INTERVENÇÕES LÚDICAS COM MÃES DE RECÉM-NASCIDOS PRÉ-TERMO HOSPITALIZADOS

Esta pesquisa investiga a influência de intervenções lúdicas na diminuição da ansiedade materna com mães de recém-nascidos pré-termo hospitalizados, em um hospital universitário da Grande São Paulo. São estudadas 30 mães que tiveram parto prematuro, com faixa etária entre 16 e 40 anos e escolaridade até 2º grau, por meio de estudo avaliativo-interventivo-evolutivo. Inicia-se por uma entrevista psicológica semidirigida, com o objetivo de traçar o histórico gestacional, seguida de aplicação da Escala de Ansiedade, Depressão e Irritabilidade IDA, visando identificar o nível de ansiedade materna e do Inventário de Percepção Neonatal IPN-I para verificar a expectativa das mães em relação ao comportamento de choro, alimento e vômito de seus bebês pré-termo. A seguir são efetuadas intervenções grupais lúdicas em 16 encontros, um a cada semana, de 60 minutos, segundo modelo piagetiano, que estimula processos afetivosemocionais e cognitivos. Os dados relativos ao histórico gestacional revelam que 75% das mães encontram-se na segunda gestação e já sofreram aborto ou óbito fetal; têm ida de gestacional média de 31 semanas; peso médio do bebê ao nascer de 1.640g. e tempo de internação médio de 39,93 dias. Na análise do IDA em relação à ansiedade, 75% delas apresentam escore de alta intensidade (11,25), também alto quanto à depressão (10); o escore médio (3,73) da irritabilidade exteriorizada acompanha o da irritabilidade interiorizada (3,23). A correlação entre depressão e ansiedade indica que uma reação emocional segue a outra, não havendo diferença significativa importante entre ambas (p=0,306). O IPN-I comprova que as 30 mães têm expectativas em relação ao próprio filho similares aos bebês em geral, mostrando escores médios de 8,63 e 9,20, respectivamente, confirmados pelo escore 10,0 apontado em 75% da amostra, o que configura uma alta expectativa quanto aos aspectos de sono, alimentação e vômito dos bebês. A análise qualitativa revela que a criação de grupos lúdicos mostra-se favorável, com alta adesão e motivação das mães, favorecendo a diminuição da ansiedade, a adaptação à realidade vivida e a interação mãe-bebê de forma saudável durante a internação. O estudo apresenta a trajetória interventiva de três casos emblemáticos de diferentes níveis de ansiedade, ilustrando esta evolução. Estes dados sugerem que esta modalidade de intervenção caracterize-se como uma medida de prevenção, promoção e preservação da saúde física e psíquica da mãe e do recémnascido prematuro, com repercussões na família e na sociedade.(AU)

Avaliação do ganho de peso de bebês prematuros em relação ao leite materno cru e leite pasteurizado

This study aims to evaluate the weight gain of premature newborns fed with breast milk from their mothers' from those that are fed with breast milk from the milk bank. The research is the quantitative, descriptive and observational kind. It was conducted in the Neonatal Intensive Care Unit and Housing from the Maternity Hospital Escola Januário Cicco (MEJC), that is a reference for high risk pregnancy and birth in Rio Grande do Norte. The premature newborns included were following these parameters: gestational age from 26 to 37 weeks, initially hospitalized at UTIN, with oral diet, by means by gavage, cup and/or suction. Studies with premature newborns with a zero diet longer than seven days or complications that interfered in the evaluation of weight gain were excluded from this study. The sample was selected for convenience and had data of all newborns hospitalized at UTIN from the May to June of 2014 time period, followed to their discharge, ended by August of 2014 and had the inclusion parameters of the study. From the period of the data collection, 60 premature newborns entered the maternity and 39 of those were the sample of research. The project was approved by the Research Ethics Committee from UFRN, under CAAE nº 0699.0.000.294-11. The data was analyzed by means of descriptive and deduced statistics. The results indicated that the involved in the study, were born from mother with average age of 25,36 years, with less than nine years education 21 (53,8%), had the family income less than a minimum wage 24 (61,5%). Among the newborn, the female gender predominated 20 (51,3%), had cesarean delivery 25 (64,1%), had moderate prematurity 29 (74,5%), more of 1.500g 22 (556,4%). The birth weight average was 1.608,49g. The total of diets were 9.994, and an average of 256 for each newborn, in a 32,12 days of hospitalization time period. Most of the diet supplies were from the breast milk bank (50,34%), however 56,4% of the newborns had most of the diet from their mothers' milked breast milk. It was detected that 38,5% of the newborns had, in some given moment, artificial milk. The daily weight gain average of all newborns was 2,59g, but 35% of them had an average above 10g per day. From the newborn's group (n=25) that had medium weight gain, only 9 of them (36,0%) received mainly their own mothers' milked breast milk. It's been conclusive that most of the premature newborns gained weight predominantly from diets from the breast milk of the Milk Bank, showing the need of a bigger incentive to exclusive breast feeding.

