Browsing by Author "Rodrigues, Célia"
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- Covering the incubator top with a padded blanket reduces noise levels inside the incubator? A pilot study during simulated tasksPublication . Carvalhais, Carlos; Rodrigues, Célia; Xavier, Ana; Silva, Manuela V.; Santos, JoanaNoise levels in Neonatal Intensive Care Units may cause physiological stress, which can impact cognitive development and increase length of stay. Several studies performed in NICU, have consistently noted that the recommended noise levels have been exceeded at day and night periods, inclusively inside incubators. The aim for controlling noise levels in the NICU is to preserve a large portion of each hour for infant sleep. Noise levels found in hospitals frequently disturb sleep states and disrupt stable behavioural states in healthy term and preterm infants. This study aims to verify if covering the incubator top with a padded blanket effectively reduces noise levels inside incubators. Noise levels inside incubator were measured during simulated tasks with and without a padded blanket. The study included short measurements (5 up to 10 min.) for the assessment of the sound pressure levels (C-weighted peak sound pressure level (LCpeak), A-weighted equivalent sound pressure level (LAeq), A-weighted, Maximum, Sound Level (Lmax) and A-weighted, Minimum, Sound Level (Lmin)). Measurements were performed using a sound level meter class 1 (Brüel&Kjær, model 2250) which was verified with an acoustic calibrator class 1 (Brüel&Kjær, model 4231). Noise levels inside the incubator covered with a blanket were lower than the incubator without the blanket. The average levels were 52.0±0.9 dB(A) for LAeq, 67.4 dB(A) Lmax and 48.5 dB(A) Lmin with blanket, and 57.8±4.9 dB(A) LAeq, 83.7 dB(A) Lmax, 44.1 dB(A) Lmin. LCpeak levels were also lower in the simulation with the blanket (98.7 and 102.8 dB (C), respectively). In the studied NICU the use of the padded blanket is mandatory mainly for lightning control. Although, it also seems a good practice to minimize noise levels inside incubators. However, noise levels remained higher than the recommended by international agencies. Noise in the neonatal intensive care unit can be detrimental to the health of the hospitalized infant. Isolated strategies of reducing noise include staff training, warning lights, and ear coverings, all of which have had limited success. A combined approach focused on newborn, staff and physical environment may be more effective.
- Lactic acid increases the susceptibility of Candida albicans to fluconazolePublication . Alves, Rosana; Mota, Sandra; Silva, Sónia; Rodrigues, Célia; Brown, Alistair J.; Henriques, Mariana; Casal, Margarida; Paiva, SandraCandida spp. often inhabit niches that are glucose-limited but rich in alternative carbon sources, such as lactate or acetate, an ability that contributes to cells’ virulence. In glucose-poor niches, Candida albicans cells express JEN1 and JEN2 genes encoding the carboxylic acids transporters Jen1 and Jen2, respectively, which have been reported to be important in the early stages of infection. In this work, we aimed at analysing biofilm formation and antifungal drug resistance of C. albicans cells grown either in the presence of glucose or lactic acid. Additionally, we tested the involvement of Jen1 and Jen2 on these processes. Our results show that biofilm formation and susceptibility to fluconazole depend on the carbon source used. Wild-type and jen1jen2 lactic acid-grown cells formed more biofilm biomass, with predominance of yeast cells, than the ones grown in glucose. In the presence of this sugar a hyphae network is observed only for wild-type cells. In the presence of lactic acid, a jen1jen2 mutant strain exhibited a more compact biofilm with higher resistance to fluconazole when compared to the wild type. In the case of planktonic cells, the phenotype was exactly the opposite; the double mutant strain was more susceptible to fluconazole in lactic acid containing media. These findings show that carboxylic acids transporters have an important role in biofilm formation and in the acquisition of resistance to antifungal drugs, supporting the view that adaptation of Candida cells to the carbon source present in host niches affects their pathogenicity.
- Variability of noise levels in a portuguese neonatal intensive care unitPublication . Carvalhais, Carlos; Rodrigues, Célia; Xavier, Ana; Silva, Manuela V.; Santos, JoanaThe neonatal intensive care units accommodates patients who are confined to their environment, being exposed to several environmental factors, such as noise. There exist a few official recommendations regarding noise levels within the hospital environment. The World Health Organization (WHO) proposes that the average background noise in hospitals should not exceed 35 dB LAeq for areas where patients are treated or observed and other organizations such the United States Environmental Protection Agency (45 dB(A) daytime / 35 dB(A) night) and the American Academy of Paediatrics, through the Committee on Environmental Health (45 dB(A)). The aim of this study was to investigate the intensity and pattern of noise levels such as variability and their sources within a Portuguese NICU. The study was carried out in a NICU located in the North of Portugal. The measurements were carried out continuously over 24 hours, next the workstation located at the centre of the NICU. Measurements were performed using a sound level meter class 1 (Brüel&Kjær, model 2250) which was verified with an acoustic calibrator class 1 (Brüel&Kjær, model 4231). The results showed that noise levels were excessive in the NICU, exceeding the international recommendations. The average levels were 55.3±5.4 dB(A) for LAeq with the levels ranging between 41.3 dB(A) (recorded at 5:09 a.m.) to 71.60 dB(A) (recorded at 12:58 p.m.). The highest LCpeak level was 104.4 dB (C) (recorded at 6:15 a.m.). For the other acoustic parameters, it was found 84.8 dB(A) for Lmax and 39.6 dB(A) for Lmin. The occurrence of high average noise levels in combination with the variability in noise levels and the frequency of peak noises may contribute to detrimental effects both for premature infants and health care professionals. Average noise levels exceeded those recommended by the WHO. The primary sources of noise were identified as staff conversations and alarms. Further research into strategies to reduce noise, and evaluation of interventions, is required to enhance by one side the therapeutic environment and for other the healthy and safe workplace.