Significados de vivencias en cuidados gestacionales de nacidos con bajo peso

El bajo peso al nacer se considera un problema en salud pública multifactorial, con consecuencias como la morbimortalidad neonatal, deficiencias en el desarrollo cognitivo y el aumento del riesgo de desarrollo de enfermedades crónicas en etapas posteriores de la vida. Objetivo: interpretar los significados de las vivencias en cuidados gestacionales de las mujeres con hijos con bajo peso al nacer a término, que permitan identificar aspectos de salud, socioeconómicos, emocionales, entre otros, que sean relevantes durante la gestación y que puedan ser caracterizados e incluidos en el marco de las políticas públicas vinculantes en Sincelejo, Sucre. Metodología: fenomenología aplicada a ocho mujeres madres de niños/as con bajo peso al nacer a término. La información fue procesada con el método Colaizzi. Resultados: derivaron cinco macro categorías: 1) Cuidado y cuidado de sí en la gestación. 2) La salud en movimiento durante los cuidados de la gestación. 3) El cambio como vivencia permanente en la gestación. 4) Economía y gestación. 5) Las emocionalidades habitan la gestación. Conclusiones: El estudio atiende al nacimiento y a los factores contextuales, sociales y familiares relacionados. Se convirtió en una vía hacia el conocimiento protagonizado por las gestantes de gran utilidad para las políticas públicas.

Low birth weight is considered a multifactorial public health problem with consequences such as neonatal morbidity and mortality, deficiencies in cognitive development and increased risk of developing chronic diseases in later stages of life. Objective: To interpret the meanings of the experiences in pregnancy care of women with low birth weight babies at term, which allow the identification of health, socioeconomic and emotional aspects, among others, that are relevant during pregnancy, and that can be characterized and included in the framework of binding public policies in Sincelejo, Sucre. Method: Phenomenology applied to eight mothers of low-birth-weight babies at term. The information was processed with the Colaizzi method. Results: Five macro-categories were derived: 1) Care and self-care during pregnancy; 2) Health in motion during pregnancy care 3) Change as a permanent experience in pregnancy 4) Economy and gestation 5) Emotionality inhabiting gestation. Conclusions: The study addresses birth, contextual, social and family related factors. This study became a path towards knowledge carried out by pregnant women, which is very useful for public policies.

O baixo peso ao nascer se considera um problema na saúde pública multifatorial, com consequências como a morbimortalidade neonatal, deficiências no desenvolvimento cognitivo e o aumento do risco de desenvolvimento de doenças crônicas em etapas posteriores da vida. Objetivo: interpretar os significados das vivências em cuidados gestacionais das mulheres com filhos com baixo peso ao nascer a termo, identificar aspeitos de saúde, socioeconómicos, emocionais, entre outros, que sejam relevantes durante a gestação e que possam ser caracterizados e incluídos no marco das políticas públicas vinculantes em Sincelejo, Sucre. Metodologia: fenomenologia aplicada a oito mulheres mães de meninos/as com baixo peso ao nascer a termo. A informação foi processada com o método Colaizzi. Resultados: derivaram cinco macro categorias: 1) Cuidado e cuidado de si na gestação. 2) A saúde em movimento durante os cuidados da gestação. 3) O câmbio como vivência permanente na gestação. 4) Economia e gestação. 5) As emocionalidades tem a gestação. Conclusões: O estudo atende ao nascimento e aos fatores contextuais, sociais e familiares relacionados. Tornou-se em uma via para o conhecimento protagonizado pelas gestantes é de grande utilidade para as políticas públicas.

Análisis de las Intervenciones de Bebés de 9 Meses durante la Lectura Compartida / Analysis of the Interventions of 9 Month-old Babies during Shared Storybook Reading

Resumen La lectura compartida es frecuente en la infancia. Sin embargo, la participación de infantes menores de un año en esta actividad ha sido poco explorada. Este trabajo describe y analiza las intervenciones de bebés de 9 meses en la lectura conjunta materno-infantil en hogares argentinos. Transcribimos y analizamos filmaciones realizadas por 10 madres. Clasificamos las intervenciones en: acción responsiva o espontánea; vocalización responsiva o espontánea; acción responsiva + vocalización; acción espontánea + vocalización. Los bebés realizaron mayoritariamente acciones espontáneas (con o sin vocalizaciones). Luego, clasificamos las acciones (con o sin vocalizaciones) en: convencionales (pasar la página, señalar) o manipulativas (morder, sacudir los libros); otras no orientadas (tomar otro objeto, mirar fuera del escenario). Encontramos que las acciones fueron principalmente manipulativas. Finalmente, clasificamos las acciones en: inespecíficas (morder el libro, sacudirlo) u orientadas (intentar agarrar los objetos representados). Predominaron las acciones inespecíficas. Los hallazgos muestran bebés sensoriomotores en exploración. Sin embargo, algunas intervenciones revelaron también un incipiente desarrollo simbólico al usar los libros convencionalmente y reconocer las imágenes como objetos simbólicos. La lectura compartida es un escenario en el que se accede a diversos sistemas de representación (imágenes, números, letras), permitiendo desarrollar tempranamente un potencial simbólico en contextos sociales relevantes.