Mortalidade segundo sua causa de morte e seus determinantes: uma análise para as capitais brasileiras e municípios do nordeste do Brasil, 2000 e 2010

This dissertation considered the development of two papers, both related to mortality in Brazil. In the first article, "The context of mortality according to the three broad groups of causes of death in Brazilian capitals, 2000 and 2010", the objective was to analyze the mortality rate according to the three major groups of causes of death in Brazilian capitals. In the second article, "Typology and characteristics of mortality from external causes in the municipalities in the Northeast of Brazil, 2000 and 2010", it was built up a typology for the Northeastern municipalities taking into account information on mortality from external causes and a set of indicators related to socioeconomic, demographic, and infrastructure aspects of such municipalities, both articles for the years 2000 and 2010. Thus, we used data from the Mortality Information System of the Ministry of Health. Furthermore, it was used information from the Demographic Census for those years. The variables relating to socioeconomic and demographic conditions used in this study were those available on the home page of the United Nations Program for Development. The variables relating to socioeconomic and demographic conditions used in this study were those available on the home page of the United Nations Program for Development. Was used in Article 1 the pro-rata distribution method to accomplish the redistribution of ill-defined causes. Moreover, made use of the technique of cluster analysis with the aim of grouping the capital that had proportions of deaths from ill-defined causes similar to each other. Already in Section 2, we used the technique of Empirical Bayesian estimation; spatial statistics technique; and finally, the Grade of Membership method to find types of municipalities from information on mortality from external causes associated with socioeconomic, demographic and infrastructure variables. As the main results, it stands out in Article 1, in relation to data quality, we observed the formation of four groups of similar capital between themselves, as the proportion of illdefined causes. Regarding the behavior of mortality, according to the three major groups of causes of death, it was noted both for 2000 and for 2010 the prevalence of deaths from noncommunicable diseases for both sexes, although the reduction was identified rates in some of the capitals. Communicable diseases stood out as the second cause of death among women. Also, we found that deaths due to external causes are responsible for the second cause of death among men, as well as presenting an increase among women. As for the Article 2, stands out, in general, not just an extension of mortality from external causes in the municipalities, as well as an enlargement of the configurator stain existence of external cause deaths for the whole area of Northeast. Regarding the typology of municipalities, three vi extreme profiles were buit: the profile 1, which comprises municipalities with high rates of mortality from external causes and the best social indicators; the profile 2, that was composed of municipalities that are characterized by having low mortality rates from external causes and the lowest social indicators; and the profile 3, that brings together municipalities with intermediate mortality rates and median values considered in relation to social indicators. Although we have not seen changes in the characteristics of the profiles, we observed an increase in the proportion of municipalities that belong to the extreme profile 3, taking into account the mixed profiles.

Avaliação da suplementação de vitamina E sobre a concentração de alfa-tocoferol no leite materno em mulheres com partos prematuros

