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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
21

Neonatal ICU parent groups an evaluation : a research report submitted in partial fulfillment ... /

Miller, Judith S. Seidl, Lorna S. January 1980 (has links)
Thesis (M.S.)--University of Michigan, 1980.
22

Neonatal ICU parent groups an evaluation : a research report submitted in partial fulfillment ... /

Miller, Judith S. Seidl, Lorna S. January 1980 (has links)
Thesis (M.S.)--University of Michigan, 1980.
23

(Con) vivendo com o bebà prematuro de muito baixo peso (<1.500g): a experiÃncia materna durante a internaÃÃo e apÃs a alta hospitalar / (CON) LIVING WITH PREMATURE BABY WEIGHT OF VERY LOW (<1500g): A MATERNAL EXPERIENCE DURING AND AFTER HOSPITAL DISCHARGE.

Leila Medeiros Melo 30 March 2010 (has links)
FundaÃÃo Cearense de Apoio ao Desenvolvimento Cientifico e TecnolÃgico / O avanÃo dos cuidados perinatais possibilitou a sobrevivÃncia de um nÃmero cada vez maior de crianÃas de muito baixo peso ao nascer (MBPN), criando a necessidade de reflexÃo acerca das orientaÃÃes prestadas à mÃe durante a hospitalizaÃÃo do bebÃ, bem como sua repercussÃo no dia-a-dia dos cuidados domiciliares - temÃtica ainda pouco estudada. Este estudo objetivou investigar os aspectos relacionados à saÃde e nutriÃÃo de crianÃas prematuras extremas, com peso ao nascer inferior a 1.500g, a partir das vivÃncias maternas durante o perÃodo da internaÃÃo do bebà e apÃs a alta hospitalar. Neste sentido, a abordagem qualitativa, exploratÃrio-descritiva, com utilizaÃÃo de entrevistas semi-estruturadas, buscou abordar a experiÃncia vivenciada por onze mÃes que deram à luz a seus bebÃs com MBPN na maternidade Assis Chateaubriand. As entrevistas foram realizadas no domicÃlio das mÃes, entre os meses de junho e outubro de 2009. AtravÃs de uma anÃlise compreensivo-interpretativa, os resultados apontaram dificuldades intersubjetivas de comunicaÃÃo com os profissionais de saÃde, a ocorrÃncia expressiva do desmame precoce com a introduÃÃo de mingaus e outros alimentos prejudiciais à saÃde do bebà prematuro, diferenÃas significativas entre as orientaÃÃes prestadas nas enfermarias da maternidade (mÃtodo canguru), grande dificuldade no exercÃcio da maternagem apÃs a alta e a existÃncia de uma rede de apoio informal, durante as consultas de follow-up, em que a opiniÃo de outras mÃes e familiares determinou a prÃtica assumida no cuidado domiciliar. AlÃm disso, a desarticulaÃÃo nos sistemas de referÃncia e contra-referÃncia dos serviÃos de saÃde tem comprometido a qualidade do atendimento prestado. Evidenciou-se que as mÃes precisam ser acolhidas em grupos formais de aconselhamento durante e apÃs o internamento, com orientaÃÃo e escuta mÃtua, recebendo informaÃÃes estruturadas sobre a alimentaÃÃo e o cuidado domiciliar para estabelecer prÃticas de cuidado mais adequadas à saÃde de seus filhos. AlÃm disso, a ampliaÃÃo da sala destinada à ordenha mamÃria e, tambÃm, da capacidade de atendimento e orientaÃÃo da enfermaria Canguru sÃo mudanÃas pertinentes dentro da estrutura da maternidade que parecem capazes de proporcionar melhores condiÃÃes ao cuidado materno com o bebà MBPN. / The advance in perinatal care allowed the survival of a growing number of very low birth weight (VLBW) infants, creating the need for questioning orientations given to mothers during their babies hospitalization, as well as its repercussion in daily homecare â a theme still insufficiently explored. The aim of this study was to investigate aspects regarding health and nutrition of extreme premature babies, with birth weight less than 1.500g from the mothers experiences during hospitalization and after discharge. Thus, the qualitative approach, exploratory-descriptive, along the use of semi-structured interviews intended to access the experience of eleven mothers who delivered their newborns with VLBW in Maternidade Escola Assis Chateaubriand. Interviews took place at the mothers domicile between June and October, 2009. Over a comprehensive interpretative analysis, the results pointed to the intersubjective communication difficulties with health care professionals, the large occurrence of early weaning and introduction of porridge and other food that are harmful to the preterm baby health, important differences between the orientations provided at the ward in the maternity hospital (kangaroo method), great difficulty in the role of motherhood after discharge and the existence of an informal support network during the follow up consultations when the other mothers and relatives opinions determined the assumed practice of home care. Besides, the lack of communication between the reference and counter-reference systems of the health units compromises the quality of the provided care. Moreover, mothers need to be taken in formal counseling groups while their babies are in the hospital and after, with orientation and mutual listening, receiving structured information about feeding and home care to apply more adequate methods in the care of VLBW neonate. The enlargement of the room intended to manual milking and also the capacity of reception and orientation at the kangaroo ward are relevant changes inside the structure of the maternity hospital that seem to be capable of ensuring better conditions in the maternal care of the VLBW infant.
24

