Thesis (M.Sc.)--Memorial University of Newfoundland, 2003. / Bibliography: leaves 61-86.

<p>Föräldraskapet är en upplevelse som de flesta ser fram emot, men ibland uppstår komplikationer. Barnet behöver extra vård och föräldrarnas föreställningar kring tiden med det nyfödda barnet blir omkullkastade. Syftet med denna litteraturstudie är att beskriva föräldrarnas upplevelse av att deras nyfödda barn vårdas på neonatalavdelning. Metoden som används är en systematisk litteraturstudie där tidigare forskning inom området sammanställs. Använda databaser för sökningen av artiklar är Elin@Kalmar, Cinahl och PsychInfo. Artiklar som var relaterade till syftet kvalitetsgranskades och resultatet bygger på 10 vetenskapliga artiklar. Resultatet visar att föräldrarna upplever påfrestningar olika beroende på hur tidigt barnet är fött, föräldrarnas möjlighet till engagemang i omsorgsarbetet och hur smärtpåverkat barnet är. Även föräldrarnas sociala status och utbildning påverkar deras förmåga att hantera påfrestningarna. En känslostorm pågår hos föräldrarna där känslor som rädsla, skuld, oro, hopplöshet och overklighet är centrala. Det framkommer också hur viktigt det är att föräldrarna kan kommunicera med sjuksköterskan samt att muntlig och skriftlig information ger en känsla av kontroll och samhörighet. En öppen och jämställd relation med sjuksköterskan inger trygghet och tröst.</p>

Thesis (Sc. D.)—Massachusetts Institute of Technology, Dept. of Electrical Engineering and Computer Science, 1980. / Includes bibliographical references (p. 264-270). / This electronic version was scanned from a copy of the thesis on file at the Speech Communication Group. The certified thesis is available in the Institute Archives and Special Collections.

Introduction: Several factors have been observed to influence the value of newborn screening analytes (NBS) and should be adjusted for in the interpretation of blood spot samples. The thesis aimed to examine the association of NBS with 1) mode of delivery among term infants and 2) clinical subtypes (i.e., spontaneous onset of labour) of birth among preterm infants. Methods: A retrospective population-based cross-sectional study design was employed. A multivariable logistic regression model was used to examine associations between NBS and mode of delivery among term infants and subtypes among preterm infants. Results: 1) Metabolic profiles of infants born by planned cesarean delivery differ from those born by vaginal delivery following spontaneous onset of labour and 2) Metabolic profiles of preterm infants did not differ by clinical subtype. Conclusions: Our findings conclude that mode of delivery is an important covariate to consider in future modelling studies, but the inclusion of preterm birth subtypes is less compelling.