Abstract Shared reading is a significant and frequent activity in early childhood. However, the interventions in this kind of activities by babies and infants under one-year have been little explored. The main objective of this work was to describe 9-month-old babies' interventions in reading situations with their mothers at Argentinian homes. The focus of the analysis was babies' actions during reading with their mothers. Ten mothers filmed shared reading sessions with their babies. Then we transcribed and analyzed babies' interventions in three levels. First, we classified the interventions in: responsive action, spontaneous action, responsive vocalization, spontaneous vocalization, responsive action + vocalization, spontaneous action + vocalization. Isolated vocalizations were rare. The babies performed mostly spontaneous actions (with or without vocalizations). Responsive actions were less frequent (with or without vocalizations). Second, we classified babies' actions (with or without vocalizations) in 1-conventional, like turn the page, point to the book, put the book in reading position, 2-manipulative, like bite, shake, put the book in the mouth, open and close the book, try to grab/suck/ touch objects represented in pictures, 3- other actions- actions not oriented to books, like shake another object present in the interaction or looking to some object or person outside the scene. We found that babies' actions were mainly manipulative. Finally, we categorized manipulative actions in 1- unspecific actions, like bite, shake, put the book in the mouth, open and close the book, and 2- pictures-oriented ones, like try to grab, suck, touch objects present in pictures. Unspecific actions predominated. Findings show sensory motor babies in exploration. Nevertheless, the presence of conventional actions and picture-oriented actions are signs of an incipient symbolic development. That is, babies use books conventionally and recognize pictures as symbolic objects. In sum, shared reading is one of the richest scenarios for early symbolic development. In this context babies and children access to diverse representational systems (words, pictures, numbers, letters). This activity allows children to development their symbolic potential in relevant social contexts.

Application and prospect of neonatal critical illness score in China / 中国小儿急救医学

Neonatal critical illness score(NCIS) has been published for over 20 years in China and has played an active role in critical neonatal transport, illness severity assessment, and prognosis evaluation.However, there are still some limitations in the scoring system with the development of medical technology, such as failure to include crucial perinatal information, unable to quantify single indicators, difficulty in obtaining PaO 2 without oxygen inhalation, complex evaluation indicators, long evaluation time and data was difficult for scientific research, etc.Therefore, it is necessary to update and simplify it for the clinical treatment and scientific study of critically ill newborns.This review summarized NCIS application in China and compared it with foreign neonatal critical scores such as score for neonatal acute physiology, clinical risk index for babies, etc.Combined with the rising technology of artificial intelligence and deep learning in recent years, it was more straightforward and optimized to enhance its accuracy and applicability, which was aimed to play a more active role in the treatment of critical newborns and scientific research.

Programa de acompanhamento de educadoras de berçário: relato de experiência / Monitoring program for nursery educators: experience report / Programa de monitoreo de educadores de guardería: reporte de experiencia

O presente estudo tem por objetivo apresentar o Programa de Acompanhamento de Educadoras de Berçário - PROACEB e relatar a experiência de sua implementação, baseado em um estudo realizado com 32 educadoras que atendiam bebês. O PROACEB é fundamentado na abordagem de pikleriana e tem como finalidade promover a qualidade das interações educadora-bebê durante os cuidados básicos. Está organizado em módulos, embasados nos três princípios da abordagem pikleriana: 1) atividade autônoma do bebê; 2) organização do ambiente; 3) competências da educadora e o vínculo seguro com o bebê. Evidências dos relatos das educadoras indicam que o PROACEB se mostrou promissor como um programa inicial de formação continuada de educadoras de berçário, uma vez que vai ao encontro das demandas dos bebês e das profissionais.

This study aims to present the Mentoring Program for Nursery Educators - MPNE and to detail its implementation, based on a study carried out with 32 educators who attended to babies. MPNE is based on the Piklerian approach and aims to promote the quality of child-educator interactions during basic care. It is organized into modules, based on three principles of the piklerian approach: 1) autonomous baby activity; 2) organization of the environment; 3) the teacher's skills and the security bond with the baby. Evidence from the educators' speeches indicates that MPNE has shown to be useful as a starting point for addressing important knowledge and skills for a child-educator quality interaction.

Este estudio tiene como objetivo presentar el Programa de Monitoreo de Educadores de Guardería - PROACEB y detallar su implementación, a partir de un estudio realizado con 32 educadores infantiles. El PROACEB se basa en el enfoque Pikleriano y tiene como propósito promover la calidad de las interacciones educadora-infante durante la atención básica. Está organizado en módulos, basados en los tres principios del enfoque pikleriano: 1) actividad autónoma del bebé; 2) organización del ambiente; 3) las habilidades de la educadora y el vínculo seguro con el bebé. La evidencia de los informes de los educadores indica que PROACEB se ha mostrado prometedor como un programa de educación continua inicial para los educadores de guardeías, ya que satisface las demandas de los bebés y de los profesionales.

Impact of breastfeeding on respiratory and gastrointestinal infections in infants of Muslim mothers of Kolkata, India

Background: Breast milk contains some proteins whose functions are not nutritive but anti-infective, which prevents infants from infections. Objective: The objective of the present study was to evaluate an association between the occurrence of diarrhea and respiratory tract infection (RTI) and breastfeeding among infants of Muslim mothers in Kolkata. Materials and Methods: An observational cross-sectional community-based study was conducted among mother–infant pairs of a total of 540 numbers in Muslim-dominated urban slums of Kolkata. The study period was from November 1, 2017, to October 31, 2018. Results: The findings indicated that 82.22% of breastfed infants had no diarrhea, and the absence of RTI was observed in 69.81%. It was also noted that both episodes of diarrhea and RTI in infants become less when the duration of breastfeeding increases. The study also significantly (P < 0.001 and P = 0.03) revealed that the occurrence of diarrhea and RTI was found to have lower incidence in colostrum-fed babies. Out of 391 colostrum- fed babies, about 85.42% had no diarrhea, and the absence of RTI was noticed in 72.12%. In conclusion, breast milk gives protection to babies against diarrheal diseases and RTI. It is the most appropriate food for infants. Conclusions: It is concluded that the prevention of RTI and diarrhea in infants, exclusive breastfeeding (EBF), early initiation of breastfeeding, and avoidance of bottle feeding should be the best practice to be recommended. To explore appropriate intervention strategies for reinforcing early initiation and continuation of EBF from birth to 6 months of life.