The term vitamin E refers to a group of eight molecular compounds which differ in structure and bioavailability, and the RRR-alpha-tocopherol more biologically active form. The composition of vitamin E in breast milk undergoes variations during lactation, colostrum and milk richer in this micronutrient compared to transitional and mature milk. Newborns, especially premature infants are more susceptible to vitamin E deficiency and to prevent the damage caused by this deficiency has been proposed supplementation of neonates with this micronutrient, however, there is no consensus to carry out this intervention. Thus, maternal supplementation with RRRalpha-tocopherol in the postpartum period can be a good alternative to try to raise the alpha-tocopherol levels in breast milk and therefore provide the premature newborn adequate amounts of vitamin E. This study to evaluate the effect of supplementation with 400 UI acetate RRR-alpha-tocopherol in women with premature births, on the concentration of alpha-tocopherol in breast milk colostrum, transitional and mature. The study included 89 healthy adult women were enrolled in the control group (n = 51) and supplemented group (n = 38). Blood samples were collected and milk colostrum soon after birth (0h milk) twenty-four hours, new rate of colostrum milk was collected (24h milk). The transitional and mature milk were collected in seven days (7d milk) and thirty days (30d milk) after delivery, respectively. Supplementation in the supplemented group was held after the collection of blood and 0h milk. The alpha-tocopherol analyzes were performed by high-performance liquid chromatography. Serum levels of alpha-tocopherol less than 516 μg/dL were considered indicative of nutritional deficiency. The average concentration of alphatocopherol in the serum of the control group mothers was 1159.8 ± 292.4 μg/dL and the supplemented group was 1128.3 ± 407.2 μg/dL (p = 0.281). All women had nutritional status in vitamin E suitable. In both groups, it was observed that the concentration of vitamin E in colostrum milk was higher compared to transitional and mature milk. In the supplemented group, the concentration of alpha-tocopherol in the milk increased 60 % after supplementation, from 1339.3 ± 414.2 μg/dL (0h milk) to 2234.7 ± 997.3 μg/dL (24h milk). While the control group values in colostrum 0h and colostrum 24h were similar (p = 0.681). In the control group the follow-on milk alphatocopherol value was 875.3 ± 292.4 μg/dL and in the group supplemented 1352.8 ± 542.3 μg/dL, an increase of 35% in the supplemented group compared to control (p <0.001). In mature milk alpha-tocopherol concentrations between the control group (426.6 ± 187.5 μg/dL) and supplemented (416.4 ± 214.2 μg/dL) were similar (p = 0.853). Only 24h milk supplemented group answered the nutritional requirement of alpha-tocopherol (4 mg/day) of the newborn. These results show that the transport of this micronutrient for milk occurs in a controlled and limited way. Thus, the native vitamin E supplementation increases the concentration of alpha-tocopherol in colostrum and milk and transition does not influence the concentration in mature milk. Only the increase in colostrum milk was sufficient to meet the nutritional requirement of premature newborns.

Avaliação da concentração de vitamina A materna e de neonatos prematuros e a termo

Vitamin A is an essential nutrient for many physiological processes such as growth and development, so that their adequate nutritional state is essential during pregnancy and lactation. Lactating women and children in breastfeeding are considered risk groups for vitamin A deficiency and some factors may increase the risk of vitamin A deficiency, such as prematurity. The aim of this work was to evaluate the vitamin A concentration in preterm and term lactating women and newborns by determination of retinol in maternal serum, umbilical cord serum and breast milk collected until 72 hours postpartum. 182 mothers were recruited and divided into preterm group (GPT; n = 118) and term group (GT, n = 64). In preterm group were also analyzed transition milk (7th-15th day; n = 68) and mature milk (30th-55th day; n = 46) samples. Retinol was analyzed by high-performance liquid chromatography (HPLC). Maternal retinol concentration in serum was 48.6 ± 12.3 µg/dL in GPT and 42.8 ± 16.3 µg/dL in the GT (p <0.01). Cord serum retinol was 20.4 ± 7.4 µg/dL in GPT and 23.2 ± 7.6 µg/dL in GT (p> 0.05). Among newborns, 43% of premature and 36% of term had low levels of serum retinol in umbilical cord (<20 µg/dL). In colostrum, the retinol in preterm and term groups had an average of 100.8 ± 49.0 µg/dL and 127.5 ± 65.1 µg/dL, respectively (p <0.05). The retinol average in preterm milk increased to 112.5 ± 49.7 µg/dL in transition phase and decreased to 57.2 ± 23.4 µg/dL in mature milk, differing significantly in all stages (p <0.05). When comparing with the recommendation of vitamin A intake (400 µg/day) GT colostrum reached the recommendation for infants, but in GPT the recommendation was not achieved at any stage. Mothers of premature infants had higher serum retinol than mothers at term; however, this was not reflected in serum retinol of umbilical cord, since premature had lower concentration of retinol. Such condition can be explained due to lower maternal physiological hemodilution and placental transfer of retinol to the fetus during preterm gestation. Comparison of retinol in colostrum showed lower concentrations in GPT; however the transition phase there was a significant increase of retinol content released by the mammary gland of preterm mothers. This situation highlights a specific physiological adaptation of prematurity, likely to more contribute to formation of hepatic reserves of retinol in premature infants.

