Percepções da família da criança com doença crônica frente às relações com profissionais da saúde

A prevalência de doença crônica na infância tem aumentado, impondo à família contato contínuo com profissionais de saúde, ocasião em que a relação desempenha papel relevante. Raras explorações científicas abordam tal temática, apesar de ser apontada como núcleo fundamental para a interação efetiva. O objetivo desse estudo foi caracterizar como a família de criança doente crônica percebe sua relação com os profissionais de saúde. Foram entrevistados 20 cuidadores de criança com doença crônica. O referencial teórico e metodológico adotados foram, respectivamente, o Interacionismo Simbólico e a análise de conteúdo temática. O processo analítico revelou quatro categorias temáticas: papel do cuidador, relações angustiantes, serviços e profissionais e buscando relações acolhedoras. O resultado deste processo interacional que apresenta incongruência de expectativas e comportamentos entre profissional e família é falho e gera sentimento de desamparo, o qual é amenizado pela escuta e compreensão de outras famílias em situação similar.

New evidence for the social embeddedness of infants' early triangular capacities.

Infants appear to be active participants in complex interactional sequences with their parents far earlier than previously theorized. In this report, we document the capacity of 3-month-old infants to share attention with two partners (mothers and fathers) simultaneously, and trace links between this capacity and early family group-level dynamics. During comprehensive evaluations of the family's emergent coparenting alliance completed in 113 homes, we charted infants' eye gaze patterns during two different mother-father-infant assessment paradigms. Triangular capacities (operationalized as the frequency of rapid multishift gaze transitions between parents during interactions) were stable across interaction context. Infants exhibiting more advanced triangular capacities belonged to families showing evidence of better coparental adjustment. Theoretical and practice implications of these findings are discussed.

Prevalença i valoració de l’assessorament fet sobre l’ús de les contencions mecàniques en els serveis socials residencials de gent gran

Aquest treball tracta de fer un recull de dades per conèixer la prevalença de les contencions físiques en els establiments residencials de gent gran de Catalunya, valorar quina incidència té l’assessorament que s’ha fet en la disminució de les contencions en un primer moment i obtenir la valoració que els centres n’han fet unany més tard

Neonatal mortality in infants with low birth weigh

Objective To evaluate the factors associated with neonatal mortality in infant born with low birth weight. Method Cross-sectional study that analyzed data from 771 live births with low birth weight (<2500 g) in the city of Cuiabá, MT, in 2010, of whom 54 died in the neonatal period. We obtained data from the Information System on Live Births and Mortality, by integrated linkage. Results In multiple logistic regression, neonatal mortality was associated with: number of prenatal visits less than 7 (OR=3.80;CI:1,66-8,70); gestational age less than 37 weeks (OR=4.77;CI:1.48-15.38), Apgar score less than 7 at the 1st minute (OR=4.25;CI:1.84-9.81) and the 5th minute (OR=5.72,CI:2.24-14.60) and presence of congenital anomaly (OR=14.39;IC:2.72-76.09). Conclusion Neonatal mortality in infants with low birth weight is associated with avoidable factors through adequate attention to prenatal care, childbirth and infants.


Research priorities for nursing care of infants, children and adolescents: a West Australian Delphi study.

