A vivência materna no cuidado do filho prematuro hospitalizado durante a segunda etapa do Método Canguru

INTRODUCTION: The Kangaroo Mother Care (KMC) is a perinatal assistance model aimed at improving the quality of care provided to the premature newborn (NB), which reduces the separation time from their parents, the stress and pain, provides proper thermal control, increases mother breastfeeding and baby’s weight gain. In the second stage of the KMC, the baby is held in the kangaroo position for indeterminate time, which assures stronger bonds between mother and newborn. OBJECTIVES: To understand the perception of premature newborn’s mothers in relation to the KMC. CASUISTRY AND METHOD: This is a descriptive research with qualitative approach, carried out at the Neonatology Unit of the Uberlândia Clinic Hospital of the Federal University of Uberlândia, after approval by the Committee of Ethics in Research with Human Beings under opinion nº 3.054.210. The participants were nine accompanying mothers of their preterm child, which were hospitalized in the Kangaroo Unit. The inclusion criteria were mothers, with age equal or higher than 18 years old, accompanying preterm children who were hospitalized for at least five days in the KMC accommodation. The data collection was carried out from February to April 2019, through semi structured interview based on guiding questions. The reports were recorded and, after the transcription, the audio digital files were deleted. The identity of the participants was substituted by the numerical order of the interviews collection, in order to eliminate any possibility of identification. The responses to the guiding questions were subjected to a content analysis from Laurence Bardin’s perspective. RESULTS: After the application of the analysis criteria and identification of meaning and context units, four thematic categories emerged: “Kangaroo Unit inherent aspects”; “Maternal perspective”; “Multi-professional performance”; “Skin-to-skin contact and caring for premature: mother legitimation”. FINAL CONSIDERATIONS: The mother’s experience with the hospitalization of their children in the second stage of KMC permeated the woman’s intern conflict in the gestation until the premature child’s birth, the issues involving the hospital environment, the duality of feelings regarding the delicate health situation of the baby, the decision of remaining in the Kangaroo Unit, which reflects the distance from family life, the difficulties faced to be full time in the unit and the family and emotional support. In contrast, it was determined the emergence of positive feelings, the creation of bonds with the baby in skin-to-skin contact, the learning in the care of the preterm, the happiness in performing the maternity and discovering herself the authentic mother.Trabalho de Conclusão de Curso (Graduação)INTRODUÇÃO: O Método Canguru (MC) é um modelo de assistência perinatal voltado para a melhoria da qualidade do cuidado prestado ao recém-nascido (RN) prematuro, que reduz o tempo de separação com os pais, o estresse e dor, proporciona o controle térmico adequado, aumento do aleitamento materno e o ganho de peso do bebê. Na segunda etapa do MC a posição canguru é realizada por tempo indeterminado, o que assegura maior vínculo entre mãe e prematuro. OBJETIVOS: Compreender a percepção das mães de RN prematuros em relação ao MC. CASUÍSTICA E MÉTODO: Trata-se de pesquisa descritiva com abordagem qualitativa, realizada na Unidade de Neonatologia do Hospital de Clínicas de Uberlândia da Universidade Federal de Uberlândia após a aprovação pelo Comitê de Ética em Pesquisa com Seres Humanos sob o parecer nº 3.054.210. As participantes foram nove as mães acompanhantes dos seus filhos prematuros que estavam internados na Unidade Canguru. Os critérios de inclusão foram mães com idade igual ou superior a 18 anos, acompanhantes dos filhos prematuros que estavam internados por no mínimo cinco dias no alojamento do MC. A coleta de dados foi realizada de fevereiro a abril de 2019, por meio de entrevista semiestruturada a partir de perguntas norteadoras, sendo os relatos gravados e posteriormente à transcrição o arquivo digital dos áudios foi apagado. Para evitar qualquer forma de identificação das participantes sua identidade foi substituída por numeração da ordem de coleta das entrevistas. As respostas às questões norteadoras foram submetidas à análise de conteúdo na perspectiva de Laurence Bardin. RESULTADOS: Após aplicação dos critérios de análise, identificação das unidades significação e de contexto, emergiram quatro categorias temáticas: “Aspectos inerentes da Unidade Canguru”; “Perspectivas materna”; “Atuação multiprofissional”; “Contato pele a pele e cuidar do prematuro: legitimação da mãe”. CONSIDERAÇÕES FINAIS: A vivência das mães na internação com seus filhos na segunda etapa do MC permeou o conflito interno da mulher na gestação até o nascimento do filho prematuro, as questões com ambiente hospitalar, a dualidade de sentimentos frente à delicada situação de saúde do bebê, a decisão de permanecer internada na Unidade Canguru a qual reflete a distância do convívio familiar, as dificuldades enfrentadas para estar em tempo integral na unidade, o suporte familiar e emocional. Emergiram, em contraponto, sentimentos positivos, a criação de vínculo com o bebê no contato pele a pele, o aprendizado nos cuidados do prematuro, a felicidade em exercer a maternidade e descobrir-se a autêntica mãe

Cuidado desenvolvimental para recém-nascidos pré-termos: revisão de escopo

Objective: To map the evolution of developmental care provided to preterm newborns in Neonatal Intensive Care Units to synthesize current scientific evidence. Methods: Bibliographic search for a scoping review was conducted in November 2022 on the MEDLINE, Virtual Health Library, CINAHL, Embase and Web of Science databases. Studies discussing developmental care in neonatal units in the past five years, without language restriction, were included. Results: The scoping review included articles, whose main topics were skin-to-skin contact, noise and light control, family participation, and team awareness and training. Conclusion: Developmental care practices contribute to the neuropsychomotor development of preterm infants, improve care, reduce morbidity and mortality, and the length of hospitalization.Objetivo: mapear como o cuidado desenvolvimental prestado aos recém-nascidos pré-termos tem sido desenvolvido nas unidades de terapia intensiva neonatal com a finalidade de sintetizar as evidências científicas atuais. Métodos: revisão de escopo com busca realizada em novembro de 2022 nas bases MEDLINE, Biblioteca Virtual em Saúde, CINAHL, Embase e Web of Science. Foram incluídos estudos que retratavam o cuidado desenvolvimental nas unidades neonatais, nos últimos cinco anos, sem restrição de idioma. Resultados: incluíram-se sete artigos e os principais temas foram: contato pele a pele, controle do ruído e luminosidade, participação da família e sensibilização e treinamento da equipe. Conclusão: esses cuidados contribuem para o desenvolvimento neuropsicomotor do prematuro, melhoram a assistência e reduzem a morbimortalidade e o tempo de internação

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost