Neurobehavioral signals in preterm infants in body weight check: a quasi-experimental study / Señales neuroconductuales en prematuros en la verificación del peso corporal: un estudio cuasiexperimental / Sinais neurocomportamentais em prematuros na verificação do peso corporal: estudo quase-experimental

ABSTRACT Objective: to describe and compare the frequency of neurobehavioral signs in preterm infants in traditional and humanized body weight check. Methods: a quantitative, quasi-experimental, cross-over study, carried out in a Neonatal Unit at a university hospital with a sample of 30 preterm newborns, randomly assigned and allocated in control group (traditional) and intervention group (humanized), with collection of general data, vital signs before and after procedures and footage. Results: there was a higher frequency of approach signs in humanized weight check compared to traditional check. Moreover, withdrawal signs were more frequent in traditional weight check compared to humanized check. Conclusion: in this regard, humanized body weight check provided greater benefits to preterm infants, making it necessary to foster discussions about humanization of care, so that this practice can be performed routinely in health units.

RESUMEN Objetivo: describir y comparar la frecuencia de signos neuroconductuales en prematuros en la verificación del peso corporal de forma tradicional y humanizada. Métodos: estudio cuantitativo, cuasiexperimental, cross-over, realizado en una Unidad Neonatal de un hospital universitario con una muestra de 30 recién nacidos prematuros, asignados aleatoriamente y asignados en el grupo control (tradicional) y en el grupo intervención (humanizado), con la recolección de datos generales, signos vitales antes y después de los procedimientos y filmaciones. Resultados: hubo mayor frecuencia de señales de acercamiento en la verificación de peso de forma humanizada en comparación con la forma tradicional. Además, los signos de retracción fueron más frecuentes en la verificación de peso de forma tradicional en comparación con la forma humanizada. Conclusión: de esa forma, la verificación del peso corporal de forma humanizada proporcionó mayores beneficios a los prematuros, siendo necesario estimular discusiones sobre la humanización de la atención, para que esa práctica pueda ser realizada de forma rutinaria en las unidades de salud.

RESUMO Objetivos: descrever e comparar a frequência dos sinais neurocomportamentais em prematuros na verificação do peso corporal de forma tradicional e humanizada. Método: estudo quantitativo, quase-experimental, tipo cross-over, realizado em uma Unidade Neonatal de um hospital universitário com amostra de 30 recém-nascidos prematuros, randomicamente assinalados e alocados no grupo controle (tradicional) e no grupo intervenção (humanizada), com a coleta de dados gerais, sinais vitais antes e depois dos procedimentos e filmagem. Resultados: observou-se uma frequência maior dos sinais de aproximação na verificação do peso de forma humanizada em relação à tradicional. Além disso, os sinais de retraimento se mostraram mais frequentes na verificação do peso de forma tradicional em comparação à humanizada. Conclusão: desse modo, a verificação do peso corporal de forma humanizada proporcionou maiores benefícios aos prematuros, tornando-se necessário estimular discussões sobre a humanização da assistência, para que esta prática possa ser realizada de forma rotineira nas unidades de saúde.

Neurobehavioral Deficits and Parkinsonism in Occupations with Manganese Exposure: A Review of Methodological Issues in the Epidemiological Literature

Exposure to manganese (Mn) is associated with neurobehavioral effects. There is disagreement on whether commonly occurring exposures in welding, ferroalloy, and other industrial processes produce neurologically significant neurobehavioral changes representing parkinsonism. A review of methodological issues in the human epidemiological literature on Mn identified: (1) studies focused on idiopathic Parkinson disease without considering manganism, a parkinsonian syndrome; (2) studies with healthy worker effect bias; (3) studies with problematic statistical modeling; and (4) studies arising from case series derived from litigation. Investigations with adequate study design and exposure assessment revealed consistent neurobehavioral effects and attributable subclinical and clinical signs and symptoms of impairment. Twenty-eight studies show an exposure-response relationship between Mn and neurobehavioral effects, including 11 with continuous exposure metrics and six with three or four levels of contrasted exposure. The effects of sustained low-concentration exposures to Mn are consistent with the manifestations of early manganism, i.e., consistent with parkinsonism. This is compelling evidence that Mn is a neurotoxic chemical and there is good evidence that Mn exposures far below the current US standard of 5.0 mg/m3 are causing impairment.