Contribuições e especificidades da clínica winnicottiana para a prematuridade: Evidências a partir de dois casos / Contributions and specificities of the Winnicottian clinic for prematurity: Evidence from two cases / Aportaciones y especificidades de la clínica de Winnicott para la prematuridad: Evidencia de dos casos

O presente estudo investigou as contribuições dos princípios e da técnica da clínica winnicottiana no atendimento a duas mães e seus bebês no contexto da prematuridade. No primeiro caso, a mãe tinha 20 anos e a filha nasceu com 27 semanas gestacionais, pesando 1.020 gramas, e permaneceu 81 dias no hospital; no segundo, a mãe tinha 21 anos e as filhas gêmeas nasceram com 27 semanas gestacionais, pesando 1.600 gramas, e permaneceram 49 dias no hospital. O atendimento foi realizado durante a internação dos bebês. O foco da análise dos resultados foi no processo do atendimento, considerando cinco eixos temáticos derivados dos atendimentos: tolerância e confiabilidade; setting constante e confiável; acompanhamento das mães nas primeiras aproximações das filhas; espaço para elaboração dos conflitos conjugais e familiares; e desafios e impasses da clínica winnicottiana para a prematuridade. Os resultados revelaram que os atendimentos auxiliaram as mães em suas dificuldades frente à maternidade, bem como para verbalizar e elaborar as culpas, as perdas, o luto e os medos que a experiência do nascimento prematuro agrega à maternidade.

The present study investigated the contributions of the principles and techniques of Winnicott's clinic in the care of two mothers and their babies in the context of prematurity. In the first case, the mother was 20 years old and the daughter was born at 27 weeks gestational age, weighing 1,020 grams, and stayed 81 days in the hospital. In the second, the mother was 21 years old and the twin daughters were born at 27 weeks gestational age, weighing 1,600 grams, and stayed 49 days in the hospital. Care was provided during the babies' hospitalization. The focus of the analysis of the results was on the process of care, considering five thematic axes derived from the sessions: tolerance and reliability; constant and reliable setting; support for the mothers in the first approaches to their daughters; room for the elaboration of conjugal and family conflicts; and challenges and impasses of the Winnicottian clinic for prematurity. The results revealed that the consultations helped the mothers in their difficulties facing maternity, as well as to verbalize and elaborate the guilt, losses, mourning and fears that the experience of premature birth adds to maternity.

El presente estudio investigó las contribuciones de los principios y técnicas de la clínica de Winnicott en el cuidado de dos madres y sus bebés en el contexto de la prematuridad. En el primer caso, la madre tenía 20 años y la hija nació a las 27 semanas de edad gestacional, con un peso de 1.020 gramos, y permaneció 81 días en el hospital. En el segundo, la madre tenía 21 años y las hijas gemelas nacieron a las 27 semanas de edad gestacional, pesaron 1.600 gramos, y permanecieron 49 días en el hospital. La atención se prestó durante la hospitalización de los bebés. El foco del análisis de los resultados fue el proceso de atención, considerando cinco ejes temáticos derivados de las consultas: tolerancia y confiabilidad; setting constante y confiable; acompañamiento de las madres en los primeros acercamientos a sus hijas; espacio para la elaboración de conflictos conyugales y familiares; y desafíos e impasses de la clínica winnicottiana para la prematuridad. Los resultados revelan que las consultas ayudaron a las madres en sus dificultades frente a la maternidad, así como a verbalizar y elaborar las culpas, las pérdidas, el duelo y los miedos que la experiencia del nacimiento prematuro añade a la maternidad.

Impacto del abandono de la lactancia materna exclusiva sobre la salud de los lactantes / Impact of exclusive breastfeeding withdrawal on the health of babies

Introducción: El abandono de la lactancia materna es uno de los problemas que enfrenta el Sistema Nacional de Salud en Cuba por las consecuencias desfavorables que representa para la salud de los lactantes. Objetivo: Identificar la relación entre el abandono de la lactancia materna exclusiva y las afectaciones en la salud de los lactantes. Material y Métodos: Se realizó un estudio descriptivo, retrospectivo de corte transversal, en 105 lactantes del Policlínico Aleida Fernández Chardiet nacidos en 2019, cuyas madres dejaron de utilizar la lactancia materna exclusiva antes del sexto mes. Las variables utilizadas fueron edad materna, tiempo de duración de la lactancia materna exclusiva, las enfermedades más frecuentes diagnosticadas en el niño y la necesidad de ingresos hospitalarios. Se aplicó la prueba no paramétrica de independencia Chi Cuadrado para demostrar la relación entre variables. Resultados: Predominó el abandono de la lactancia materna exclusiva antes de los 3 meses y no se encontró relación estadísticamente significativa entre esta y las afecciones más frecuentes de los lactantes (las IRA en 40 por ciento y las EDA en 23,8 por ciento). El 55,2 por ciento necesitó ingreso hospitalario antes del sexto mes y la relación con el abandono precoz de la lactancia materna exclusiva fue estadísticamente significativa. Conclusiones: El abandono precoz de la lactancia materna exclusiva afecta la salud de los lactantes y aunque las afecciones no tuvieron una relación estadísticamente significativa con aquella sí tienen una elevada frecuencia en estos niños de tan corta edad(AU)

Introduction: Breastfeeding withdrawal is one of the challenges faced by the Cuban National Health System due to its adverse consequences on the health of babies. Objective: To identify the relationship between exclusive breastfeeding withdrawal and health disorders in babies. Material and Methods: A descriptive, retrospective, cross-sectional study was carried out on 105 breastfed babies from "Aleida Fernández Chardiet" Policlinic who were born in 2019 and were precociously weaned from exclusive breastfeeding before the sixth month. The variables used were: maternal age, duration of exclusive breastfeeding, most frequent diseases diagnosed in the child, and need for hospital admission. The chi-squared non-parametric independence test was used to show the relationship among variables. Results: Exclusive breastfeeding withdrawal before the third month was predominant (71, 4 percent); the most frequent diseases diagnosed were respiratory diseases and diarrheas (40 percent and 23,8 percent, respectively); about half the babies required hospital admission (55,2 percent) before the sixth month; the relationship with early withdrawal of breastfeeding was statistically significant. Conclusions: Early withdrawal of breastfeeding has negative effects on the health of babies. Although the illnesses did not have a statistically significant relationship with it, a high frequency of their incidence was found in such young babies(AU)

Reflections about the Molecular Tool That Could Change the Course of Human History: Genome Editing / Reflexiones sobre la herramienta molecular que podría cambiar el curso de la historia humana: la edición genómica / Reflexões sobre as ferramentas moleculares que poderiam mudar o rumo da história humana: a edição de genoma

Abstract Genetic editing has many applications in almost all areas of society, but may also lead to unpredictable consequences. Genome editing to modify the human germline is at the center of global discussion. Owing to the increasing number of unanswered scientific, ethical, and policy questions, the scientific community agrees that it would be inappropriate to genetically modify embryos. A serious and open debate is necessary to decide whether such research should be suspended or encouraged. Here we show some bold arguments in favor of deleting deleterious genes from the human genome and the risks liberal eugenism poses.

