborns vaccine response. Concerning reactogenicity, only induration (5.5%), redness (2.4%), heat (1.3%) and fever (12.9%) were observed following the 829 vaccine doses applied. Six newborns did not respond to Butang® vaccine. Of them, four were male. A booster dose was applied in all no vaccine responders. All but one not developed anti-HBs protector titers following a booster dose. The Butang® showed to be safe and immunogenic when administered to newborns in the first 12 hours of life. However, more studies will be need to evaluate its lifetime effectiveness. / A vacinação é a melhor forma de prevenção da hepatite B. Para avaliar a imunogenicidade e reatogenicidade da vacina brasileira contra hepatite B (Butang®) em recém-nascidos (RN), foram recrutados 294 nascidos na região leste de Goiânia, Goiás. Todos receberam a primeira dose da vacina nas primeiras 12 horas de vida. A segunda e terceira doses foram aplicadas após 30 e 150 dias, respectivamente. Um total de 250 RN concluíram o estudo, sendo coletadas amostras sanguíneas, aproximadamente, 45 dias após a última dose para detecção do marcador anti-HBs, utilizando-se o ensaio imunoenzimático de micropartícula (MEIA). Todos os participantes foram avaliados para reações locais e sistêmicas 48-72 horas após cada dose. As mães dos RN foram testados para os marcadores anti-HBs e anti-HBc pelo ensaio imunoenzimático. Dos 250 RN, 97,6% (IC 95%: 94,8-99,1) desenvolveram títulos protetores de anti-HBs, sendo que a maioria superiores a 100 mUI/mL (90,8%). A média geométrica dos títulos de anti-HBs foi igual a 572 mUI/mL (IC 95%: 471,1 694,6), não sendo observada diferença entre os RN do sexo feminino e masculino. Uma proporção maior de baixo respondedores (10-99 mUI/mL) foi observada em crianças do sexo masculino (58,8% vs 41,2%). Anticorpos anti-HBs e/ou anti-HBc maternos não interferiram na resposta vacinal dos RN. Quanto à reatogenicidade da Butang®, foram observadas somente induração (5,5%), rubor (2,4%), calor (1,3%) e febre (12,9%) em 829 doses aplicadas. Seis RN não responderam à vacina Butang®. Destes, quatro eram do sexo masculino. Em todos foi administrada uma dose de reforço. Somente uma criança não desenvolveu títulos protetores de anti-HBs após a dose de reforço. A vacina Butang® demonstrou ser segura e imunogênica quando administrada em recém-nascidos nas primeiras 12 horas de vida. No entanto, mais estudos serão necessários para avaliar a sua eficácia em longo prazo.

Estudo transversal, analítico que objetivou analisar o acesso do recém-nascido (RN), após o nascimento, ao atendimento de enfermagem na rede básica em um município paulista. Participaram RN usuários do Sistema Único de Saúde (SUS) nascidos e residentes no município de Ribeirão Preto-SP no período de 01 de janeiro de 2010 a 31 de dezembro de 2014. Os dados foram obtidos das planilhas do Programa Floresce uma Vida, do Programa de Saúde da Criança da Secretaria Municipal de Saúde (SMS). Variáveis estudadas foram: tipo de unidade de atendimento, idade do RN, peso ao nascer, idade materna, paridade, número de consultas pré-natal realizadas, encaminhamento do RN para serviço especializado, realização da triagem neonatal e da vacina BCG. O processamento foi realizado a partir do gerenciamento do banco de dados do Floresce uma Vida, sendo utilizado o programa Statistica versão 12.0. Na fase descritiva da análise, buscou-se informações que identificassem melhoria no acesso aos serviços de saúde, contemplando o atendimento da criança na primeira semana de vida. Na fase analítica, foram verificadas associações entre as variáveis peso ao nascer, idade materna e paridade e a variável acesso dos RN às ações de enfermagem na rede básica. Para a distribuição espacial dos dados referentes ao acesso às ações de enfermagem, procedeu-se ao cálculo da porcentagem das ações de enfermagem ocorridas segundo as áreas de abrangência dos serviços de saúde da Atenção Primária do município. O projeto de pesquisa foi aprovado pelo Comitê de Ética em Pesquisa da Escola de Enfermagem de Ribeirão Preto da Universidade de São Paulo (CAAE nº 47836115.5.0000.5393) (Ofício nº 152/2015). No período estudado, nasceram 41.267 crianças, das quais 22.463 (54,4%) são usuárias SUS. Foram registradas 19.234 (85,6%) consultas de enfermagem, 19.376 (86,3%) vacinas BCG e 19.769 (88,0%) triagens neonatais. Através da análise espacial, observou-se que os Distritos de Saúde Leste e Central foram os que apresentaram menor porcentagem de realização das ações de enfermagem, inclusive quando se analisa a realização dos três procedimentos no mesmo dia. Ações preconizadas para a primeira semana de vida, como triagem neonatal, vacina BCG e consulta de enfermagem, apresentaram cobertura inferior ao