Anxiety and Depression in Mothers of Preterm Infants and Psychological Intervention During Hospitalization in Neonatal ICU

The objective of this study was to evaluate and compare symptoms of anxiety and depression before and after psychological intervention in mothers of babies born preterm with very low birth weight, hospitalized in the Neonatal Intensive Care Unit. Fifty nine mothers, without psychiatric antecedents, were distributed into two groups according to the type of psychological intervention received. Group G1 included 36 mothers who received routine psychological treatment associated with initial structured intake using support materials (video and guidance manual). Group G2 included 23 mothers who received routine psychological intervention without support material. The STAI and BDI, respectively. were used to evaluate maternal indicators of anxiety and depression. The results revealed that both groups showed a reduction in levels of state or trait anxiety and depression after psychological intervention and discharge of the baby from the hospital. In regard to the emotional symptoms at a clinical level, a statistically significant reduction in the level of state-anxiety was verified in G1. The findings confirmed the need for psychological support for mothers of preterm infants and the use of materials focusing on ""prematurity"" for reduction of the situational anxiety on a clinical level.

Prenatal Lipopolysaccharide Reduces Social Behavior in Male Offspring

Objective: This study investigated the relationship between maternal sickness behavior during pregnancy and offspring development and behavior. Methods: Pregnant Wistar rats were administered with lipopolysaccharide (LPS, 100 mu g/kg, i.p.) on gestation day (GD) 9.5. Dams` sickness behavior was analyzed, and at birth, offspring number and weight were evaluated. Male offspring was evaluated through physical development, play behavior, adult social interaction, plus maze studies and morphological analysis of the brain. Results: Results, with respect to the control group, showed that: (1) LPS decreased general activity, food intake, and weight gain in dams, but no pyrexia was observed following treatment; (2) LPS reduced litter size, but no alterations in physical development were observed; (3) LPS reduced play behavior parameters in baby rats; (4) LPS decreased adult social interaction; (5) no alterations were observed between groups on plus maze studies; (6) no differences were observed between groups on morphological analyses of the brain. Conclusion: These data reveal that LPS administered on GD 9.5 impaired male offspring`s social behavior in infancy and adulthood. These results may be related to an alteration in motivational states or/and increased anxiety. Copyright (C) 2010 S. Karger AG, Basel

Natural selection and quantitative genetics of life-history traits in Western women: A twin study

Whether contemporary human populations are still evolving as a result of natural selection has been hotly debated. For natural selection to cause evolutionary change in a trait, variation in the trait must be correlated with fitness and be genetically heritable and there must be no genetic constraints to evolution. These conditions have rarely been tested in human populations. In this study, data from a large twin cohort were used to assess whether selection Will cause a change among women in contemporary Western population for three life-history traits: age at menarche, age at first reproduction, and age at menopause. We control for temporal variation in fecundity (the baby boom phenomenon) and differences between women in educational background and religious affiliation. University-educated women have 35% lower fitness than those with less than seven years education, and Roman Catholic women have about 20% higher fitness than those of other religions. Although these differences were significant, education and religion only accounted for 2% and 1% of variance in fitness, respectively. Using structural equation modeling, we reveal significant genetic influences for all three life-history traits, with heritability estimates of 0.50, 0.23, and 0.45, respectively. However, strong genetic covariation with reproductive fitness could only be demonstrated for age at first reproduction, with much weaker covariation for age at menopause and no significant covariation for age at menarche. Selection may, therefore, lead to the evolution of earlier age at first reproduction in this population. We also estimate substantial heritable variation in fitness itself, with approximately 39% of the variance attributable to additive genetic effects, the remainder consisting of unique environmental effects and small effects from education and religion. We discuss mechanisms that could be maintaining such a high heritability for fitness. Most likely is that selection is now acting on different traits from which it did in pre-industrial human populations.

Attachment style and coping resources as predictors of coping strategies in the transition to parenthood

The relations among adult attachment style, coping resources, appraised strain, and coping strategies were examined in a prospective study of married couples having their first child (N = 92). Attachment and coping resources were measured during the second trimester of pregnancy, and parenting strain and coping strategies were assessed when the babies were about 6 weeks old. Results supported a theoretical model proposing that attachment is predictive of coping resources and appraised strain, and that attachment, resources, and strain are predictive of coping strategies. Results also highlighted the complexity of associations among attachment, stress, and coping: Gender differences in mean scores and predictive associations were obtained, and some interactions were found between resources and strain in predicting coping strategies. The findings support the utility of integrating theories of attachment and coping in explaining couples' adjustment to important developmental transitions.