Efeitos da contenção facilitada durante a aspiração endotraqueal sobre a concentração salivar de cortisol e saturação de oxigênio de recém-nascidos prematuros / Effects of facilitated tucking during endotracheal suctioning on the salivary cortisol concentration and oxygen saturation in premature infants

Vilar, Débora Maia 16 August 2018 (has links)
Orientador: Regina Célia Spadari-Bratfisch / Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Biologia / Made available in DSpace on 2018-08-16T17:17:02Z (GMT). No. of bitstreams: 1 Vilar_DeboraMaia_M.pdf: 7544917 bytes, checksum: f3ab74bac3bf9de6c6c51585cf73b87c (MD5) Previous issue date: 2010 / Resumo: Na UTI Neonatal, além da exposição contínua a ruídos e luminosidade, o prematuro é submetido a inúmeros procedimentos diagnósticos e terapêuticos, os quais estão associados à dor. A aspiração endotraqueal é um procedimento freqüente e doloroso, causador de estresse no neonato. O principal objetivo deste estudo é avaliar os efeitos da contenção facilitada na resposta de estresse de neonatos prematuros durante a aspiração endotraqueal. Trata-se de um ensaio clínico controlado e aleatorizado, no qual participaram 36 recémnascidos prematuros da Unidade de Terapia Intensiva Neonatal do CAISM/UNICAMP. Os pacientes foram aleatoriamente distribuídos em dois grupos, controle e propósito. Os indivíduos do grupo propósito foram submetidos à aspiração endotraqueal com a utilização da contenção facilitada enquanto que os recém-nascidos do grupo controle foram tratados de acordo com o protocolo convencional. Foram determinadas as concentrações de cortisol salivar antes e após o procedimento, saturação de oxigênio durante o procedimento de aspiração, bem como o número de introduções da sonda endotraqueal. No grupo da contenção facilitada, houve redução significativa no número de episódios de queda da saturação de oxigênio. Dentre os episódios de queda, foram observados eventos de hipóxia apenas no grupo controle. Não foi observada diferença significativa na concentração salivar de cortisol entre os grupos, bem como no número de introduções da sonda. Nos indivíduos que tiveram queda da saturação de oxigênio, as médias de concentração salivar de cortisol estavam mais elevadas em todas as avaliações realizadas. Estes dados permitem concluir que a contenção facilitada é um procedimento eficaz na redução de hipóxia durante o procedimento de aspiração endotraqueal / Abstract: In the Neonatal Intensive Care Unit (NICU), in addition to continued exposure to noise and light, the premature infant is subjected to numerous diagnostic and therapeutic procedures, which are associated with pain. The endotracheal suctioning is a frequent and painful procedure, causing stress in the neonate. The main objective of this study is to evaluate the effects of the containment on the stress response of premature neonates during the endotracheal suctioning. This is a randomized controlled trial, which was attended by 36 premature newborns at the Neonatal Intensive Care Unit of CAISM / UNICAMP. Patients were randomly divided into two groups, control and purpose. Individuals in the group purpose underwent endotracheal aspiration with the use of containment while the newborns in the control group were treated following the standard protocol. It was determined the concentration of the salivary cortisol before and after the procedure, the oxygen saturation during the aspiration procedure, and the number of introductions of the endotracheal tube. In the group who was subjected to containment, there was a significant decrease in the number of episodes involving dropouts oxygen saturation. Among the episodes of dropout, hypoxic events were only observed in the control group. There was no significant difference in salivary cortisol concentration between the groups, as well as the number of introductions of the probe. In individuals who had a decrease in oxygen saturation, mean salivary cortisol concentration was higher in all evaluations. These data indicates that the containment is indeed effective in reducing hypoxia during the endotracheal suction procedure in premature infants / Mestrado / Fisiologia / Mestre em Biologia Funcional e Molecular
25