esperado, principalmente quando se analisa a realização destas três ações no mesmo dia. Dentre as crianças que não realizaram esses três procedimentos no mesmo dia, identificou-se, como maioria, aquelas que apresentaram peso adequado ao nascer e cujas mães, com idade entre 20 e 34 anos, realizaram sete ou mais consultas de pré-natal. As informações obtidas através do estudo constituem-se instrumento para gestores e equipes de saúde identificarem as fragilidades que são passíveis de intervenções e reavaliarem as estratégias de atendimento ao RN, qualificando a assistência prestada, mediante a garantia do acesso em tempo oportuno e do cuidado integral, transpondo resultados para realidades semelhantes a nível regional e/ou nacional / Cross-sectional and analytical study that aimed to analyze the newborns (RN) access, after birth, to the nursing care in basic health network at an inner city of São Paulo state. We included RN, users of Brazilian Health System (SUS) that was born and lived in Preto Ribeirão from January 1st 2010 to December 31th 2014. Data were obtained from spreadsheets of the Floresce uma Vida Programme, belonging to Child Health Programme of Municipal Health Department (SMS). Variables studied were type of care unit, the newborn age, birth weight, maternal age, parity, and number of prenatal consultations, referral for specialized service, neonatal screening and BCG vaccine. Data were processing from the Floresce uma Vida database, using the Statistica software version 12.0. In descriptive analysis, we sought information that could identify improvement on access to health services, considering the child\'s care in the first week of life. In analytical analysis, we sought possible associations between the variables birth weight, maternal age and parity and the variable newborns access to nursing actions in the basic health network. For the spatial distribution of data related to access to nursing actions, we calculated the percentage of nursing actions that occurred according to the areas covered by the health services of Primary Care. The Research Ethics Committee approved the research (CAAE Nº 47836115.5.0000.5393, Oficio nº 152/2015). During the study period, 41,267 children were born; 54.4% are SUS users. We identified the occurrence of 19,234 (85.6%) nursing visits, 19,376 (86.3%) BCG vaccines and 19,769 (88.0%) neonatal screening. Through spatial analysis, we observed that Eastern and Central Health Districts showed the lowest percentage of achievement of nursing actions, even when we analyzed the performance of the three procedures on the same day. Recommended actions for the first week of life, such as newborn screening, BCG vaccine and nursing consultation, had lower coverage than expected, especially their performance on the same day. Among the children who did not have these three procedures on the same day, we identified, as most, those who had adequate weight at birth and whose mothers, aged 20 to 34, had seven or more prenatal consultations. The information obtained through the study, are a tool for managers and healthcare teams to identify the weaknesses that are amenable to intervention and re- evaluate the newborn care strategies, qualifying the assistance provided, through the guarantee of timely access and comprehensive care, transposing results for similar realities in the regional and / or national level

Submitted by Neusa Fagundes (neusa.fagundes@unioeste.br) on 2018-07-10T19:46:34Z No. of bitstreams: 2 Joziana_Pastro2018.pdf: 1649555 bytes, checksum: 769cd69a9e879a09907152dd2e64987c (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2018-07-10T19:46:34Z (GMT). No. of bitstreams: 2 Joziana_Pastro2018.pdf: 1649555 bytes, checksum: 769cd69a9e879a09907152dd2e64987c (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2018-03-13 / Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq / Retinopathy of prematurity (ROP) is a vasoproliferative disease, related to blindness, in Premature Newborns (PN) who, within other factors, used oxygen during hospitalization. Early visual follow-up of preterm newborns by ophthalmologists makes it possible to identify the stage and grade of the disease and the indication of treatment or attendance of its evolution. Nursing orientation is essential to the PN relatives, since ROP is not an easily seen disease, so, parents being aware that the ophthalmologic follow-up is of vital importance for the visual recovery of the baby will make a difference in the child future visual health. Therefore, this study aims to evaluate the prevalence and evolution of ROP in PN, hospitalized in a Neonatal Intensive Care Unit (NICU) and attended at a referral ophthalmologic follow-up service. This is a quantitative, descriptive and exploratory study, carried out in the city of Cascavel. Data collection was done in medical records of PN, born between January 2014 and June 2016, hospitalized in the NICU of the West Paraná University hospital, and followed by the outpatient clinic of Cascavel Eyes Hospital, totaling 181 charts. A quantitative analysis was performed through descriptive and inferential statistic. The prevalence of ROP was 11.31% (n = 50). Relating its characteristics to evolution, the diagnoses prevalent in the PN of the study were respiratory diseases (41.99%) and among comorbidities, sepsis prevailed (63.54%). 