This paper describes a study that aimed to identify research priorities for the care of infants, children and adolescents at the sole tertiary referral hospital for children in Western Australia. The secondary aim was to stimulate nurses to explore clinical problems that would require further inquiry. Background. Planning for research is an essential stage of research development; involving clinicians in this exercise is likely to foster research partnerships that are pertinent to clinical practice. Nursing research priorities for the paediatric population have not previously been reported in Australia. Design. Delphi study. Method. Over 12 months in 2005-2006, a three-round questionnaire, using the Delphi technique, was sent to a randomly selected sample of registered nurses. This method was used to identify and prioritise nursing research topics relevant to the patient and the family. Content analysis was used to analyse Round I data and descriptive statistics for Round II and III data. Results. In Round I, 280 statements were identified and reduced to 37 research priorities. Analysis of data in subsequent rounds identified the top two priority research areas as (1) identification of strategies to reduce medication incidents (Mean = 6 center dot 47; SD 0 center dot 88) and (2) improvement in pain assessment and management (Mean = 6; SD 1 center dot 38). Additional comments indicated few nurses access the scientific literature or use research findings because of a lack of time or electronic access. Conclusions. Thirty-seven research priorities were identified. The identification of research priorities by nurses provided research direction for the health service and potentially other similar health institutions for children and adolescents in Australia and internationally. Relevance to clinical practice. The nurse participants showed concern about the safety of care and the well-being of children and their families. This study also enabled the identification of potential collaborative research and development of pain management improvement initiatives.

Changes in physiological and behavioral parameters of preterm infants undergoing body hygiene: a systematic review

Objective To verify the effect of bathing on the body temperature of preterm infants (PTI). Method Systematic review conducted in the following bibliographic electronic sources: Biblioteca Virtual em Saúde/Lilacs (BVS), Cumulated Index of Nursing and Allied Health Literature (CINAHL), Cochrane Library, Google Scholar, PubMed, SCOPUS and Web of Science, using a combination of search terms, keywords and free terms. The review question was adjusted to the PICO acronym (Patient/population, Intervention, Control/comparative intervention, Outcome). The selected publications were evaluated according to levels of evidence and grades of recommendation for efficacy/effectiveness studies, as established by the Joanna Briggs Institute. Results Eight hundred and twenty four (824) publications were identified and four studies met the inclusion criteria, of which three analyzed the effect of sponge baths and the effect of immersion baths. Conclusion Sponge baths showed a statistically significant drop in body temperature, while in immersion baths the body temperature remained stable, although they studied late preterm infants.

Professor Göran von Bonsdorff 14.12.1972

Kirje

La matèria de Bretanya a Catalunya, Escòcia i Anglaterra

Aquest projecte examina la literatura artúrica medieval catalana occitana, anglesa i escocesa. Un estudi comparatiu a partir de les fonts franceses originals palesa les seves diferents adaptacions i traduccions als models culturals autòctons, mostrant les característiques comunes i les diferenciadores dins del marc literari europeu. S’argumentà que els contexts històrics i intel•lectuals influïren en la composició d’aquestes obres de manera que la llegenda artúrica respon a les inquietuds polítiques i socials contemporànies. Les tensions interterritorials i internacionals existents a la Corona d'Aragó condicionaren la composició de les obres com és el cas de La faula de Guillem de Torroella, que pot ser interpretada en clau dels enfrontaments entre Pere III i Jaume III de Mallorca i el paper que hi podria haver jugat una intervenció francesa en favor dels illencs. Per la seva banda, el Roman de Fergus utilitza la figura artúrica per enaltir la reialesa normanda escocesa i excloure els habitants d'origen celta de les esferes de poder. Des del punt de vista de la traducció i els estudis vernaculars, s’examinà com la Matèria de Bretanya contribuí a l’establiment i promoció d’una cultura nacional escrita en llengua pròpia davant de la cultura llatina hegemònica. Les prestigioses fonts franceses de les quals es deriven els texts catalans, francesos i anglesos permeteren de manera simbòlica que les llengües d'aquests països adquiriren el mateix prestigi que el francès, tot ajudant a la promoció de les llengües vernaculars en ambients cultes.

Umbilical venous concentrations of estradiol in infants with early-onset neonatal sepsis and chorioamnionitis.