Thesis (M.S.)--Boston University

CoordenaÃÃo de AperfeiÃoamento de NÃvel Superior / RecÃm-Nascidos PrÃ-Termo (RNPT) sÃo submetidos, diariamente, à punÃÃo arterial nas primeiras horas de vida para exames de dosagem do pH e gases. A punÃÃo arterial, embora dolorosa, raramente à acompanhada de medida analgÃsica. Objetivou-se avaliar o efeito das intervenÃÃes mÃsica, mÃsica e glicose 25% e glicose 25% no alÃvio da dor dos RNPT submetidos à punÃÃo arterial e analisar a relaÃÃo das variÃveis neonatais e terapÃuticas com os escores da dor do RNPT, obtidos atravÃs da escala Premature Infant Pain Profile (PIPP). Ensaio clÃnico randomizado transversal de carÃter experimental triplo cego, conduzido no setor da Unidade de InternaÃÃo Neonatal (UIN) de um hospital pÃblico, em Fortaleza/CearÃ/Brasil de novembro/2011 a agosto/2012. A amostra constou de 80 RNPT, 24 randomizados no Grupo Experimental 1 (GE1 â mÃsica); 33, no Grupo Experimental 2 (GE2 - mÃsica e glicose 25%) e 23, no Grupo Controle Positivo (GCP). Uma mÃsica de ninar foi tocada durante 10 minutos antes da punÃÃo arterial por meio de MP3 interligado ao fone de ouvido, para os neonatos do grupo GE1 e GE2, sendo a glicose 25% administrada para os RNPT do grupo GE2 e GCP dois minutos antes da punÃÃo arterial. O desfecho primÃrio foi o escore da dor obtido com a escala PIPP nos 240 segundos apÃs a punÃÃo arterial em um intervalo de 30 em 30 segundos. Os desfechos secundÃrios foram alteraÃÃes relacionadas à mÃmica facial, FrequÃncia CardÃaca (FC) e SaturaÃÃo de OxigÃnio (SatO2). Pesquisa aprovada por comità de Ãtica parecer n 060717/11. Observou-se que as variÃveis neonatais numÃricas dos RNPT do grupo GE1 versus valores totais PIPP mostraram-se com p significante nas variÃveis: perÃmetro cefÃlico (PC â p=0,003), perÃmetro torÃcico (PT â p=0,032), Apgar 1 (p=0,001), Apgar 5 (p=0,047), idade gestacional corrigida (p=0,003) e idade gestacional corrigida em dias (p=0,008). No grupo GE2 versus valores totais PIPP, o p foi significante nas variÃveis: PT (p=0,002), Apgar 1 (p=0,009) e no Apgar 5 (p=0,002). Jà no grupo GCP versus valores totais PIPP, o p mostrou-se significante nas variÃveis: peso ao nascer (p=0,045) e ao PC (p=0,027). Quanto Ãs variÃveis terapÃuticas, os RNPT tiveram a maior concentraÃÃo dos valores PIPP, entre valores &#8805;7 de dor intensa a moderada. A variÃvel terapÃutica significante foi o uso de oxigenoterapia, sendo o Continuous Positive Airway Pressure (CPAP), a medida mais presente nos escores de dor intensa a moderada (p=0,012) no grupo GE2. Em relaÃÃo ao escore total de dor medido pelos trÃs avaliadores atravÃs da escala de dor PIPP, observou-se diferenÃa estatisticamente significante dos escores de dor devido à intervenÃÃo (p=0,000). O grupo GE2 (57,6%) apresentou maior porcentagem de dor mÃnima, &#8804; 6, em relaÃÃo aos outros grupos GE1 (29,2) e GCP (47,8). Conclui-se que à considerada vÃlida a hipÃtese de que os RNPT submetidos ao efeito da mÃsica e glicose 25%, antes e durante a punÃÃo arterial, apresentam menores escores de dor, em comparaÃÃo Ãqueles em uso somente de mÃsica ou de glicose 25%, com uma diferenÃa de 1,5 pontos, conforme a classificaÃÃo da escala PIPP. / Every day preterm infants (PI) are submitted to arterial puncture in the first hours of life for testing the gases and pH dosage. Although arterial puncture is painful, it is rarely accompanied by any analgesic measure. We Aimed to evaluate the effects of interventions: music, music and 25% glucose, and 25% glucose in relieving the pain of PI undergoing arterial puncture, and analyze the association of neonatal and therapeutic variables with the pain scores of PI obtained through the Premature Infant Pain Profile (PIPP). A cross-sectional randomized clinical trial of triple-blind experimental type, carried out at the Neonatal Care Unit (NCU) in a public hospital in Fortaleza-CE, Brazil, from November 2011 to August 2012. The sample consisted of 80 preterm infants, 24 randomized in Experimental Group 1 (EG1 â music); 33 in Experimental Group 2 (EG2 â music and 25% glucose); and 23 in Positive Control Group (PCG). Lullaby music was played for 10 minutes before arterial puncture through a MP3-player connected to earphones, for the infants in the EG1 e EG2, with 25% glucose administered to infants in the EG2 and PCG two minutes before arterial puncture. The primary outcome was the pain scores obtained with the PIPP in the first 240 seconds after the arterial puncture in an interval of 30 to 30 seconds. Secondary outcomes were the changes related to facial movements, Heart Rate (HR) and oxygen saturation (SpO2). This research was approved by the ethics committee under protocol No. 060 717/11. It was observed that the numeric neonatal variables of the PI in the EG1 versus total PIPP scores presented significant p in the variables: head circumference (HC â p=0.003), chest girth (CG â p=0.032), 1-minute Apgar (p=0.001), 5-minute Apgar (p=0.047), corrected gestational age (p=0.003), and corrected gestational age in days (p=0.008). In the EG2 versus total PIPP scores, p was significant in the variables: HC (p=0.002), 1-minute Apgar (p=0.009) and 5-minute Apgar (p=0.002). In the PCG versus total PIPP scores, p was significant in the variables: birth weight (p=0.045) and HC (p=0.027). Regarding therapeutic variables, PI had the highest concentration of PIPP scores among values &#8805; 7 of moderate to severe pain. The therapeutic variable significant was the use of oxygen, with the Continuous Positive Airway Pressure (CPAP) as the most present in scores of moderate to severe pain (p=0.012) in the EG2. Regarding the total pain score measured in the three interventions through the PIPP, we observed a statistically significant difference in pain scores due to the intervention (p=0.000). The EG2 (57.6%) presented a higher percentage of minimal pain, &#8804; 6, regarding the other groups, EG1 (29.2) and PCG (47.8). We conclude that it is considered valid the hypothesis that preterm infants submitted to the effects of music and 25% glucose, before and during arterial puncture, present lower pain scores compared to those that only use music or 25% glucose, with a difference of 1.5 points, according to the PIPP classification.