Resumen La edición genética tiene muchas aplicaciones en casi todos los ámbitos de la sociedad, pero también puede tener consecuencias impredecibles. La edición del genoma de la línea germinal humana es el centro de una discusión mundial. Debido al creciente número de cuestionamientos científicos, éticos y políticos, muchos sin una respuesta concreta, el consenso de la comunidad científica manifiesta que sería inapropiado modificar genéticamente embriones humanos. Se considera necesario un debate serio y abierto para decidir si se debe suspender o fomentar la investigación en este sentido. En el presente documento, se exponen algunos argumentos audaces a favor de la eliminación de los genes nocivos del genoma humano y los riesgos que supone el eugenismo liberal.

Resumo A edição de genoma tem muitas aplicações em todos os âmbitos da sociedade, no entanto pode ter consequências imprevisíveis. A edição do genoma da linha germinal humana é o centro de uma discussão mundial. Devido ao número crescente de questionamentos científicos, éticos e políticos, muitos sem resposta concreta, o consenso da comunidade científica manifesta que não seria apropriado modificar geneticamente embriões humanos. Consideramos que é necessário um debate sério e aberto para decidir se é necessário suspender ou fomentar a pesquisa nesse sentido. Aqui mencionamos alguns argumentos audazes a favor da eliminação de genes nocivos do genoma humano e os riscos decorrentes do eugenismo liberal.

Processos de transição com ingresso de bebês na educação infantil: revisão bibliográfica / Transition processes when infants enroll in ECEC: literature review / Processus de transition sur l'accueil des bébés dans les institutions d'éducation de la petite enfance: revue de littérature / Procesos de transición del ingreso de bebés en la Educación Infantil: una revisión bibliográfica

Resumo Como consequência do complexo, multifacetado e contraditório processo de aquisição de direitos das mulheres trabalhadoras e das crianças, tem havido grande aumento de frequência de bebês em instituições de educação infantil. Interrogou-se, assim, como a literatura discute a transição de cuidados/educação mais centrados em contextos domiciliares para os compartilhados com a instituição. Esta revisão bibliográfica sistemática utilizou termos transição, adaptação, bebês e creche em cinco línguas e em seis bases de dados. Os resultados indicam crescimento da temática nas duas últimas décadas, com maior produção no Brasil e nos Estados Unidos. Atentando-se à complexidade do processo, autores focalizam processos e ações antes e após o ingresso nas instituições, além de mudanças de longo tempo. Discutem-se questões teóricas, relação família-instituição, papel do professor e estratégias de acolhimento.

Abstract As consequence of the complex, multifaceted, and contradictory process of acquiring the rights of working women and children, the frequency of babies in institutions of early childhood education and care has greatly increased. It was therefore questioned how literature discusses the transition from care/education more centered in the home contexts to those shared with the institution. This systematic bibliographic review used the terms transition, adaptation, babies, and daycare, in five languages and in six databases. Results indicate a growth of the theme in the last two decades, with greater production in Brazil and the Unites States. Paying attention to the complexity of the process, authors focus on processes and actions before and after enrolling in the institutions, in addition to long time changes. Theoretical issues, family-institution relationship, the teacher's role, and welcoming strategies are discussed.

Résumé En raison du processus complexe, multiforme et contradictoire d'acquisition des droits des femmes qui travaillent et des enfants, il y a eu une forte augmentation de la fréquence des bébés dans les institutions d'éducation de la petite enfance. On s'est donc interrogé sur la manière dont la littérature traite de la transition des soins/éducation plus centrés sur le domicile à ceux partagés avec l'institution. Cette revue bibliographique systématique a utilisé les termes transition, adaptation, bébés et garderie en cinq langues et en six bases de données. Les résultats indiquent une croissance du thème au cours des deux dernières décennies, avec une plus grande production au Brésil et aux États-Unis. En prêtant attention à la complexité du processus, les auteurs se concentrent sur les processus et actions avant et après leur accueil dans les institutions, en plus des changements sur une longue période. Les questions théoriques, la relation famille-institution, le rôle de l'enseignant et les stratégies d'accueil sont discutés.

Resumen Como consecuencia del complejo, multifacético y contradictorio proceso de adquisición de derechos -de las mujeres trabajadoras y los niños-, se ha producido un gran aumento en la frecuencia de bebés en las instituciones de educación infantil. Se cuestionó, por lo tanto, cómo la literatura discute la transición de acciones asistenciales/educativas más centradas en el hogar a las compartidas con la institución. Esta revisión bibliográfica sistemática utilizó los términos transición, adaptación, bebés y guardería, en cinco idiomas y seis bases de datos. Los resultados indican un crecimiento del tema en las últimas dos décadas, con mayor producción en Brasil y Estados Unidos. Considerando la complejidad del proceso, los autores se enfocan en procesos y acciones previas y luego de ingresar a las instituciones, además de un largo tiempo. Se discuten aspectos teóricos, relación familia-institución, rol del docente y estrategias para acoger el contexto.