Volunteerism and government policy in infant welfare in Queensland, Australia, 1931-1961: Working round the ban

Whereas in other Australian states voluntary organizations set up and managed infant health clinics and state governments only later became involved, in order to resolve conflicts or raise standards, Queensland began with government control. From the start, these well-baby clinics were established and maintained by the state government, whose policy precluded any involvement by the voluntary sector in baby clinic management or other aspects of the work of the Maternal and Child Welfare section of the Department of Health and Home Affairs. One organization, the Mothercraft Association of Queensland, attempted to contribute to maternal-infant welfare in the years 1931-1961. This article will discuss how the association worked in a way that was complementary to the government's work, and non-confrontationist, to achieve some of its goals.

Couple distress after sudden infant or perinatal death: A 30-month follow up

Objective: To examine, using a 30-month prospective study, patterns of anxiety, depression and alcohol use in couples following stillbirth, neonatal death or sudden infant death syndrome. Methodology: One hundred and thirty-eight bereaved and 156 non-bereaved couples completed standardized interviews at 2, 8, 15 and 30 months post-loss. Results: At all interviews, bereaved couples were significantly more likely than non-bereaved couples to have at least one distressed partner. Rarely were both partners distressed in either group. For bereaved couples, 'mother only' distress declined from 21% to 10% during the study. 'Father only' distress ranged from 7% to 15%, peaking at 30 months. Bereaved mothers who were distressed at 2 months reported significantly lower marital satisfaction at 30 months. Conclusions: At the couple level, the experience of a baby's death is multifaceted. Gender differences are common and partners' needs may change over time. Early recognition of these differences may facilitate longer-term adjustment for both partners.

Postpartum issues' for expectant mothers and fathers

Objective: To investigate the postpartum psychosocial and infant care topics that women and men who attend preparation for parenthood classes have been thinking or worrying about during the pregnancy. Furthermore, to compare the rates of endorsement of such issues for women and men so that clinicians can use this information to help plan which topics to include in preparation for parenthood classes. Design: A survey of expectant parents attending preparation for parenthood classes at a local public hospital. Participants completed a 17- to 19-item postpartum issues checklist devised for the study. Setting: Preparation for parenthood classes conducted in a public hospital in South Western Sydney, Australia. Participants: People attending the session were in their 2nd to 3rd trimester, of low to middle socioeconomic status, and 95% were expecting their first child. Eighty-five percent of women were accompanied by their male partner at the session. Data are reported from 201 women and 182 men. Measure: A 17-item issues checklist was devised initially and later expanded to 19 items. The initial checklist covered three psychosocial issues: interpersonal, intrapersonal, and parental competency. The expanded checklist also included items on infant care issues. Participants rated each item as to the extent to which they had been thinking or worrying about it over the past few weeks. Results: More than half of the men and women had been thinking or worrying about their ability to cope as new parents; just less than half of both men and women endorsed the item regarding the effect having a baby would have on their relationship with their partner; approximately 40% of women had thought that they might get bored or lonely when at home with the baby, and an equal rate of men reported that their partner experiencing this sense of boredom or loneliness was an issue for them. There were few differences between the genders in the rate of endorsement on the issues checklist. Conclusion: That many of the issues on the checklist are prevalent in both women and men at this time in the pregnancy would suggest that these are topics that would be pertinent for inclusion at preparation for parenthood classes. Although the checklist is not exhaustive, the data reported give empirical justification for inclusion of these topics in such classes.

Limb constriction as a complication of intra-uterine vesico-amniotic shunt: Fetoscopic release

Complete fetal bladder outlet obstruction was first diagnosed in a fetus at 13.5 weeks. After sequential vesico-centesis had shown good renal function, a vesico-amniotic shunt was inserted at 17 weeks with a Rodeck catheter. The procedure was successful and amniotic fluid volume re-accumulated to normal levels. A detailed scan at 20 weeks showed that the distal free end of the catheter was wound round the left fetal thigh. As the fetus grew, there was progressive constriction of the fetal thigh by the catheter. By 29 weeks, Doppler blood flow changes to the left leg were apparent. Fetoscopic surgery was performed at 30 weeks to release the constriction. The catheter was divided successfully, but the divided end of the shunt subsequently retracted into the fetal abdomen, producing urinary ascites, bilateral hydroureter and hydronephrosis. The baby was delivered at 31.5 weeks in good condition. Endoscopic resection of anterior and posterior urethral valves was performed at 6 months of age. At 2 years, the child has normal renal function, growth parameters and developmental milestones. Mild indentation of the left thigh was still apparent, although there was no functional impairment. Copyright (C) 2002 S. Karger AG, Basel.