A dor gera desconforto, estresse e irritabilidade em recÃm-nascidos. Objetivou-se avaliar a dor dos recÃm-nascidos prÃ-termo por meio da escala Neonatal Facial Coding System (NFCS) durante a punÃÃo arterial, no grupo com intervenÃÃo musical e no grupo com intervenÃÃo de glicose 25%. Ensaio clÃnico randomizado transversal, duplo cego, realizado em um hospital pÃblico, em Fortaleza/CearÃ/Brasil. Os dados foram coletados de maio/agosto/2013, com base em levantamento de banco de filmagens de recÃm-nascidos prÃ-termo, assistidos nas unidades de cuidados intensivos e intermediÃrios neonatais, entre novembro/2011 e agosto/2012. A amostra constou de 48 recÃm-nascidos prÃ-termo, 26 randomizados no Grupo Experimental (MÃsica), 22 no Grupo Controle (Glicose 25%). Uma mÃsica de ninar foi tocada durante 10 minutos antes da punÃÃo arterial por meio de MP4 interligado ao fone de ouvido, para os neonatos do Grupo Experimental, sendo 2ml de glicose 25% administrada para os do Grupo Controle dois minutos antes da punÃÃo arterial. Coleta realizada por meio da anÃlise das expressÃes faciais contidas num formulÃrio para caracterizar o Momento PrÃ-IntervenÃÃo (10 minutos anteriores ao Momento de Tratamento, distribuÃdos em oito minutos iniciais e dois minutos finais); e em cinco momentos para o NFCS: Basal (14 segundos), Tratamento (quatro segundos â antissepsia), Doloroso (20 segundos), RecuperaÃÃo 1 (20 segundos â compressÃo) e RecuperaÃÃo 2 (20 segundos â cinco minutos apÃs recuperaÃÃo 1). As expressÃes faciais foram analisadas por quatro especialistas, sendo um no Momento PrÃ-IntervenÃÃo, que mensurou o nÃmero de movimentos do choro, espirro, bocejo, franzir de testa, olhar focalizado, olhar vago, dormindo, movimento da cabeÃa e membros superiores em face e outros trÃs, que avaliaram a mÃmica facial pela NFCS. Pesquisa aprovada por comità de Ãtica sob o parecer n 060717/11. A ANOVA mostrou que, no Momento PrÃ-IntervenÃÃo, prevaleceu o movimento franzir de testa no Grupo Experimental, movimento de cabeÃa no Grupo Controle nos oito minutos iniciais. Jà nos dois minutos finais, a expressÃo dormindo manifestou-se equivalente nos grupos, com significÃncia favorÃvel à mÃsica para olhar vago (p<0,001). Ao comparar o Momento PrÃ-IntervenÃÃo com o Doloroso, o teste de Fisher indicou que a mÃdia de dor foi igual no Grupo Experimental (7,6Â1,8) e no Grupo Controle (8,0Â2,8). Os valores mÃdios do NFCS foram semelhantes nos dois grupos nos Momentos Basal, RecuperaÃÃo 1 e RecuperaÃÃo 2, com diferenÃa estatisticamente significante no Momento Tratamento (p=0,014) e no Momento Doloroso (p=0,029) para Grupo Controle (teste de Bonferoni), mas nÃo mostraram efeito do tempo com a intervenÃÃo (Wilkâs Lambda=0,207; F=1,314; p=0,316); tambÃm, nÃo houve tendÃncia de crescimento ou decrÃscimo do escore de dor (Wilkâs Lambda=0,184; F=1,517; p=0,223). Nas variÃveis neonatais numÃricas e terapÃuticas, os recÃm-nascidos do Grupo Experimental e do Controle versus valores totais do NFCS no Momento Doloroso nÃo se mostraram com p significante quando avaliados pelo teste t-Student. Conclui-se que a hipÃtese de nÃo inferioridade do efeito da mÃsica em relaÃÃo à soluÃÃo de glicose 25% nos Momentos Tratamento e Doloroso foi inconclusiva, considerando-se vÃlida nos Momentos Basal, RecuperaÃÃo 1 e RecuperaÃÃo 2, conforme os escores de dor do NFCS em recÃm-nascidos prÃ-termo.