Maternal outcomes among HIV positive pregnant mothers and birth outcomes of HIV exposed newborns in Nyahururu County Referral Hospital, Kenya

Background Approximately 37 million people were living with HIV by the end of 2015. This led to high morbidity and mortality among women of childbearing age, especially in SubSaharan Africa which was the epicentre of this global pandemic. Strengthening and implementing prevention of mother-to-child (PMTCT) services could reduce the incidence of vertical transmission and improve quality of life. We aimed to determine maternal and birth outcomes among HIV-positive pregnant mothers and HIV-exposed newborns in Nyahururu county referral hospital, Laikipia, Kenya. Main Outcomes Measures Reduce maternal morbidity and mortality and other birth-related complications. In addition, this will also reduce infant mortality and morbidity among HIV-exposed infants. Materials And Methods This was a hospital-based descriptive prospective study conducted at the PMTCT department at the Nyahururu County referral hospital. A sample of 180 HIV-positive pregnant women enrolled at the PMTCT consented to participate in the study. We monitored them until delivery and labour complications were addressed. Babies were scored against the APGAR scale, weighed and spot dried blood samples taken before breastfeeding; and started on prophylactic antiretroviral therapy. RESULTS Out of 180 participants, only 17 did not complete the study. Our findings indicate that 97.5 % of the mothers delivered in the hospital, had labour lasting less than 12 hours, 92.6% had a normal delivery and 94.9% had no complications during the labour period. About 2.5 % of the women had misoprostol administration. The majority of exposed babies had an average weight of between 2.51 - 3.00kg. No neonatal asphyxia was evident among exposed babies. Conclusions: The majority of the respondents delivered in the hospital; no neonatal asphyxia was evidenced and there was a significant correlation between APGAR scores and infant weight. There is a need for active follow-up and monitoring of HIV pregnant women and their unborn babies until delivery.

Knowledge of emergency preparedness among nurses in Machakos level five Hospital in Machakos County, Kenya

BACKGROUND An emergency is an unexpected event that disrupts normal operations within a health facility and requires immediate interventions to address it. Knowledge of emergency preparedness is an important role of clinical nursing to enhance patient outcomes. This study aimed to determine the types of emergencies received at Machakos Level 5 Hospital (ML5H) and to assess the nurses' level of knowledge on emergency preparedness. MATERIALS AND METHOD This was a descriptive cross-sectional research design. The study was conducted at Machakos Level 5 Hospital, Machakos County, Kenya. The sample included 132 nurses working at ML5H, who were randomly selected and consented to participate in the study. Data was collected using a self-administered questionnaire and an observation checklist. Data were coded and entered into SPSS version 25 software and the analysis included descriptive statistical tests. RESULTS A little more than a half (56%) of the nurses were found to have adequate knowledge of emergency preparedness; 65% had attended training on emergency preparedness and 63% indicated that training had enhanced their competence. CONCLUSION A higher proportion of nurses reported not participating in emergency drills that could be used to improve their knowledge and skills in emergency preparedness. The results of the study indicate that there is a need to enhance the knowledge of nurses' on emergency preparedness.

Qual a importância da convivência de grupos e pares de bebês e crianças? / Quelle est l'importance de la coexistence de groupes et de couples de bébés et de jeunes enfants? / What is the importance of the coexistence of groups and pairs of babies and children?

Qual a importância, em termos de constituição do psiquismo, da convivência em grupos ou pares de bebês e crianças pequenas? Esta é a pergunta que orienta este artigo, inspirado pelas restrições de convívio coletivo que estes pequenos sofreram, e ainda sofrem, diante da Pandemia do Covid-19. Para explorar tal assunto, o artigo aborda o percurso teórico que Lacan desenvolve sobre a participação do pequeno semelhante na constituição subjetiva. A argumentação principal será articulada em torno da noção do Complexo da intrusão, inserido nos Complexos familiares, na qual o pequeno semelhante surge como um intruso e inaugura uma triangulação inicial, anterior ao Complexo de Édipo freudiano, que tem participação na formação do eu.

Quelle est l'importance, du point de vue de la constitution du psychisme, de la coexistence en groupes ou couples de bébés et de jeunes enfants ? C'est la question qui guide cet article, inspiré des restrictions de socialisation collective que ces petits ont subi, et subissent encore, face à la Pandémie de Covid-19. Pour explorer ce sujet, l'article aborde le cheminement théorique que Lacan développe sur la participation du petit semblable à la constitution subjective. L'argument principal s'articulera autour de la notion de Complexe d'Intrusion, insérée dans les Complexes Familiaux, dans laquelle le petit semblable apparaît comme un intrus et inaugure une première triangulation, antérieure au Complexe d'Œdipe freudien, qui participe à la formation de je.

What is the importance, in terms of the constitution of the psyche, of the coexistence in groups or pairs of babies and small children? This is the question that guides this article, inspired by the restrictions of collective socializing that these little ones suffered, and still suffer, in the face of the Covid-19 Pandemic. In order to explore this subject, the article approaches the theoretical path that Lacan develops on the participation of the small similar in the subjective constitution. The main argument will be articulated around the notion of the Intrusion Complex, inserted in the Family Complexes, in which the toddler appears as an intruder and inaugurates an initial triangulation, prior to the Freudian Oedipus Complex, that participates in the formation of the ego.

Interação Mãe-Bebê: A Relação Entre o Processo de Vinculação e as Práticas Parentais / Mother-Baby Interaction: The Relationship Between the Bonding Process and Parentenal Pratictices

Buscou-se descrever as práticas parentais de mães de bebês aos três meses e investigar o seu efeito sobre a interação mãe-bebê. Participaram do estudo, 39 díades mães-bebê. As mães responderam a um Inventário de Estilos Parentais para Pais e Mães de Bebês (IEPMB). As díades foram filmadas em condição estruturada (Face-to-Face Still Face ­ FFSF). As práticas parentais identificadas a partir do IEPMB foram classificadas como Positivas ou Negativas, distribuídas entre os níveis Baixo, Médio e Alto. Os comportamentos observados durante o FFSF foram categorizados em Orientação Social Positiva (OSP), negativa (OSN) (para bebês e mães) e Autorregulação do bebê. Houve predominância de práticas parentais positivas, com efeito da Prática Positiva Alta indicando maior ocorrência de autorregulação dos bebês durante o 2o episódio. A interação dos fatores indicou efeito sobre a OSP dos bebês e suas mães, no 3o episódio, com melhores resultados para mães com Prática Positiva Média e Negativa baixa. Os resultados podem subsidiar programas de intervenção na primeira infância.