Desempenho comunicativo de crianças prematuras em idade pré-escolar / Communicative performance of preterm children at preschool age

Caroline Kauffmann Becaro 23 May 2014 (has links)
A prematuridade é considerada um fator de risco biológico para o desenvolvimento típico infantil. Este estudo foi delineado com o objetivo de comparar o desempenho de crianças nascidas prematuras (abaixo de 37 semanas gestacional) com crianças típicas de idade (acima de 38 semanas) entre quatro e cinco anos e onze meses quanto ao desempenho comunicativo e desempenho escolar. Após o cumprimento dos aspectos éticos, foram avaliadas 40 crianças prematuras (GE) e 40 crianças nascidas a termo com desenvolvimento típico (GC), pareadas quanto à idade cronológica, gênero, escolaridade e tipo de escola, 80 pais e 80 professores das respectivas crianças. Foi realizada entrevista com os responsáveis e aplicado o Inventário MacArthur de Desenvolvimento Comunicativo: Primeiras palavras e gestos, com os responsáveis e professores. Os professores responderam ao Protocolo de Avaliação do aluno. A avaliação foi composta, também por Observação do Comportamento Comunicativo; Teste de Vocabulário por Imagens Peabody, Teste de Linguagem Infantil ABFW Parte de Vocabulário e do Teste de Screening de Desenvolvimento Denver II. Os procedimentos de análise seguiram as normativas previstas nos manuais dos instrumentos. O tratamento estatístico constou de análise descritiva e aplicação dos seguintes testes: Teste t de Studant, Teste de Mann-Whitney, Teste Qui-Quadrado, com valores de significância p <0,005. Os resultados indicaram que na comparação entre GE e GC, quanto ao desempenho comunicativo houve diferença estatística significante. Na comparação entre GE e GC, quanto ao desempenho motor não houve diferença estatística significante. Quanto ao desempenho escolar foi verificado, pelos professores que as crianças prematuras apresentaram queixas relevantes de aprendizagem e comportamentais. Porém, o grupo de prematuros não se comportou de forma homogênea. Os resultados deste estudo podem reafirmar que a prematuridade pode interferir nas habilidades comunicativas e escolares. / Prematurity is considered a biological risk factor for the typical child development. This study was designed with the objective comparing the performance of children born prematurely (under 37 weeks) and typical of age (over 38 weeks) between four and five years eleven months, on the communicative performance and school performance. After meeting the ethical aspects were evaluated, 40 preterm and 40 term infants with typical development, matched for chronological age, gender, education and type of school, 80 parents and 80 children´s teachers were evaluated. An interview with their responsible and applied the MacArthur Communicative Development Inventory: First words and gestures, to caregivers and teachers. Teachers responded to the Protocol of student assessment. The evaluation was made also by Observation of Communicative Behavior, the Peabody Picture Vocabulary Test, Child Language ABFW - Part Vocabulary and the Denver II Development Screening Test. For the analysis procedures were followed the regulations set out in the manuals of each instrument. Statistical consist of application of different tests, such as \"t\" Test of Studant, Mann-Whitney Test and Chi- squared, with significance values p <0.005. The results indicated that the comparison between experimental and control groups, on the communicative performance was statistically significant difference. In the comparison between GE and GC as the motor performance was no statistically significant difference. In the school performance was verified by teachers that preterm children showed significant learning and behavioral complaints. However, the preterm group did not behave homogeneously. The results of this study can reaffirm that prematurity can interfere with communication performance.
26