Objective: Fetuses are exposed to high concentrations of estradiol due to placental production. Experimental data suggest that estradiol is an important modulator of the immune response. However, the role of estradiol in the pathogenesis of early-onset neonatal sepsis (EOS) is unknown. The purpose of this pilot study was to determine estradiol levels in umbilical venous blood of newborns with EOS or chorioamnionitis exposure. Methods: Estradiol concentrations were measured by enzyme immunoassay in 37 newborns with EOS, 37 newborns with chorioamnionitis and 37 controls matched for gestational age and gender. Results: Estradiol levels correlated with gestational age, birth weight, gender and mode of delivery (p < 0.05). Multivariate analysis revealed higher estradiol levels in the EOS than in the chorioamnionitis group (odds ratio 8.43, 95% CI 1.63-43.45, p = 0.01) with the highest levels in patients with proven bacteraemia (p = 0.02). No difference was found between the EOS and the control group. Exploratory analysis showed an association between lower estradiol levels and a longer duration of mechanical ventilation (n = 28, p = 0.02). Conclusions: Umbilical venous estradiol levels were similar in EOS compared to controls. Further investigation is needed to evaluate whether high estradiol levels in infants with chorioamnionitis increases the risk of developing EOS.

Metabolic cost of growth in very low-birth-weight infants.

Forty-eight measurements of energy expenditure were performed in 15 very low-birth-weight infants during the first 6 wk of life. Their mean birth weight and gestation age was 1223 g and 31 wk respectively. Their mean weight gain was 11.2 g/kg . d (range: -6.6 to +15.9 g/kg . d.). The mean energy expenditure increased from 170 kJ/kg . d (wk 1) to 252 kJ/kg . d (wk 6). There was a significant relationship between weight gain and energy expenditure (r = 0.58, P less than 0.001) and also between the net increase in body weight gain and the net increase in energy expenditure (r = 0.80, P less than 0.001). From the slopes of these regression lines, the metabolic cost of growth was found to be approximately 2.3 kJ/g of weight gain. Carbohydrate oxidation represented 80% of energy expenditure at the second wk and decreased to 65% the 6th wk, whereas lipid oxidation during the same period increased from 14 to 30% and the relative protein oxidation remained unchanged, covering 5-6% of the energy expended.

A criança: Seus Direitos e Políticas Governamentais Estabelecidas para a sua Concretização em Cabo Verde

Este trabalho centra-se na problemática da Criança em Cabo-Verde, nas políticas de desenvolvimento deste país, que visam a defesa dos direitos da Criança, bem como o seu bem-estar social. Donde, se procurou fazer, no primeiro capítulo o enquadramento histórico e a contextualização económica, cultural e social de Cabo -Verde, de modo a conhecer melhor esta realidade. No capítulo três analisam-se os Direitos da Criança, especialmente os seus “não – direitos”, dado que ainda se encontra numa fase muito embrionária a aplicação global dos Direitos da Criança, no que concerne ao estabelecido, tanto na Declaração como na Convenção dos Direitos da Criança, respectivamente estabelecidas em 1959 e 1989, e abordadas no capítulo dois deste Trabalho. Este trabalho foi desenvolvido com o objectivo de melhor entender a situação das crianças neste país, a diferentes níveis, as suas dificuldades e anseios, bem como a protecção que lhes é devida, umas vezes concretizada, mas na maior parte dos casos ainda não. O trabalho de campo realça a importância do papel desempenhado pelas ONGs e Instituições governamentais, bem como o desenvolvimento alcançado, tendo sempre como objectivo, o processo integrador das Crianças. A metodologia de Investigação assenta em Inquéritos e Entrevistas, aplicados a uma amostra significativa. Os resultados procuraram dar respostas, sobre a realidade estudada. As conclusões, não são muito surpreendentes, mas são sobretudo, confirmativas das preocupações equacionadas como hipóteses, no início do estudo. É pois um trabalho de carácter mais qualitativo do que quantitativo, pelas suas próprias características intrínsecas, que ilustra a evolução deste país e o esforço politico tentado e já bastante conseguido, na melhoria e protecção das condições de vida da população em geral e das crianças em particular.