This research aims to practices the parenting practices of three-month-old babies' mothers and to investigate its effect on mother-baby interaction. Thirty-nine mother-baby dyads participated in the study. The mothers responded to an Inventory of Parenting Styles for Fathers and Mothers Babies (IEPMB). The dyads were filmed in a structured condition (Face-to-Face Still Face - FFSF). The Parental practices identified from the IEPMB were classified as Positive or Negative, distributed among the Low, Medium and High levels. The Interactive behaviors were categorized into Positive Social Orientation (OSP) or Negative (OSN) (for babies and mothers) and baby Self-Regulation. There was a predominance of positive parenting practices, with the effect of High Positive Practice indicating a higher occurrence of babies' self-regulation during the 2nd episode. The interaction of the factors indicated an effect on the OSP of babies and their mothers in the 3rd episode, with better results for mothers with Medium Positive and Low Negative Practices. The results can subsidize early childhood intervention programs.

The influence of the quality in daycare environments on children's motor development between six to 15 months old / Influência da qualidade do ambiente das creches no desenvolvimento motor de crianças entre seis e 15 meses

Abstract Objectives: to analyze the influence of the quality in the environment on children's motor development between six to 15 months old attending early childhood education centers. Methods: a cross-sectional and analytical study addressing children's motor development between six to 15 months old, both sexes, enrolled in nursery (0-12 months) and preschoolers (12-24 months). The Affordances in the Home Environment for Motor Development-Infant Scale and Alberta Infant Motor Scale were used in the Brazilian versions Results: the sample was comprised of 104 children and 30 early childhood education centers: presenting a mean age of 9.15 months, 88% attended full-time and 12% part-time schooling (mornings or afternoons). One center was classified with a low Affordances, 26 were considered Sufficient, and three were Adequate. Of the participating children, 40% presented typical motor development. The higher levels of Affordances suggest better motor development, and lower levels of suspected delayed motor development. Conclusion: the environments of early childhood education centers influence children's motor performance, especially daily activities and the use of toys. The lower the Affordances level, more likely children are suspected of delayed motor development.

Resumo Objetivos: analisar a influência da qualidade do ambiente no desenvolvimento motor de crianças na faixa etária entre seis e 15 meses que frequentam centros de educação infantil. Métodos estudo de delineamento transversal e analítico sobre o desenvolvimento motor de crianças entre seis e 15 meses de idade, de ambos os sexos, matriculadas em turmas de berçário (0-12 meses) e maternal I (12-24 meses), com utilização das escalas validadas Affordances in the Home Environment for Motor Development-Infant Scale e Alberta Infant Motor Scale. Resultados: a amostra de 104 crianças e 30 centros de educação infantil apresentou idade média de 9,15 meses, 88% permanecia em período integral e 12% meio período (manhã ou tarde), um centro foi classificado como Affordance Fraca, 26 Suficiente e três Adequada. Das crianças participantes, 40% apresentaram desenvolvimento motor normal. Os maiores níveis de Affordance indicam melhor desenvolvimento motor e níveis menores de Affordance sinalizam suspeita de atraso motor. Conclusão: o ambiente de centros de educação infantil em que a criança está inserida exerce influência no desempenho motor, principalmente ligado às atividades diárias e uso de brinquedos. Quanto menor o nível de Affordance mais possibilidades de suspeita de atraso motor infantil.

Necessidades do bebê com deficiência física na creche: a percepção de educadoras / Necesidades del bebé con discapacidad física en la guardería: percepción de educadoras / The needs of children with physical disabilities in day care: the perception of educators

RESUMO. Este estudo teve como objetivo investigar a percepção de educadoras frente às necessidades de duas bebês com deficiência física em contexto de inclusão na creche. Realizou-se um estudo de caso múltiplo, com seis educadoras que atendiam a turma de Mariana (24 meses), e quatro educadoras que atendiam a turma de Vitória (18 meses), as quais responderam uma entrevista semiestruturada. Ambas as bebês tinham deficiência física e frequentavam escolas de educação infantil da rede pública de Porto Alegre. Os dados foram analisados através de diversas leituras do material, produzindo um relato clínico. Em relação à Mariana, as educadoras destacaram a necessidade de estímulo e de suporte físico à bebê, bem como a importância do afeto na relação educadora-bebê, presente em um 'olhar a mais', mais sensível. Quanto à Vitória, as educadoras reforçaram a importância da integração entre as áreas da saúde e da educação, assim como de um olhar mais atento às diferentes necessidades da bebê com deficiência. A partir dos resultados, foi possível compreender nesse 'olhar a mais', destacado pelas educadoras como necessário para atender à demanda das bebês com deficiência física, uma exigência de maior disponibilidade corporal e psíquica.

RESUMEN. Este estudio tuvo como objetivo investigar la percepción de educadoras frente a las necesidades del bebé con discapacidad física en el contexto de inclusión en la guardería. Se realizó un estudio de caso múltiple, cuyas participantes fueron seis educadoras que atendían a la clase de Mariana, y cuatro educadoras que atendían a la clase de Vitória, las cuales respondieron una entrevista semiestructurada. Ambas bebés tenían deficiencia física y frecuentaban escuelas de Educación Infantil de la red pública de la ciudad de Porto Alegre/Brasil. Los datos fueron analizados a través de diversas lecturas del material, produciendo un relato clínico. En cuanto a Mariana, 24 meses, las educadoras destacaron la necesidad de estímulo y de soporte físico a la bebé, así como la importancia del afecto en la relación educadora-bebé, que hace presente en una 'mirada a más', más sensible. En cuanto a Vitória, 18 meses, las educadoras reforzaron la importancia de la integración entre las áreas de la salud y la educación, así como de una mirada más atenta a las diferentes necesidades de la bebé con discapacidad. A partir de los resultados, fue posible comprender en esa 'mirada a más', destacada por las educadoras como necesario para atender a la demanda de los bebés con discapacidad física, una exigencia de mayor disponibilidad corporal y psíquica.