Orientador: Emilio Carlos Elias Baracat / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-10T19:56:13Z (GMT). No. of bitstreams: 1 Souza_TathianaGhiside_M.pdf: 2695580 bytes, checksum: b0307c601001a0729b775051fc783c4c (MD5) Previous issue date: 2008 / Resumo: Recém-nascidos prematuros correspondem de 7 a 10% de todos os nascimentos, mas concentram aproximadamente 85% de todas as complicações perinatais, com alto risco para o desenvolvimento de lesões pulmonares, principalmente a displasia broncopulmonar (DBP), e do sistema nervoso central. O objetivo deste estudo foi descrever e comparar a avaliação neurológica de recém-nascidos pré-termo (RNPT) com e sem DBP. Recém-nascidos pré-termo com peso de nascimento inferior a 1.500g e idade gestacional menor de 32 semanas foram avaliados com 40 semanas de idade gestacional corrigida, no Centro de Atenção Integral a Saúde da Mulher (CAISM) da UNICAMP. Foi utilizada a Avaliação Neurológica de Dubowitz, composta integralmente por 34 itens, dos quais 29 foram avaliados, divididos em 6 categorias: tônus, padrões de tônus, reflexos, movimentos, sinais anormais e comportamento. O estado de consciência do RN no momento do exame foi graduado utilizando-se os 6 graus definidos por BRAZELTON (1973). No período de janeiro de 2005 a setembro de 2007, vinte e quatro recém-nascidos, 12 com DBP e 12 controles sem a doença foram avaliados. A idade média de nascimento foi de 28 semanas (+- 1,38) no grupo com DBP e 31 semanas (+- 1,44) no grupo controle; peso médio no grupo de estudo de 884g (+- 202g) e no grupo controle de 1.156g (+- 216g). Dezoito dos 29 itens avaliados foram homogêneos entre os grupos (p = 1,00) e a pontuação geral dos dois grupos não apresentou diferença (p = 0,30). Na análise dos dados descritivos, observou-se um percentual maior de anormalidade no grupo com DBP em oito itens. A avaliação neurológica de RNPTs com e sem Displasia Broncopulmonar, pelo método Dubowitz, não apresenta diferença às 40 semanas de idade gestacional corrigida / Abstract: Preterm newborns corresponds to 7 to 10% of all births, but concentrates approximately 85% of all perinatal complications, with high risk of pulmonary injuries development, mainly bronchopulmonary dysplasia (BPD), and in the central nervous system. This study objective describes and compares preterm newborns neurological assessment with and without BPD. Preterm newborns with birth weight less than 1.500g and gestational age less than 32 weeks were evaluated by Dubowitz Method, with 40 weeks corrected gestational age, at Centro de Atenção Integral a Saúde da Mulher (CAISM) - UNICAMP. Dubowitz Neurological Assessment was used, consisting of 34 items, which 29 were evaluated, grouped in 6 categories: tone, tone patterns, reflexes, movements, abnormal signs and behavior. Newborn behavioral state was graded in 6 degrees defined by BRAZELTON (1973). From January 2005 to September 2007, twenty four newborns with average birth age of 28 weeks (+- 1,38) from BPD group and 31 weeks (+- 1,44) from control group were evaluated; Study¿s group mean weight was 884g (+- 202g) and control¿s group was 1.156g (+- 216g). Eighteen from 29 checked items were classified as homogeneous among groups (p = 1.00) and general score on two groups were not significantly different (p = 0.30). When analyzed in descriptive manner, the data showed greater abnormality percentage on the BPD group in eight items. The neurological assessment using Dubowitz Neurological method on preterm newborns with and without BPD does not show differences from 40 weeks corrected gestational age / Mestrado / Saude da Criança e do Adolescente / Mestre em Saude da Criança e do Adolescente