Uso de resíduos de queima de casca de café e argila da região sul da Bahia na obtenção de isolador elétrico cerâmico

The electrical ceramic insulators industry, uses noble raw materials such as siliceous and aluminous clays of white burning, in order to provide plasticity of the mass and contribute to electrical and mechanical properties required of the product, and feldspar with the flux function In literature references the composition of the masses indicates that the clay participates in percentage between 20 and 32, and feldspar 8 to 35, these materials have significant cost. In this research was performed the total replacement of commercial clay, for white burning clay from Santa Luzia region in southern Bahia and partial replacement of feldspar by ash residue of husk conilon coffee burning, from extreme south of Bahia. The objective of replacement these raw materials is to aver its technical feasibility and call attention for the embryo pole of ceramic industry for the existing in the south and extreme south of Bahia, which has significant reserves of noble raw materials such as clay white burning, kaolin, quartz and feldspar, and generates significant volume of gray husk conilon coffee as alternate flux. Clay Santa Luzia is prima noble material whose current commercial application is the production of white roofing. The residue of coffee husk ash is discarded near of production sites and is harmful to the environment. Phase diagrams and statistic design of experiments, were used for optimization and cost savings in research. The results confirmed the expectations of obtaining electrical ceramic insulators, with white burning clay of Santa Luzia and partial replacement up to 35.4% of feldspar, by treaty residue of conilon ash coffee husk burning. The statistic design that showed best results was for formulation with percentages of: clay 26.4 to 30.4%; kaolin 14.85 to 17.1%; feldspar 12.92 to 16.96%; R2 residue 7.08 to 9.2% and Quartz 32.5 to 38.75%, relative to the total mass of the mixture. The best results indicated; 0.2 to 1.4% apparent porosity , water absorption 0.1 to 0.7%, flexural strength 35 to 45MPa , dielectric strength 35-41 kV/cm , the transverse resistivity 8x109 2.5x1010 Ω.cm and for the dielectric constant ε/ε0 7 to 10.4, specification parameters for manufacturing ceramic electrical insulators of low and medium voltage.

Petrologia e geoquímica do magmatismo ediacarano Serra do Caramuru, Rio Grande do Norte, NE do Brasil

The Serra do Caramuru and Tapuio stocks, located in the extreme NE of Rio Piranhas-Seridó Domain (RN), are representative of the Ediacaran-Cambrian magmatism, an important magmatic feature of the Brasilian / Panafrican orogeny of the Borborema Province. These bodies are lithologically similar, intrusive in paleoproterozoic gneiss embasement, being separated by a thin belt of mylonitic orthogneiss. The field relations show a magmatic stratigraphy initiated by dioritic facies that coexists with the porphyritic granitic and equigranular granitic I facies, and less frequently with equigranular granitic II facies. These rocks are crosscut by late granitic dykes and sheets with NE-SW / NNE-SSW orientation. The dioritic facies (diorite, quartz diorite, quartz monzodiorites, tonalite and granodiorite) is leucocratic to melanocratic, rich in biotite and hornblende. The granitic facies are hololeucocratic to leucocratic, and have biotite ± hornblende. Petrographic and geochemical (whole rock) data, especially from Serra do Caramuru pluton, suggest fractionation of zircon, apatite, clinopyroxene (in diorites), opaque minerals, titanite, biotite, hornblende, allanite, plagioclase, microcline and garnet (in dykes). The behavior of trace elements such as Zr, La and Yb indicates that the dioritic magma does not constitute the parental magma for the granitic facies. On the other hand, the granitic facies seems to be cogenetic to each other, displaying differentiation trends and very similar rare earth elements (REE) spectra [12.3≤(La/Yb)N≤190.8; Eu/Eu*=0.30-0.68]. Field relationships and REE patterns [6.96≤(La/Yb)N≤277.8; Eu/Eu*=0.18-0.58] demonstrate that the granitic dykes and sheets are not cogenetically related to the Serra do Caramuru magmatism. The dioritic facies is metaluminous (A/CNK = 0.88-0.74) and shoshonitic, whereas the granitic ones are metaluminous to peraluminous (A/CNK = 1.08-0.93) and high potassium calc-alkaline. Dykes and sheets are strictly peraluminous (A/CNK = 1.01-1.04). Binary diagrams relating compatible and incompatible trace elements and microtextures indicate the fractional crystallization as the dominant mechanism of magmatic evolution of the various facies. The Serra do Caramuru and Tapuio stocks have well preserved magmatic fabric, do not show metamorphic minerals and are structurally isotropic, showing crosscutting contact with the ductile fabric of the basement. These observations lead to interpretate a stage of relative tectonic stability, consistent with the orogenic relaxation period of the Brasiliano / Pan-African orogeny. Chemical plots involving oxides and trace elements indicate late to post-collisional emplacement. In this context, the assumed better mechanism to describe the stocks emplacement within an extensional T Riedel joint, with ENE-WSW extensional vector. The U-Pb zircon age of 553 ± 10 Ma allows correlating the Serra do Caramuru magmatism to the group of post-collisional bodies, equigranular high potassium calc-alkaline granites of the NE of Rio Piranhas-Seridó Domain.

