Estudo randomizado sobre o uso de equipamentos de proteção contra a luz artificial na recuperação de neonatos prematuros

A vida na Terra evoluiu ao longo de bilhões de anos em ambientes predominantemente externos, sob condições ambientais cíclicas. Como consequência, complexos mecanismos fisiológicos de detecção e geração de ritmicidade desenvolveram-se. Para seres humanos, assim como para diversos organismos, variações de iluminação são a principal pista temporal externa capaz de sincronizar os ritmos biológicos ao ambiente. Entretanto, com o advento da eletricidade, seres humanos passaram a expor-se menos à luz natural durante o dia e mais à luz artificial durante a noite, o que traz consequências para a saúde. A iluminação em Unidades de Tratamento Intensivo Neonatais (UTIN) costuma ser contínua ou irregular, e neonatos ficam expostos à luz também no período noturno, o que pode impactar negativamente seu desenvolvimento até a alta hospitalar. Neste contexto, o objetivo deste trabalho foi avaliar o impacto do uso de equipamentos individuais de proteção contra a luz artificial no período noturno no desenvolvimento e crescimento de neonatos prematuros. Neonatos nascidos com menos de 37 semanas gestacionais que não necessitavam mais de cuidados intensivos constantes foram randomizados para utilizar protetores oculares no período noturno (grupo intervenção, n = 21) ou para continuarem expostos à luz artificial de baixa intensidade normalmente presente na unidade (grupo controle, n = 20). Foram avaliados o número de dias até a alta, ganho de peso diário e sinais vitais (frequência cardíaca, frequência respiratória, saturação de oxigênio e temperatura corporal) a cada 6 horas (02:00, 08:00, 14:00 e 20:00). Neonatos que utilizaram protetores oculares à noite receberam alta mais cedo do que bebês do grupo controle (8 [5] dias vs 12 [3.75] dias; p < 0.05). Não foi observada diferença significativa entre os grupos com relação ao ganho de peso. Uma maior variação de frequência cardíaca foi observada no grupo intervenção, com valores menores de batimentos por minuto (bpm) às 14:00 e às 20:00. Não foram detectadas diferenças significativas nas medidas de frequência respiratória, saturação de oxigênio e temperatura corporal entre os grupos nos horários avaliados. As atividades realizadas na UTI neonatal e em outras unidades de terapia intensiva tornam inviável a implementação de um ambiente completamente escuro em qualquer momento do dia. A partir dos resultados encontrados no presente estudo e dos dados presentes na literatura, consideramos que unir um ambiente escurecido à noite com dispositivos individuais de proteção contra a luz seja uma forma de criar melhores condições para o desenvolvimento de bebês prematuros na UTIN. Além disso, a utilização de protetores oculares no período noturno é uma intervenção barata que pode reduzir os custos da internação ao diminuir o número de dias até a alta hospitalar, gerando uma economia para o sistema público de saúde.Life on Earth has evolved over billions of years in predominantly external environments, under cyclical conditions. As a consequence, complex physiological mechanisms for detecting and generating rhythmicity were developed. For human beings, as well as for several organisms, lighting variations are the main external temporal cue capable of synchronizing biological rhythms to the environment. However, with the advent of electricity, humans’ exposure to natural light during the day diminished and the exposure to artificial light at night increased, which has health consequences. Lighting in Neonatal Intensive Care Units (NICU) is usually continuous or irregular, and infants are also exposed to light at night, which can negatively impact their development until hospital discharge. In this context, the objective of this work was to evaluate the impact of the use of individual equipment for protection against artificial light at night on the development and growth of preterm neonates. Infants born at less than 37 weeks of gestation who no longer needed constant intensive care were randomized to either use eye protection at night (intervention group, n = 21) or to remain exposed to the low-intensity artificial light normally present in the unit (control group, n = 20). Number of days until discharge, daily weight gain and vital signs (heart rate, respiratory rate, oxygen saturation and body temperature) were evaluated every 6 hours (02:00, 08:00, 14:00 and 20:00). Neonates who used eye protection at night were discharged earlier than babies in the control group (8 [5] days vs 12 [3.75] days; p <0.05). There was no significant difference between groups with regard to weight gain. A greater variation in heart rate was observed in the intervention group, with lower values of beats per minute (bpm) at 14:00 and 20:00 pm. There were no significant differences in the measurements of respiratory rate, oxygen saturation and body temperature between the groups at the evaluated times. The activities performed in the neonatal ICU and other intensive care units make it impossible to implement a completely dark environment at any time of the day. Based on the results found in the present study and the data present in the literature, we consider that combining a darkened environment at night with individual light protection devices is a way of creating better conditions for the development of premature infants in the NICU. In addition, the use of eye protectors at night is an affordable intervention that can reduce the costs of hospitalization by reducing the number of days until hospital discharge, generating savings for the public health system