M.Cur. / A lot of mothers and babies are being discharged earlier from the hospital because of limits with the medical aids on the length of stay. In a few ofthese cases the mother and baby were readmitted because of health problems that persisted after they had been discharge. The question arises as to where the problem lies and what are the reasons so many patients are discharged with health problems and what can be done to prevent or reduce these problems. This study investigates the health status of the mother and their health problems on being discharged. The sample came from mothers with medical aids, in the post natal unit, in a selected clinic and ready to go home. Guidelines were developed to prevent these health problems or how to handle them differently. A literature study was undertaken on the normal physiological changes that take place with the birth of the baby and after the mothers have been discharged. According to this study changes and abnormalities could be identified. An instrument was developed to assess the mother's condition on discharge and to identify possible complications that could develop at home and obstruct health promotion. The results show that some of the mothers were discharged with one or other health problem that could cause severe problems at home. The biggest problem identified was with breast-feeding as well as oedema of the feet and hands. There were also a few mothers still unsure as to how to handle their babies. Guidelines were formed to help the nursing staff to supply information for the mother on early discharge and to help prevent health problems or to lessen them. The guidelines help the mothers to know how to look for the signs and symptoms of health problems at home Recommendations were made regarding future research on this issue.

Purpose and methods: Effective parental education about newborn screening (NBS) may help to maximize the benefits and minimize the harms of screening. We investigated experiences, knowledge and opinions regarding NBS education among Ontario mothers. Mothers whose infants recently received NBS were invited to complete a mailed survey (n=1712). Results: Of the 750 participants, 93% recalled their infant receiving NBS, while 69% recalled receiving information about NBS. Of this group, fewer than 50% reported receiving information prenatally, yet a majority of mothers (64%) viewed this as the most important time for education. Those who received information prenatally reported higher satisfaction (OR 2.4). The 40% of mothers who recalled being informed about the meaning of results had higher knowledge about NBS (OR 2.7) and reported higher satisfaction (OR 4.2). Conclusions: Parental education about NBS could place greater emphasis on the prenatal period and on fostering understanding about the meaning of results.