Petrologia e geoquímica do magmatismo ediacarano Serra do Caramuru, Rio Grande do Norte, NE do Brasil

The Serra do Caramuru and Tapuio stocks, located in the extreme NE of Rio Piranhas-Seridó Domain (RN), are representative of the Ediacaran-Cambrian magmatism, an important magmatic feature of the Brasilian / Panafrican orogeny of the Borborema Province. These bodies are lithologically similar, intrusive in paleoproterozoic gneiss embasement, being separated by a thin belt of mylonitic orthogneiss. The field relations show a magmatic stratigraphy initiated by dioritic facies that coexists with the porphyritic granitic and equigranular granitic I facies, and less frequently with equigranular granitic II facies. These rocks are crosscut by late granitic dykes and sheets with NE-SW / NNE-SSW orientation. The dioritic facies (diorite, quartz diorite, quartz monzodiorites, tonalite and granodiorite) is leucocratic to melanocratic, rich in biotite and hornblende. The granitic facies are hololeucocratic to leucocratic, and have biotite ± hornblende. Petrographic and geochemical (whole rock) data, especially from Serra do Caramuru pluton, suggest fractionation of zircon, apatite, clinopyroxene (in diorites), opaque minerals, titanite, biotite, hornblende, allanite, plagioclase, microcline and garnet (in dykes). The behavior of trace elements such as Zr, La and Yb indicates that the dioritic magma does not constitute the parental magma for the granitic facies. On the other hand, the granitic facies seems to be cogenetic to each other, displaying differentiation trends and very similar rare earth elements (REE) spectra [12.3≤(La/Yb)N≤190.8; Eu/Eu*=0.30-0.68]. Field relationships and REE patterns [6.96≤(La/Yb)N≤277.8; Eu/Eu*=0.18-0.58] demonstrate that the granitic dykes and sheets are not cogenetically related to the Serra do Caramuru magmatism. The dioritic facies is metaluminous (A/CNK = 0.88-0.74) and shoshonitic, whereas the granitic ones are metaluminous to peraluminous (A/CNK = 1.08-0.93) and high potassium calc-alkaline. Dykes and sheets are strictly peraluminous (A/CNK = 1.01-1.04). Binary diagrams relating compatible and incompatible trace elements and microtextures indicate the fractional crystallization as the dominant mechanism of magmatic evolution of the various facies. The Serra do Caramuru and Tapuio stocks have well preserved magmatic fabric, do not show metamorphic minerals and are structurally isotropic, showing crosscutting contact with the ductile fabric of the basement. These observations lead to interpretate a stage of relative tectonic stability, consistent with the orogenic relaxation period of the Brasiliano / Pan-African orogeny. Chemical plots involving oxides and trace elements indicate late to post-collisional emplacement. In this context, the assumed better mechanism to describe the stocks emplacement within an extensional T Riedel joint, with ENE-WSW extensional vector. The U-Pb zircon age of 553 ± 10 Ma allows correlating the Serra do Caramuru magmatism to the group of post-collisional bodies, equigranular high potassium calc-alkaline granites of the NE of Rio Piranhas-Seridó Domain.

