Real-time changes in rib cage expansion and use of abdominal mechanical stimulation in newborns: a quasi-experimental study / Mudanças na expansibilidade torácica com o uso de estímulo mecânico na região abdominal em recém-nascidos: um estudo quase-experimental

ABSTRACT Objective: To assess the rib cage expansion and respiratory rate in newborns using an abdominal stabilization band. Methods: The study included 32 newborns of both genders, with gestational age between 35 and 41 weeks. The abdominal stabilization band was used for 15 minutes between the xiphoid process and the anterosuperior iliac crest, with an abdominal contention 0.5cm smaller than the abdominal circumference. The rib cage expansion was evaluated by a breathing transducer (Pneumotrace II™) three minutes before using the band, during the use (15 minutes), and ten minutes after removing the band. The Shapiro-Wilk test verified data normality, and the Wilcoxon test compared the variables considering rib cage expansion and respiratory rate. Significance was set to p<0.05. Results: There was an increase in respiratory rate when comparing before and ten minutes after removing (p=0.008) the abdominal stabilization band, as well as when comparing during its use and ten minutes after its removal (p=0.001). There was also an increase in rib cage expansion when comparing before and during the use of the abdominal stabilization band (p=0.005). Conclusions: The use of the abdominal stabilization band promoted an increase in the rib cage expansion and respiratory rate in the assessed newborns and may be a viable option to improve the respiratory kinematics of this population.

RESUMO Objetivo: Avaliar a expansibilidade torácica e a frequência respiratória em recém-nascidos que fizeram uso de uma faixa de estabilização abdominal. Métodos: O estudo incluiu 32 recém-nascidos de ambos os sexos, com idade gestacional entre 35 e 41 semanas. A faixa de estabilização abdominal foi mantida por 15 minutos entre o processo xifoide e a espinha ilíaca anterossuperior, com contenção abdominal 0,5 cm menor do que a circunferência abdominal. A expansibilidade torácica foi avaliada por um transdutor piezoelétrico (Pneumotrace II™) 3 minutos antes do uso da faixa, durante 15 minutos, e 10 minutos após sua retirada. A normalidade das variáveis foi testada pelo teste de Shapiro-Wilk e a análise comparativa da expansibilidade torácica e da frequência respiratória foi realizada por meio do teste t pareado, considerando-se p<0,05. Resultados: Houve aumento da frequência respiratória quando comparados os tempos antes do uso da faixa e 10 minutos após a retirada (p=0,008), bem como quando comparados os tempos durante o uso e 10 minutos após a retirada da faixa (p=0,001). Houve aumento da expansibilidade torácica quando comparados os tempos antes e durante o uso da faixa (p=0,005). Conclusões: O uso da faixa de estabilização abdominal conferiu aumento da expansibilidade torácica e da frequência respiratória nos recém-nascidos estudados, podendo ser uma opção viável para a melhora da cinemática respiratória dessa população.

Real-time changes in rib cage expansion and use of abdominal mechanical stimulation in newborns: a quasi-experimental study.

OBJECTIVE: To assess the rib cage expansion and respiratory rate in newborns using an abdominal stabilization band. METHODS: The study included 32 newborns of both genders, with gestational age between 35 and 41 weeks. The abdominal stabilization band was used for 15 minutes between the xiphoid process and the anterosuperior iliac crest, with an abdominal contention 0.5cm smaller than the abdominal circumference. The rib cage expansion was evaluated by a breathing transducer (Pneumotrace II™) three minutes before using the band, during the use (15 minutes), and ten minutes after removing the band. The Shapiro-Wilk test verified data normality, and the Wilcoxon test compared the variables considering rib cage expansion and respiratory rate. Significance was set to p<0.05. RESULTS: There was an increase in respiratory rate when comparing before and ten minutes after removing (p=0.008) the abdominal stabilization band, as well as when comparing during its use and ten minutes after its removal (p=0.001). There was also an increase in rib cage expansion when comparing before and during the use of the abdominal stabilization band (p=0.005). CONCLUSIONS: The use of the abdominal stabilization band promoted an increase in the rib cage expansion and respiratory rate in the assessed newborns and may be a viable option to improve the respiratory kinematics of this population.

"I Am Afraid of Positioning my Baby in Prone": Beliefs and Knowledge about Tummy Time Practice.

Objective: To identify beliefs and knowledge about tummy time (TT) practice and its repercussions on motor development. Methods: Longitudinal study carried out with parents/caregivers of infants older than 30 days of life. Two assessments were performed. A structured interview was conducted, while the babies were between one and six months old to identify beliefs, knowledge about TT, and the motor milestone achievement expected for the age. At six to 12 months, the risk of motor development delay was tracked using the survey of well-being of young infant questionnaire (SWYC). Results: 41 families responded to the SWYC questionnaire (21 were allocated to the TT group). 31.70% reported that it was not important to put the infants in a prone position while awake, and 70.70% said they are afraid their babies would become breathless when positioned in a prone position. 85.70% of infants from the TT group showed typical development, while 55% of the control group showed atypical development for their age (p = 0.01). Only three infants from the control group were at risk of delayed motor development (p = 0.10). Conclusions: Most of the families feel insecure about proning their babies and fear breathlessness when positioned. Acquisition of motor milestones prevailed in the TT group, suggesting an association between TT practice and motor milestone achievement.