ABSTRACT. This study aimed to investigate the perception of educators regarding the needs of two babies with physical disabilities in the context of inclusion in the day care center. A multiple-case study was carried out. The participants were six educators who oversaw Mariana's class, and four educators who oversaw Vitoria's class, and all 10 educators answered a semi-structured interview. Both babies were physically disabled and attended public schools in Porto Alegre/Brazil. The data were analyzed through several readings of the material, which resulted in a clinical report. In relation to Mariana (age 24 months) the educators emphasized the baby's need for stimuli and physical support, as well as the importance of affection in the educator-baby relationship, which was present as a more sensitive 'extra thought'. As for Vitória (age 18 months), educators reinforced the importance of integration between the health and education fields, as well as closer attention to the different needs of the disabled baby. Based on the results, it was possible to observe within that 'extra thought' - highlighted by the educators as necessary to fulfill the needs of babies with physical disabilities - a demand for greater physical and psychic availability.

ABORDAGEM DAS TEMÁTICAS "SAÚDE BUCAL DE GESTANTES E BEBÊS" E "SAÚDE DO HOMEM" EM SALAS DE ESPERA: SIGNIFICÂNCIAS POLÍTICO-PEDAGÓGICAS DAS EXPERIMENTAÇÕES VIVENCIADAS EM UM ESTÁGIO SUPERVISIONADO / APPROACH TO THEMES "BUCAL HEALTH OF GESTANTS AND BABIES" AND "MAN'S HEALTH" IN WAITING ROOMS: POLITICAL-PEDAGOGICAL MEANINGS OF THE EXPERIMENTS ENCOURAGED IN A SUPERVISED STAGE

Objetivo: analisar as significâncias político-pedagógicas de duas vivências experimentadas ("Saúde bucal de gestantes e bebês" e "Saúde do homem") por estagiários de um curso de Odontologia em salas de espera de uma Unidade de Atenção Primária de Saúde (UAPS). Metodologia: estudo qualitativo transversalmente estruturado sob estratégia narrativo-descritiva e moldado à técnica argumentativa. Resultados: o "Estágio Supervisionado em Unidade de Atenção Primária I" foi didaticamente sistematizado em dois períodos, "Pré-intervenção" e "Intervenção". Do primeiro, se desvendaram três ações, a "Pactualização do enlace ensino-serviço-comunidade", a "Contextualização dos acadêmicos estagiários" e a "Estruturação e ambientalização das equipes de trabalho". Já o segundo foi guiado pela lógica pedagógica do instrumento "TPC" (Teorizar-Praticar-Criticar), onde todas as ações programadas seguiram a lógica ativa do planejamento estratégico, ou seja, contextualizadas às realidades do cenário de prática, ou seja, salas de espera da Unidade de Atenção Primária de Saúde do bairro JK do município de Governador Valadares, MG. Conclusão: das experimentações vivenciadas algumas inferências merecem destaque: a concepção pedagógica de estratégias práticas de ensino pautadas na articulação ensino-serviço-comunidade; a escuta na identificação dos problemas/demandas a serem enfrentadas pela equipe estagiária; o reconhecimento do potencial dos ambientes de espera para a implantação de ações educativas; a importância de disseminar os aprendizados advindos de experimentações práticas de estágios.

Objective: to analyze the political-pedagogical significance of two experienced experiences ("Oral Health of Pregnant Women and Babies" and "Men's Health") by trainees of a Dentistry course in waiting rooms of a Primary Health Care Unit. Methodology: qualitative study transversally structured under a narrative-descriptive strategy and molded to the argumentative technique. Results: The "Supervised Internship in Primary Care Unit I" was systematized in two periods, "Pre-intervention" and "Intervention". From the first, three actions were unveiled, the "Pactualization of the teaching-service-community link", the "Contextualization of trainee academics" and the "Structuring and environmentalization of work teams". The second one was guided by the pedagogical logic of the instrument "TPC" (Theorizar-Praticar-Criticar), where all the actions programmed followed the active logic of strategic planning, that is, contextualized to the realities of the practice scenario, expects the Primary Health Care Unit of the JK district of the municipality of Governador Valadares, MG. Conclusion: from the weightings listed some inferences deserve to be highlighted: the pedagogical conception of practical teaching strategies based on the teaching-service-community articulation; listening in the identification of problems / demands to be faced by the trainee team; the recognition of the potential of waiting environments for the implementation of educational actions; the importance of disseminating the learning that comes from practical experimentation of internships.

Magnitude, risk factors and outcome of low birth weight babies admitted to neonatal intensive care unit of a tertiary care centre in Puducherry, India

Background: This study was undertaken to know the magnitude, risk factors and outcome of LBW babies admitted in NICU in a tertiary centre.Methods: This is a hospital based, retrospective study, of LBW babies admitted to NICU of Sri Venkateshwara Medical College hospital and research centre, Puducherry, from Jan 2019 - Dec 2019.Results: About 340 babies were admitted to NICU and 56 were LBW babies, 5 were excluded and 51 LBW babies analysed. Magnitude of LBW babies, 51 (15%). Socio demographic pattern showed, IUGR (62.7%). Term IUGR (52%) and preterm IUGR (9.8%). Preterm babies (37.2%). Preterms <28 weeks of gestation (7.8%), 28-34 weeks (9.8%) and 34 to < 37 weeks (19.6%). LBW babies <1kg (7.8%), 1-1.5kg (1.9%) and 1.5 to 2.49 kg (90.1%). Male (52.9%), female babies (47%). LBW babies from rural area (62.7%), urban area (37.2%). Among the maternal risk factors, maternal anemia was common (31.3%). Elderly primi (13.7%), PROM and twin pregnancy in (9.8%) each, bad obstetric history (7.8%). PIH, APH, GDM and oligohydramnios in (3.9%) each. Rh negative pregnancy, grand multipara, teenage pregnancy, ART with hypothyroidism and unbooked pregnancy seen in (1.9%) each. Fetal distress (19.6%). Morbidity was (92.1%). Most common was jaundice (31.9%), sepsis (21.2%). Feeding difficulties (19.1%), TTNB (17%), apnea of prematurity (14.8%). Hypoglycemia and HIE in (12.7%) each. Hypothermia and HMD in (10.6%) each. Seizures in (8.5%) MAS and NEC (4.2%) each, congenital anomalies and hypocalcemia in (2.1%) and mortality in (7.8%). Extreme prematurity, ELBW with sepsis and RDS being common cause of mortality.Conclusions: Iron tablets intake, nutritional care, regular antenatal checkup, spacing pregnancy, avoidance of teenage and elderly pregnancy is important. Improving the infrastructure, manpower in NICU to manage preterm babies, when surfactant and ventilation is given.