Estudio aerobiológico del municipio de Las Rozas de Madrid y aplicación de resultados al control del polen alergénico

La presencia de polen aerovagante tiene un papel importante en la salud de la población, como responsable de reacciones alérgicas que afectan a un alto porcentaje de la población. Por ello la Comunidad de Madrid creó en 1993 la Red Palinológica de la Comunidad de Madrid (Red PALINOCAM) un dispositivo de vigilancia que analiza y cuantifica diariamente, durante todo el año, los niveles polínicos en nuestra región. En su diseño se tuvo en cuenta, el mapa de vegetación y el mapa de zonificación sanitaria, ubicándose los captadores en las zonas más densamente pobladas y procurando que estuvieran representadas las diferencias biogeográficas del territorio. En 2008 se amplío la red con un nuevo punto de muestreo dependiente del Laboratorio Municipal de las Rozas, que interesaba para completar la información de polen en el eje centro- noroeste de nuestra comunidad. Este ocupa una posición intermedia entre el límite metropolitano al oeste de la capital, y el extremo más rural al norte en Collado Villalba, y cubre un área cuya población es superior a los 200.000 habitantes. Su contribución por tanto al conocimiento de la variabilidad y dinámica estacional del polen atmosférico en Madrid es importante y por ello nos planteamos esta tesis, una vez que contamos con datos suficientes, 5 años completos, desde 2009 a 2013...

Análisis del establecimiento de la longitud telomérica durante el desarrollo temprano en los mamíferos

Los telómeros se encuentran en el foco de atención de muchas investigaciones por su papel en el mantenimiento de la integridad cromosómica y su implicación en procesos como el envejecimiento, el cáncer y la regeneración tisular. En ausencia de mecanismos compensatorios, el ADN telomérico sufre un acortamiento progresivo en cada división celular debido a la incapacidad de las ADN polimerasas convencionales de replicar el extremo 5’ de los cromosomas. La telomerasa, una ribonucleoproteína con actividad transcriptasa inversa (componente TERT), compensa el acortamiento telomérico sintetizando las secuencias teloméricas de novo en el extremo 3’ de los cromosomas utilizando como molde una molécula de ARN asociada (componente TERC). La mayoría de los tipos celulares presentan una actividad telomerasa limitada, acortándose los telómeros en cada división mitótica. Por ello, la actividad de la telomerasa y el acortamiento telomérico son factores limitantes en la esperanza de vida de los mamíferos, mientras que el acortamiento de los telómeros contribuye al envejecimiento limitando la regeneración tisular. Durante el desarrollo embrionario los telómeros se alargan, quedando determinadas las reservas teloméricas con las que contará el recién nacido. Por este motivo, el estudio de la dinámica de la elongación telómerica y su regulación durante el desarrollo embrionario temprano en mamíferos es de gran interés debido a las implicaciones que la longitud telomérica (LT) del recién nacido tiene en las etapas posteriores del desarrollo...

Tratamiento endoscópicamente asistido de la sinostosis sagital precoz (escafocefalia)

La sinostosis sagital precoz o escafocefalia es la forma más frecuente de craneosinostosis. Se produce por el cierre prematuro de la sutura sagital lo que da lugar a un cráneo alargado en su diámetro anteroposterior. El término escafocefalia fue acuñado por Baer en 1860, y significa cabeza en forma de quilla o bote (gr. σκαφοζ, barco), lo que describe a la perfección las deformidades presentes en estos pacientes: una cabeza alargada en su diámetro anteroposterior, con estrechamiento del diámetro biparietal y abombamientos compensadores frontales y occipitales. Su incidencia se calcula en torno a uno de cada 2000 a 3000 recién nacidos vivos con una proporción de 3,5 a 1 entre varones y mujeres. Aproximadamente el 72 % de los casos son de tipo esporádico aunque se ha observado agregación familiar en un 6% de los pacientes afectados. Se acepta que la causa de las craneosinostosis simples es multifactorial, con un origen heterogéneo desde el punto de vista etiológico y distintos procesos fisiopatológicos que pueden confluir en su desarrollo. Se postula que las craneosinostosis no sindrómicas tienen un componente genético, con interacciones entre genes y factores ambientales que aún no se conocen en su totalidad. Junto a factores mecánicos (como la restricción del movimiento fetal, compresiones por gestaciones múltiples, anomalías anatómicas uterinas...), se reconocen causas relacionadas con trastornos en la hidrodinámica del LCR (mielomeningocele, derivaciones ventriculoperitoneales en el tratamiento de la hidrocefalia), teratógenos o malformaciones del SNC que limitan la expansión de las vesículas telencefálicas (holoprosencefalia, microcefalia...)...

