RESUMEN
High-risk newborns are exposed to neonatal conditions such as prematurity, very low birth weight, and congenital malformations that can affect development and behavior. Coronavirus disease 2019 (COVID-19) restraint and control measures have been identified as important stressor events and cumulative risk factors for behavioral changes in these children. This study examined social isolation-related factors that contribute to internalizing and externalizing behavior problems in children already at risk for neurodevelopmental disorders. This cross-sectional, multicenter study included 113 children (18 months to 9 years) who were followed in reference services for neonatal follow-up in tertiary units of the public health system in the city of Rio de Janeiro, Brazil. Behavior was assessed using the child behavior checklist, and a structured questionnaire was used to assess sociodemographic aspects. In the bivariate analysis, prematurity was associated with externalizing problems and change in eating habits with internalizing problems. The logistic model indicated that both parents having completed high school and both sharing care of the child were protective factors for behavioral problems; however, reports of sleep problems and living with another child were risk factors. In conclusion, the study identified internalizing and externalizing behavior problems related to prematurity and aspects of family structure and routine in children at risk. The findings confirm the importance of family functioning for child health and family-centered interventions.
RESUMEN
Introdução: infecções hospitalares adquiridas na Unidade de Terapia Intensiva (UTI) têm custo elevado e podem representar uma deficiência da qualidade da assistência. Entre as infecções na UTI, as mais frequentes são: pneumonia associada à ventilação mecânica; infecção primária da corrente sanguínea associada a cateter venoso central; e infecção do trato urinário associada à sonda vesical de demora. Objetivos: avaliar o efeito de intervenções da equipe multidisciplinar na diminuição da incidência de infecções em UTI de um hospital terciário em Belo Horizonte. Métodos: realizou-se uma coorte histórica, analisando dados de vigilância em infecção associada a procedimentos invasivos em UTI de um hospital terciário ao longo de cinco anos, entre julho de 2007 e junho de 2012, comparando as densidades de incidência de infecção nesses períodos. Resultados: observou-se que as densidades de incidência de infecção associada a procedimentos invasivos no início do estudo estavam elevadas nos três sítios e sofreram redução significativa (p<0,05) com as intervenções realizadas. Conclusões: houve melhoria dos indicadores de qualidade na UTI a partir de intervenções da equipe multidisciplinar do hospital em estudo, com significativa redução das taxas de infecção.
Introduction: Nosocomial infections in Intensive Care Units (ICUs) are expensive and can reflect a deficiency in the quality of care. The most common nosocomial infections in ICUs are ventilator-associated pneumonia, central line-associated primary blood stream infections and urinary catheter-associated urinary tract infections. Objectives: Evaluatethe effect of a multidisciplinary team in decreasing the incidence of infections in an ICU of a tertiary hospital in Belo Horizonte. Methods: We performed a historical cohort by analyzing surveillance data of infections associated with invasive procedures in a ICU of a tertiary hospital from Jul./2007 to Jun./2012, comparing the incidence densities of infection in these periods. Results: We observed that the incidence densities of infection associated with invasive procedures at baseline were higher in three main nosocomial sites and fell significantly after the interventions (p < 0.05).Conclusions: We observed a significant improvement in quality indicators at ICU after interventions of the multidisciplinary team in the hospital investigated.