Retinopathy of prematurity in preterm babies in a local medical college and hospital

Background: Retinopathy of prematurity is a multifactorial vasoproliferative retinal disease that increases in incidence with decreasing gestational age and is one of the leading causes of preventable childhood blindness in India. Advances in neonatology have led to dramatic increase in survival of preterm neonates and in turn, to the risk of developing ROP. Since most of the risk factors associated with ROP mentioned above arise in the neonatal intensive care unit (NICU) itself and most of them are avoidable, cautious monitoring of the risk factors, early screening, follow up and surgical intervention have been shown to reduce the incidence and improve the outcome of ROP.Methods: This was a prospective observational study conducted for a period of 2 years. A total of 151 infants admitted in NICU /SNCU who satisfied the inclusion criteria were enrolled in this study. Initial and follow up screening was conducted in three phases the results were documented in proforma after ethical clearance.Results: Comparison of risk factors between eyes with and without ROP was done using Chi-square test. A p-value of<0.05 was considered to be statistically significant. Incidence of ROP in centre is found to be 33.8%. Among maternal risk factors, multiple gestation and PROM/PPROM is found to be significant in the development of ROP from this study. However, mode of delivery and gestational hypertension, were found to be not significant in ROP. Among neonatal risk factors, low birth weight, lower gestational age, prolonged oxygen exposure, blood transfusion, mechanical ventilation, sepsis, phototherapy was found to be significant in this study.Conclusions: ROP, being an emerging cause for potentially blinding visual disability, needs to be diagnosed early. Due to the advancements in neonatology and better survival of preterm babies, timely screening, regular follow up, early detection and intervention is mandatory. A multidisciplinary approach is required in diagnosis and treatment of the disease. Proper counselling and motivation for parents of preterm and low birth weight babies for regular follow up is also essential.

Randomized control trial evaluating the effectiveness of ear plugs in hearing loss in NICU preterm babies

Background: The prevalence of hearing loss is higher in neonates admitted to NICU compared to the general population. Preterm babies are more vulnerable to the hearing damage due to their immature inner ear exposing them to various high frequency noises in the NICU to which they were not accustomed. Most NICU in India exceed the recommended sound levels. In order to reduce damage to the ears, foam-based earplugs are used to reduce the sound intensity reaching the ears of these premature babies.Methods: Babies admitted to NICU are allocated alternatively to receive earplugs or not. Cases are preterm babies with earplugs and controls are the ones without earplugs. The incidence of hearing loss is found by OAE testing of the ears at the end of NICU stay.Results: Out of 40 in each group, 6 babies in control group failed the OAE compared the 3 in the earplug group. Babies who did wear earplugs had longer period of NICU stay.Conclusions: Use of earplugs in babies admitted to NICU reduced the incidence of hearing loss and also length of NICU stay.

"Ciência da mãe": modos de cuidados clínicos com bebês prematuros à luz da teoria psicanalítica / "Science of the mother": modes of cinical care with premature babies in the light of the psychoanalytic theory / "Ciencia de la madre": modos de atención clínica con bebés prematuros a la luz de la teoría psicanalítica

O presente artigo tem como objetivo investigar os modos de cuidados clínicos com bebês prematuros internados em uma Unidade de Terapia Intensiva Neonatal (UTIN), à luz do referencial teórico da psicanálise, considerando os processos de instauração do sujeito e apontando para possíveis contribuições à atenção em saúde mental de bebês. A escuta psicanaliticamente orientada e as observações norteadas pelo uso do instrumento Indicadores de Risco para o Desenvolvimento Infantil (IRDI) compuseram as notas do diário de campo e permitiram a apresentação de vinhetas que ilustram a construção de possíveis dispositivos de trabalho clínico. Destaca-se a importância da sustentação de um espaço de escuta no qual se sobressaia o discurso familiar sobre o bebê, possibilitando a produção de narrativas singulares.

This article aims to investigate the clinical care modalities with premature newborn infants admitted to a Neonatal Intensive Care Unit (NICU), in the light of the theoretical framework of psychoanalysis, considering the processes of instituting the subject and pointing to possible contributions to care in mental health of babies. The psychoanalytically oriented listening and the observations guided by the use of the Risk Indicators for Child Development (IRDI) instrument compose the notes of the field diary and allowed the presentation of vignettes that illustrate the construction of possible clinical work devices. It stands out the importance of supporting the space of listening in which the familiar discourse on the baby, making possible the production of singular narratives.

El presente artículo tiene como objetivo investigar los modos de atención clínica con bebés prematuros internados en una Unidad de Terapia Intensiva Neonatal (UTIN), a la luz del referencial teórico del psicoanálisis, considerando los procesos de instauración del sujeto y apuntando para posibles contribuciones a la atención en salud mental de los bebés. La escucha psicoanalítica orientada y las observaciones orientadas por el uso del instrumento Indicadores de Riesgo para el Desarrollo Infantil (IRDI) compusieron las notas del diario de campo y permitieron la presentación de viñetas que ilustran la construcción de posibles dispositivos de trabajo clínico. Se destaca la importancia de la sustentación de un espacio de escucha en el que se sobresalía el discurso familiar sobre el bebé, posibilitando la producción de narrativas singulares.