80 PN required blood transfusion (44,20%) and 152 (83.98%) used oxygen therapy, with a predominance of mask device (n = 141; 77,90%) and orotracheal tube - TOT (n = 100; 55.25%), on average for 15 days. The highest concentration recorded was hood (45.0%). The time of use and the O2 concentration of TOT, time of mask use and time and concentration of O2 of Continuous Positive Airway Pressure (CPAP), were significant to trigger ROP. Among ROP cases, ten (5.5%) children had severe ROP and required laser treatment. All the PN diagnosed with ROP used oxygen. ROP prevailed in moderate preterm newborns (44%), with ROP grade 3 being the most severe, affecting both extreme and moderate PN. Respiratory diseases, sepsis and procedures such as blood transfusion and oxygen therapy influenced the presence of ROP, with prevalence in moderate preterm newborns. The adoption of ophthalmologic screening for ROP detection, with background examinations of the eyes in the NICU contributed to the early treatment and prevention of severe visual impairment and blindness caused by ROP. Thus, nurses are fundamentally important, from the prevention, the diagnosis until the course of the treatment and for discharge counselling. / A Retinopatia da Prematuridade (ROP) é uma enfermidade vasoproliferativa, relacionada à cegueira, em recém-nascidos prematuros (RNPT) que, dentre outros fatores, utilizaram oxigênio durante a hospitalização. O acompanhamento visual precoce de prematuros por oftalmologistas possibilita a identificação do estágio e do grau da doença, assim como a indicação de tratamento ou de acompanhamento da sua evolução. A orientação da enfermagem é primordial aos familiares dos RNPT, visto que a ROP não é uma doença de fácil visualização; portanto, os pais estarem cientes de que o acompanhamento oftalmológico é de vital importância para a recuperação visual do bebê fará diferença na vida futura da criança. Assim, este estudo objetiva avaliar a prevalência e a evolução da ROP em RNPT internados em uma Unidade de Terapia Intensiva Neonatal (UTIN) e acompanhados em serviço de seguimento oftalmológico de referência. Trata-se de uma pesquisa quantitativa, descritiva e exploratória, realizada no município de Cascavel. A coleta de dados ocorreu em prontuários de RNPT, nascidos entre janeiro de 2014 e junho de 2016, hospitalizados na UTIN do Hospital Universitário do Oeste do Paraná – HUOP, e em seguimento pelo ambulatório do Hospital de Olhos de Cascavel, totalizando 181 prontuários. Realizou-se análise quantitativa, por meio de estatística descritiva e inferencial. A prevalência de ROP foi de 11,31% (n=50). Relacionados às suas características e evolução, os diagnósticos prevalentes nos RNPT do estudo foram as doenças respiratórias (41,99%) e, entre as comorbidades, a sepse prevaleceu (63,54%). Necessitaram de transfusão de sangue 80 RNPT (44,20%), e 152 (83,98%) fizeram uso de oxigenioterapia, com predomínio do dispositivo máscara (n=141; 77,90%) e tubo orotraqueal - TOT (n=100; 55,25%), em média por 15 dias. A maior concentração registrada foi por halo (45%). O tempo de uso e a concentração de O2 de TOT, tempo de uso de máscara e tempo e concentração de O2 do Continuous Positive Airway Pressure (CPAP) foram significativos para desencadear a ROP. Dentre os casos de ROP, dez (5,5%) crianças tiveram ROP grave e necessitaram de tratamento com laser. Todos os RNPT diagnosticados com ROP fizeram uso de oxigênio. A ROP prevaleceu nos prematuros moderados (44%), sendo o grau 3 de ROP o mais grave encontrado, acometendo tanto RNPT extremos quanto moderados. Doenças respiratórias, sepse e procedimentos como a transfusão de sangue e a oxigenioterapia influenciaram na presença da ROP, com prevalência em prematuros moderados. A adoção da triagem oftalmológica para a detecção da ROP, com exames de fundo de olho sistematicamente realizados na UTIN, contribuíram para o tratamento precoce e a prevenção de deficiências visuais graves e cegueira causados pela ROP. Nesse sentido, o enfermeiro é de fundamental importância, desde a prevenção, o diagnóstico até o decorrer do tratamento e a alta.