Preterm Infant Incubator Humidity Levels: A Systematic Review

Glass, Laurie 01 January 2019 (has links)
Numerous scholars have reported that inconsistent incubator humidity in the neonatal intensive care unit (NICU) requires attention. Evidence synthesis was needed to assist the identification of optimal incubator humidity levels and duration to decrease transepidermal water loss (TEWL) and the potential for infection. The purpose of this doctoral project was to appraise and synthesize the evidence of preterm outcomes related to incubator humidity. The practice-focused question addressed what patient outcomes were impacted by incubator humidity level and duration in premature infants < 32 0/7 weeks cared for in the NICU. The foundation of this project was the Joanna Briggs Institute method for systematic reviews. Mefford’s theory of health promotion for the preterm infant was used to address the wholeness of the preterm infant’s body system. Evidence was classified using the Johns Hopkins evidence-based practice levels and quality of evidence. The search was conducted in 8 databases, and citation searching was used to identify 340 articles, 12 of which met the inclusion criteria. The evidence demonstrates that the practice of incubator humidity is warranted; however, it does not come without risks. Microbial growth was increased in high levels of incubator humidity. Unnecessary TEWL was prevented by lowering high levels of incubator humidity after the 1st week, improving skin barrier formation. Incubator humidity of 60%–70% in the 1st week was effective in preventing TEWL in infants born ≥ 26 weeks; however, future research is needed for infants < 26 weeks. When optimal levels and duration of incubator humidity are achieved, positive social change will occur from the improved outcomes of the smallest neonatal patients.
27

KUDDLER

Lewis, Evan January 2010 (has links)
No description available.
28

Host Genotype, Intestinal Microbial Phenotype, and Late-Onset Sepsis in the Premature Infant

Taft, Diana H. 10 October 2014 (has links)
No description available.
29

FATTY ACIDS IN NUTRITION SOURCES FOR PRETERM INFANTS

Fink, Naomi H. 10 1900 (has links)
<p>Of the three components of parenteral macronutrient classes (protein, carbohydrate and lipid), the lipid class is the least understood and the fatty acid distribution in lipid emulsion products has the potential to play a critical role in the development of infant morbidities. Breast milk has long been considered the gold standard for infant nutrition, but when infants cannot tolerate enteral feeds, the use of lipid emulsions cannot be avoided despite their adverse side effects.</p> <p>In this study, fatty acid profiles from five commercially available lipid emulsion products were compared to the profile of breast milk. As well, resulting serum on each of these nutrition sources were compared to the profile of either lipid emulsion (Intralipid) or breast milk. Fatty acid profiles for matched pairs of breast milk from mother and resulting serum from infants were compared as well as the profile of normotriglyceridemic serum samples to hypertriglyceridemic ones. Results indicate that not one lipid emulsion product is like another, nor do their profiles closely resemble breast milk even though they are intended to replace the fat portion of the infant’s natural source of nutrition. Serum was not found to directly reflect the fatty acid profile of the nutrition source administered, as was expected based on literature, highlighting that there is a complex web of pathways between nutrition administration and appearance of fatty acids in the serum. Further research is necessary to define the effect of fatty acid chain length and degree of saturation on these metabolic pathways, as the very essence of interrelations such as these can complicate interpretations of results.</p> / Master of Science in Medical Sciences (MSMS)
30