Conocimientos y percepciones de los profesionales sobre los cuidados centrados en el desarrollo en las unidades de neonatología

El ingreso del recién nacido prematuro en una Unidad de Cuidados Intensivos Neonatales (UCIN) supone estar expuesto a una serie de estímulos dolorosos y estresantes para los que no está preparado y que pueden tener un impacto negativo en su neurodesarrollo. Algunos tipos de cuidados aplicados al recién nacido y a la familia parecen mejorar el pronóstico de estos niños. Entre ellos tenemos los Cuidados Centrados en el Desarrollo (CCD), que son un grupo de intervenciones diseñadas para modificar el ambiente de la UCIN, minimizando de esa forma el estrés experimentado por el recién nacido prematuro e incorporando a la familia en su cuidado. La implementación de cuidados individualizados, basados en la observación de la conducta del recién nacido, parece una forma aún más eficaz de mejorar el pronóstico. Con este propósito surge el programa estandarizado de cuidados individualizados denominado NIDCAP (Newborn Individualized Developmental Care and Assesment Program). La implementación de este tipo de cuidados en las UCINs, especialmente del NIDCAP, requiere un esfuerzo importante de todos los profesionales implicados...

Ciudadanía contra el rascacielos Pelli-Cajasol de Sevilla

Esta comunicación narra la historia de una derrota de la sociedad civil preocupada por su patrimonio cultural y sus paisajes históricos urbanos. Se trata de la trayectoria de la Plataforma Ciudadana ¡Túmbala! y del Manifiesto contra la Torre Pelli-Cajasol, organizaciones de asociaciones, colectivos, personas y profesionales de diferente perfil y procedencia que desde principios del año 2009 se oponen al rascacielos de 178 metros de altura que promueve Cajasol, ahora Caixabank, en el extremo sur de la Isla de la Cartuja de Sevilla, en la denominada Puerta Triana de acceso a la Exposición Universal de 1992. El edificio, en su fase final y a punto de inaugurarse, ha roto definitivamente el perfil histórico de Sevilla, imponiendo su presencia de forma hegemónica sobre la ciudad. El camino recorrido supone la lucha de la ciudadanía por participar de las decisiones que le afectan de forma directa, como pueden ser aquellas relativas a qué es y cómo se protege su patrimonio histórico y al simbolismo que contienen determinados espacios y paisajes urbanos, ya que conforman una parte del derecho a la ciudad de todos sus habitantes. Tal lucha, infructuosa habida cuenta del resultado, se detalla a lo largo del texto, que a su vez ilustra la brecha abierta entre las instituciones públicas en todas sus escalas y la sociedad civil, así como la dominación efectiva ejercida por el poder económico y financiero de la banca.