Atuação do cirurgião - dentista da atenção primária à saúde durante a pandemia da covid-19 / Role of primary health care dental surgeons during the COVID-19 pandemic / Papel de los cirujanos dentistas de atención primaria de salud durante la pandemia de COVID-19

Introdução:A Atenção Primária à Saúde é caracterizada como a porta de entrada preferencial do Sistema Único de Saúde, ocupando lugar central no serviço. Todavia, a pandemia da COVID-19 instigou a necessidade de mudanças naorganização do trabalho das equipes de saúde da atenção básica.Objetivo:Neste cenário, torna-se fundamental conhecer a atuação docirurgião-dentista da Atenção Primária à Saúdeno que se refere à oferta dos serviços odontológicos, alterações no processode trabalho e capacidade técnica de ação, frente às condições estabelecidas pela pandemiadaCOVID-19.Metodologia:Trata-se de um estudo de caráter transversal descritivo e abordagem quantitativa, desenvolvido em um município do interior baiano, com 29 cirurgiões-dentistas vinculados àatenção básica. Esses profissionais foram convidados a responder um questionário on-lineque abordou questões relativas ao desempenho dos cirurgiões-dentistas e a condução das ações de saúde bucal frente às medidas restritivas impostas pela pandemiada COVID-19.Resultados:Foi possível identificar que o processo de trabalho e acesso da população aos serviços de odontologia sofreram interferências, expressas através da limitação do acesso da população à saúde bucal, alterações nas técnicas terapêuticas e interrupção das ações em saúde de abrangência coletiva.Conclusões:O presente estudo apontou limitaçõesno processo de trabalho do cirurgião-dentista da Atenção Primária à Saúdedurante a pandemia da COVID-19, como a dificuldade para atuar em equipe interprofissional e atender as proposições estabelecidas pelaPolítica Nacional da Atenção Básica (AU).

Introduction:Primary Health Care is the preferred gateway to the Brazilian Unified Health System, occupying a central place in the service. However, the COVID-19 pandemic instigated the need for changes in the organization of work of primary care health teams.Objective:In this scenario, it is essential to know the performance of dental surgeons in terms ofdental care offer, changes in the work process and of their technical capacity for action, in the face of the conditions established by the pandemic.Methodology:This is a descriptive cross-sectional study with a quantitative approach developed in a city in the countryside of Bahia with 29 dental surgeons linked to primary care. These professionals were invited to answer an online questionnaire that addressed issues related to the performance of dental surgeons and the management of oral health actions in the face of the restrictive measures imposed by the COVID-19 pandemic.Results:It was possible to identify that the pandemic interfered with the work process and the population's access to dental services, expressed through the limitation of the population's access to oral health, changes in therapeutic techniques and interruption of collective health actions.Conclusions:The present study pointed out limitations in the work process of the primary care dentist during the COVID-19 pandemic, such as the difficulty in working in an interprofessional team and meeting the propositions established by the Brazilian National Primary Care Policy in Health (AU).

Introducción: La Atención Primaria de Salud se caracteriza por ser la puerta de entrada preferente al Sistema Único de SaludBrasileño, ocupando un lugar central en el servicio. Sin embargo, la pandemia de COVID-19 instigó la necesidad de cambios en la organización del trabajo de los equipos de salud de atención primaria.Objetivo: En este escenario, es fundamental conocer el desempeño del odontólogo en cuanto, oferta de cuidado dental, cambios enel procesode trabajo, ya su capacidad técnica de actuación, ante las condiciones establecidas por la pandemiaMetodología: Se trata de un estudio descriptivo transversal con enfoque cuantitativo, desarrollado en una ciudad del interior de Bahía, con 29 odontólogos vinculados a la atención primaria. Estos profesionales fueron invitados a responder un cuestionario en línea que abordaba cuestiones relacionadas con la actuación de los odontólogos y la realización de acciones de salud bucal frente a las medidas restrictivas impuestas por la pandemia de la COVID-19.Resultados: Con los resultados fue posible identificar que el proceso de trabajo y el acceso de la población a los servicios odontológicos sufrieron interferencias, expresadas a través de la limitación del acceso de la población a la salud bucal, cambios en las técnicas terapéuticas e interrupción de las acciones de salud colectiva. Conclusiones: El presente estudio señaló limitaciones en el proceso de trabajo del cirujano dentista de la atención en lasaluddurante la pandemia de COVID-19, como la dificultad para trabajar enequipo interprofesional y cumplir con las proposiciones establecidas por la Política Brasileña de Atención Primaria en Salud (AU).