Avaliação da mineralização óssea em recém-nascidos pré-termo e termo adequados para a idade gestacional, alimentados com leite humano / Evaluation of bone mineralization in breastfed preterm and full-term newborns

Quintal, Virginia Spinola 18 August 2009 (has links)
INTRODUÇÃO: A Doença Metabólica Óssea é uma patologia caracterizada por alterações da mineralização esquelética decorrente do acréscimo deficiente do conteúdo mineral ósseo do recém-nascido pré-termo (RNPT). A densitometria óssea tem sido o método de escolha para avaliar o conteúdo mineral ósseo, particularmente no RNPT alimentado ou não com leite humano. OBJETIVOS: 1. Comparar os resultados do conteúdo e densidade minerais ósseos obtidos do corpo inteiro através da densitometria óssea em RNPT adequados para a idade gestacional (AIG) com os valores obtidos em recém-nascidos de termo (RNT), alimentados com leite humano exclusivo; 2. Comparar os parâmetros bioquímicos ósseos sanguíneos (cálcio, fósforo e fosfatase alcalina) entre os RNPT e RNTAIG; 3. Analisar a excreção urinária de cálcio e fósforo no RNPTAIG, alimentado com leite humano exclusivo. MÉTODOS: Estudo coorte prospectivo realizado na Unidade Neonatal da Divisão de Clínica Pediátrica do Hospital Universitário da Universidade de São Paulo (USP). Durante o período de julho de 2006 a setembro de 2008 foram estudados 28 RN sendo 14 RNPT com idade gestacional inferior a 34 semanas e 14 RNT, em 3 momentos: 40 semanas de idade pósconcepcional corrigida, 3 e 6 meses de idade pós-natal corrigida, alimentados com leite humano exclusivo da própria mãe ou procedente do banco de leite. Foi realizada a densitometria óssea através da técnica de dupla emissão de fonte de Raio-X (DXA) em um aparelho da marca Hologic, modelo Discovery A, no laboratório de metabolismo ósseo da Faculdade de Medicina da USP, sendo avaliados: conteúdo mineral ósseo (BMC), densidade mineral óssea (BMD) e massa magra. Foram também realizados: cálcio, fósforo e fosfatase alcalina séricos nas idades de 40 semanas pósconcepcionais (RNPT e RNT) e com 6 meses de idade pós-natal corrigida (RNPT). Além disso, analisou-se a concentração de cálcio e fósforo na urina de 6 horas dos RNPT entre a 3ª e a 4ª semanas de vida. RESULTADOS: O BMC do RNPT foi inferior ao obtido no RNT na mesma idade de 40 semanas pós-concepcionais (p<0,001), o mesmo ocorreu com o BMD (p<0,001) e com a massa magra (p=0,047). Destacamos que houve uma importante aceleração para que os pré-termos atingissem os valores normais encontrados nos recém-nascidos de termo aos 6 meses de idade corrigida, ie, BMC (137,1422,46 vs. 152,8620,92 g, p=0,054), BMD (0,220,02 vs. 0,230,02 g/cm2, p=0,618) e massa magra (5.750,13765,11 vs. 5.745,88726,52g, p=1,00) que foram comparáveis nos dois grupos. Os parâmetros bioquímicos séricos foram semelhantes entre os RNPT e os RNT. Entre os RNPT, três (21,4%) apresentaram exames urinários sugestivos de Síndrome da Deficiência de Fósforo sendo indicado o uso da solução oral de cálcio e fósforo. CONCLUSÕES: A avaliação da mineralização óssea através da DXA do corpo inteiro pode ser utilizada em RNPT constituindo exame de excelência, com precisão elevada e exposição baixa à radiação para detecção de alterações ósseas quando há risco de Doença Metabólica Óssea. Neste estudo, a alimentação com leite humano seja da própria mãe ou do banco de leite pode proporcionar um crescimento ósseo adequado, no RNPT, semelhante ao do RNT nos primeiros 6 meses de vida. Os parâmetros bioquímicos urinários (cálcio e fósforo) foram de utilidade para detecção precoce de hipofosfatúria e risco de deficiência mineral nos RNPT, entretanto requerem coleta de urina de 6 horas, tornando difícil a investigação após a alta hospitalar. Mesmo os RNPT, com