El animal como mediador en los discursos escultóricos actuales

La tesis El animal como mediador en los discursos escultóricos actuales, aúna la investigación sobre los procesos de creación en torno a la animalística durante los siglos XX y XXI (documental, gráfica, histórica y conceptual) con el desarrollo de la creación artística personal como sustrato. Se trata de una investigación marcadamente transversal, que recurre a disciplinas tales como: lenguajes artísticos (en especial la escultura), biología, antropología, filosofía, crítica artística, historia del arte, zoología y ética. Todas estas ramas resultan necesarias para abordar un tema de tanta complejidad como lo es la diversidad de discursos que el arte actual establece en relación al tema. La tesis busca como objetivo establecer un marco desde el que discutir, analizar y proponer el quehacer artístico personal, dialogado y contextualizado, con el arte animalista del momento. Tras un profundo estudio del panorama, que se encuentra muy escasamente desarrollado en España, se establecen siete territorios discursivos (incluido el propio personal) cuyo denominador común es recurrir al animal; en unos casos como instrumento para transmitir el discurso de los artistas y, en otros, como eje central de las obras. En ellos se otorga especial interés a aspectos como: la metodología chamánica, empleada por los actuales artistas con un afán sanador y una preocupación por la relación arte/vida; las consideraciones relativas al símbolo y la transcendencia; la mediación del animal para los discursos políticos sociales; el valor terapéutico, incluyendo en ellos los procesos catárticos; y la metáfora que suponen para los alegatos ecológicos. Todo esto sin olvidar la enorme sugerencia formal que los animales aportan como objetos estéticos, y como sugerencias para la creación de mundos fantásticos. Las inquietantes e interesantes propuestas que se han analizado determinan, en último extremo, el posicionamiento de la autora de la tesis dentro de un discurso a favor del animal, su dignidad, su valor sanador y su poder como aliado. Tras el estudio de 94 artistas reconocidos en este campo, se alcanza a ofrecer un horizonte clarificado de los mecanismos que operan en la animalística, dividiendo su estudio en los siguientes 7 apartados: En un primer capítulo, dedicado al símbolo de la trascendencia, se analiza la reutilización del símbolo, lo que conduce a determinar el comportamiento simbólico y el sentimiento poético; se recorren los diferentes procedimientos de anamnesis y viajes de iniciación propios de las tradiciones religiosas; y se observa el papel que juega el animal como espíritu auxiliar, recorriendo dentro de la escultura un camino hacia la abstracción y por tanto hacia la captación de la esencia. En estos desarrollos la materia es utilizada como vehículo de lo sagrado, de tal modo que la creación artística aspira a la inmortalidad y a la trascendencia del ser...

Trajetórias e fatores associados a qualidade de vida de mães de recém-nascidos pré-termos de muito baixo peso até três anos após o parto

Preterm birth is a public health problem worldwide. It holds growing global incidence rates, high mortality rates and a risk of the long-term sequelae in the newborn. It is also poses burden on the family and society. Mothers of very low birth weight (VLBW) preterm infants may develop psychological disorders, and impaired quality of life (QoL). Factors related to mothers and children in the postpartum period may be negatively associated with the QoL of these mothers. The aim of this study was to assess factors possibly associated with the QoL of mothers of VLBW preterm newborns during the first three years after birth. Mothers of VLBW preterm answered the World Health Organization Quality of Life (WHOQOL)-bref and the Beck Depression Inventory (BDI) in five time points up to 36 months postpartum, totalizing 260 observations. The WHOQOL–bref scores were compared and correlated with sociodemographic and clinical variables of mothers and children at discharge (T0) and at six (T1), twelve (T2), 24 (T3) and 36 (T4) months after the delivery. We used the Kruskal Wallis test to compared scores across different time points and correlated WHOQOL-bref scores with the sociodemographic and clinical variables of mothers and preterm infants. Multiple linear regression models were used to evaluate the contribution of these variables for the QoL of mothers. The WHOQOL–bref scores at T1 and T2 were higher when compared to scores in T0 in the physical health dimension (p = 0.013). BDI scores were also higher at T1 and T2 than those at T0 (p = 0.027). Among the maternal variables that contributed most to the QoL of mothers, there were: at T0, stable marital union (b= 13.60; p= 0.000) on the social relationships dimension, gestational age (b= 2.38; p= 0.010) in the physical health dimension; post-hemorrhagic hydrocephalus (b= -10.05; p= 0.010; b= -12.18; p= 0.013, respectively) in the psychological dimension; at T1 and T2, Bronchopulmonary dysplasia (b= -7.41; p= 0.005) and female sex (b= 8,094; p= 0.011) in the physical health dimension and environment, respectively. At T3, family income (b= -12.75’ p= 0.001) in the environment dimension, the SNAPPE neonatal severity score (b= -0.23; p= 0.027) on the social relationships dimension; at the T4, evangelical religion (b= 8.11; p= 0.019) and post-hemorrhagic hydrocephalus (b: -18.84 p: 0.001) on the social relationships dimension. The BDI scores were negatively associated with WHOQOL scores in all dimensions and at all times points: (-1.42 ≤ b ≤ -0.36; T0, T1, T2, T3 and T4). We conclude that mothers of preterm infants VLBW tend to have a transient improvement in the physical well-being during the first postpartum year. Their quality of life seems to return to levels at discharge between two and three years after delivery. The presence of maternal depressive symptoms and diagnosis of post-hemorrhagic hydrocephalus or BDP are factors negatively associated with the QoL of mothers. Social, religious and economic variables are positively associated with the QoL of mothers of VLBW preterm.