Agressividade e índice de Apgar

A agressividade é o comportamento que surge transversalmente como queixa isolada ou a par de outras queixas na maioria das crianças com e sem doença, que procuram apoio em saúde mental infantil. Nessas crianças, e a partir da recolha dos dados anamnesicos, tem-se verificado a constância de registo, no Livro do Bebé, de Índice de Apgar ≤ 9 ao primeiro minuto. Este estudo exploratório pretendeu analisar a hipótese teórica de que o Índice de Apgar abaixo de 10 ao primeiro minuto pode ser representativo de sofrimento fetal intraparto ou perinatal e assim fragilizar os circuitos neuronais das emoções tendo como consequência o surgimento, ao longo do desenvolvimento infantil e juvenil, de dificuldades na capacidade de gestão ou controlo das emoções, com comportamentos opositivos e/ou agressivos, como resposta defensiva de luta e fuga. Utilizou-se uma amostra de crianças inscritas no serviço de consulta externa de saúde mental infantil e juvenil, e verificou-se se as queixas de perturbação do comportamento com agressividade, formuladas no momento do acolhimento ao serviço, estão relacionadas com o Índice de Apgar ≤ 9 ao primeiro minuto e/ou com os registos de sofrimento fetal. Procurou-se, numa amostra aleatória de crianças sem queixa formulada no serviço de consulta externa de saúde mental infantil e juvenil, perceber as diferenças ou semelhanças dos registos de nascimento relativamente à amostra de crianças inscritas. Foi ainda auscultada a opinião dos profissionais dos serviços de obstetrícia e neonatologia – pediatria, mediante a aplicação de um questionário, no sentido de recolher as opiniões dos profissionais de saúde que lidam com o parto, que avaliam o Índice de Apgar dos recém – nascidos e que os seguem durante as primeiras horas ou dias de vida. Das conclusões a que chegamos, salienta-se que o sofrimento fetal intraparto pode ser predictor de dificuldades de controlo emocional traduzidas em alterações do comportamento com agressividade em situações de stress. Não se conclui que o Índice de Apgar ≤ 9 pode ser predictor de alterações do comportamento com agressividade em situações de stress, uma vez que os registos de ocorrências de sofrimento fetal intraparto e os registos do Índice de Apgar ao primeiro minuto são, na amostra de crianças com queixa, díspares, relacionando-se no entanto de modo estatisticamente significativo na amostra de crianças sem queixa. III No entanto, e apesar das dificuldades metodológicas, fica a certeza de haver mais percursos a percorrer nesta direcção para a compreensão dos distúrbios emocionais e a agressividade.

O efeito de um programa de fisioterapia na estabilização do prematuro

Mestrado em Fisioterapia.

Les parcours de vie: de l'activité professionnelle à l'inactivité fonctionnelle

Selection de textes du Colloque International aux Açores, 26-28 Novembre 2008.

O efeito de um programa de fisioterapia na estabilização do prematuro

O número de bebés que nascem prematuros tem vindo a aumentar. É indiscutível a importância dos avanços tecnológicos e da pesquisa nas Unidades de Cuidados Intensivos de Neonatologia (UCIN), sendo essencial o papel desempenhado pelos fisioterapeutas nos cuidados prestados a estes bebés. As suas potencialidades só se desenvolvem na medida em que o bebé encontra estimulação e posicionamento adequado. Realizou‑se um estudo piloto na UCIN do Centro Hospitalar Lisboa Norte (CHLN), no período de julho de 2011 a março de 2012, em que se pretendeu avaliar o efeito de um programa de fisioterapia na estabilização do prematuro. Este programa consistiu em posicionar o prematuro em decúbito dorsal, lateral direito e lateral esquerdo e decúbito ventral, permanecendo em cada posição 5 minutos. O objetivo foi avaliar, durante a permanência do bebé na UCIN, a alteração nos seguintes parâmetros: frequência cardíaca (FC) e saturação de oxigénio (SatO2), antes e depois do tratamento. A amostra por conveniência incluiu no estudo 30 bebés prematuros, sendo 13 do género feminino e 17 do género masculino, que obedeceram a critérios específicos de inclusão. Para verificar as variáveis fisiológicas FC e SatO2 foi utilizado um Oxímetro de Pulso BCI 3401. Verificou‑se que a FC diminui e a SatO2 aumentou entre a primeira avaliação e a segunda avaliação, para a amostra total, assim como para os sujeitos do género feminino e os sujeitos do género masculino, para α = 0,05 e valor p≤0,001. Contudo, a diferença entre as médias dos dois momentos de avaliação da FC e da SatO2, em função do género, não revelaram diferenças estatisticamente significativas. Em conclusão, o estudo sugere que o programa de fisioterapia promove a melhoria da SatO2 e diminuição da FC, promovendo uma melhoria da estabilização do prematuro.