exames urinários normais, apresentaram na densitometria óssea um BMC inferior aos valores encontrados nos RNT mostrando que a DXA se constitui em um método sensível e que poderá ser utilizada para o seguimento destes RNPT. / BACKGROUND: Metabolic Bone Disease is a pathology characterized by skeletal mineralization changes resulting from insufficient increase of the bone mineral content in preterm newborns (PTNB). Bone densitometry has been the method of choice to evaluate the bone mineral content, particularly in the PTNB that is or is not fed with human milk. OBJECTIVES: 1. To compare the bone mineral content and density results obtained from the whole body using bone densitometry in appropriate-for-gestational-age (AGA) PTNB with the values obtained from full-term newborns (FTNB), exclusively fed with human milk; 2. To compare blood bone biochemical parameters (calcium, phosphorus, and alkaline phosphatase) obtained from PTNB and AGA FTNB; 3. To analyze calcium and phosphorus urinary excretion in AGA PTNB exclusively fed with human milk. METHODS: Prospective cohort study conducted at the University of Sao Paulo (USP) University Hospital Pediatric Clinic Neonatal Unit. From July 2006 to September 2008, 28 NB were studied, with 14 of them being PTNB of gestational age inferior to 34 weeks and 14 being FTNB, in 3 timepoints: 40 weeks of corrected post-conception age, and 3 and 6 months of corrected postnatal age, exclusively fed with human milk from their own mothers or from a human milk bank. Bone densitometry was performed by using the dual-energy X-ray absorption (DXA) technique in a Hologic device, Discovery A model, at USP Medical School bone metabolism laboratory, and the following were evaluated: bone mineral content (BMC), bone mineral density (BMD), and lean mass. Also, the following were performed: serum calcium, phosphorus, and alkaline phosphatase at 40 weeks post-conception (PTNB and FTNB) and 6 months of corrected postnatal age (PTNB). In addition, calcium and phosphorus concentrations in PTNBs 6-hour urine were analyzed at 3 and 4 weeks of life. RESULTS: The BMC of preterm newborn was lower than in fullterm at the same 40 weeks postconceptional age (p<0.001), the same occurred with the BMD (p<0.001) and the lean mass (p=0.047). Interestingly, there was an important acceleration to achieve the normal values seen in fullterm at six months age, ie, BMC (137.14+-22.46 vs. 152.86+-20.92 g, p=0.054), BMD (0.22+-0.02 vs. 0.23+-0.02 g/cm2, p=0.618) and lean mass (5,750.13+-765.11 vs. 5,745.88726.52g, p=1.00) were comparable in both groups. PTNB and FTNBs serum biochemical parameters were similar. Among PTNBs, three (21.4%) had urinary exams suggesting Phosphorus Deficiency Syndrome, with the use of oral calcium and phosphorus solution being indicated. CONCLUSIONS: The bone mineralization evaluation using whole-body DXA may be used in PTNBs, being an optimal exam of high precision and low radiation exposure to detect bone changes when there is a risk for MBD. In this study, being fed with human milk, either from the own mothers or from a human milk bank is able to provide appropriate bone growth in PTNBs, similar to that seen in FTNBs in the first 6 months of life. Urinary biochemical parameters (calcium and phosphorus) were useful for the early detection of hypophosphaturia and mineral deficiency risk in PTNBs; however, the collection of 6-hour urine is required, as the investigation becomes difficult after hospital discharge. Even PTNBs with normal urinary exams showed, upon bone densitometry, a BMC inferior to the values found in FTNBs, which supports that DXA presents a sensitive method that can be used to follow up these PTNBs.

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