Translation and adaptation of the Indoor Environmental Quality questionnaire to Brazilian Portuguese

Introduction: Indoor environmental quality (IEQ) impacts well-being, performance, and mental and physical health. A questionnaire for assessing occupants' perception of IEQ was developed in English. This study aimed to translate this instrument into Brazilian Portuguese and adapt it for the Brazilian population. Methods: The translation and adaptation process consisted of forward translation, adjustment, back translation, back translation review, harmonization, two cognitive debriefings, and finalization. Results: The final translated version included new questions and changed the scale to a visual-analogue format. The clarity assessment showed that after cognitive debriefings all questions displayed satisfactory scores, with the majority rated higher than 9 in a 0-10 scale. Conclusions: The Brazilian Portuguese version of the IEQ questionnaire is a simple tool that can be employed in biomedical and building research to investigate the association of the perceived indoor environmental quality with health-related parameters, as well as in architecture, engineering, and management projects

Translation and adaptation of the indoor environmental quality questionnaire to Brazilian portuguese

Introduction: Indoor environmental quality (IEQ) impacts well-being, performance, and mental and physical health. A questionnaire for assessing occupants’ perception of IEQ was developed in English. This study aimed to translate this instrument into Brazilian Portuguese and adapt it to the Brazilian population. Methods: The translation and adaptation process consisted of forward translation, reconciliation, back translation, back translation review, harmonization, two cognitive debriefings, and finalization. Results: The final translated version included new questions and changed the scale to a visual-analog format. The clarity assessment showed that, after cognitive debriefings, all questions displayed satisfactory scores, with the majority rated higher than 9 on a 0-10 scale. Conclusions: The Brazilian Portuguese version of the IEQ questionnaire is a simple tool that can be employed in biomedical and building research to investigate the association of perceived IEQ with health-related parameters, as well as in architecture, engineering, and management projects. As a next step, a psychometric validation of the instrument will be performed

Effective recommendations towards healthy routines to preserve mental health during the COVID-19 pandemic

Objective: To assess the adherence to a set of evidence-based recommendations to support mental health during the coronavirus disease 2019 (COVID-19) pandemic and its association with depressive and anxiety symptoms. Methods: A team of health workers and researchers prepared the recommendations, formatted into three volumes (1: COVID-19 prevention; 2: Healthy habits; 3: Biological clock and sleep). Participants were randomized to receive only Volume 1 (control), Volumes 1 and 2, Volumes 1 and 3, or all volumes. We used a convenience sample of Portuguese-speaking participants over age 18 years. An online survey consisting of sociodemographic and behavioral questionnaires and mental health instruments (Patient Health Questionnaire-9 [PHQ-9] and Generalized Anxiety Disorder-7 [GAD-7]) was administered. At 14 and 28 days later, participants were invited to complete follow-up surveys, which also included questions regarding adherence to the recommendations. A total of 409 participants completed the study – mostly young adult women holding university degrees. Results: The set of recommendations contained in Volumes 2 and 3 was effective in protecting mental health, as suggested by significant associations of adherence with PHQ-9 and GAD-7 scores (reflecting anxiety and depression symptoms, respectively). Conclusion: The recommendations developed in this study could be useful to prevent negative mental health effects in the context of the pandemic and beyond