Bisphenol A migration from plastic materials: direct insight of ecotoxicity in Daphnia magna

Bisphenol A (BPA) is an endocrine disrupting chemical (EDC) whose migration from food packaging is recognized worldwide. However, the real overall food contamination and related consequences are yet largely unknown. Among humans, children’s exposure to BPA has been emphasized because of the immaturity of their biological systems. The main aim of this study was to assess the reproductive impact of BPA leached from commercially available plastic containers used or related to child nutrition, performing ecotoxicological tests using the biomonitoring species Daphnia magna. Acute and chronic tests, as well as single and multigenerational tests were done. Migration of BPA from several baby bottles and other plastic containers evaluated by GC-MS indicated that a broader range of foodstuff may be contaminated when packed in plastics. Ecotoxicological test results performed using defined concentrations of BPA were in agreement with literature, although a precocious maturity of daphnids was detected at 3.0 mg/L. Curiously, an increased reproductive output (neonates per female) was observed when daphnids were bred in the polycarbonate (PC) containers (145.1±4.3 % to 264.7±3.8 %), both in single as in multigenerational tests, in comparison with the negative control group (100.3±1.6 %). A strong correlated dose-dependent ecotoxicological effect was observed, providing evidence that BPA leached from plastic food packaging materials act as functional estrogen in vivo at very low concentrations. In contrast, neonate production by daphnids cultured in polypropylene and non-PC bottles was slightly but not significantly enhanced (92.5±2.0 % to 118.8±1.8 %). Multigenerational tests also revealed magnification of the adverse effects, not only on fecundity but also on mortality, which represents a worrying trend for organisms that are chronically exposed to xenoestrogens for many generations. Two plausible explanations for the observed results could be given: a non-monotonic dose–response relationship or a mixture toxicity effect.

Criação de uma plataforma e-commerce para a página de Facebook Handmade, nós apoiamos

Trabalho de projeto apresentado à Escola Superior de Comunicação Social como parte dos requisitos para obtenção de grau de mestre em Publicidade e Marketing.

Determinants of using pacifier and bottle feeding

OBJECTIVE To analyze the factors associated with the use of pacifiers and/or bottle feeding in infants aged under one year.METHODS This is a cross-sectional study with 34,366 children and using data from the database of the 2nd Nationwide Survey of Breastfeeding Prevalence performed in the Brazilian capitals and Federal District in 2008. Cluster sampling was used. The questionnaire included questions about the use of artificial nipples in the last 24 hours. The analysis considered three outcomes: exclusive use of pacifier, exclusive use of bottle feeding, and use of artificial nipples (pacifier and bottle feeding). Prevalence ratios were obtained using Poisson regression with robust variance following a hierarchical model.RESULTS The following factors were associated with exclusive use of the pacifier: mother working outside the home, primiparity, child was not breastfed within the first hour, and child had consumed tea on the first day at home. The following factors were associated with exclusive use of bottle feeding: mother working outside the home, primiparity, low birth weight, child not breastfed within the first hour, and child had consumed milk formula and tea on the first day at home. The following factors were associated with use of artificial nipples (pacifier and bottle feeding): mother working outside the home, primiparity, cesarean delivery, the male gender, low birth weight, born in a hospital not accredited as “baby friendly”, required health baby monitoring in the Primary Health Care Unit (PR = 0.91), and child had consumed milk formula, water, or tea on the first day at home.CONCLUSIONS This study identified profiles of exclusive users of pacifiers, bottle feeding, and both. The provided information can guide preventive practices for child health.