Browsing by Author "Xavier, Ana"
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- 3rd International Congress of Environmental Health: Proceedings BookPublication . Vieira Da Silva, Manuela; Oliveira, Rui S.; Rodrigues, Matilde; Nunes, Mafalda; Santos, Joana; Carvalhais, C.; Rebelo, Andreia; Freitas, Marisa; Xavier, AnaThis third edition addresses to ‘Emerging risks and challenges for the environment, health and safety’ and intended as a guide to the various symposiums and workshops, to provide all present the most recent scientific and technological advances in the areas: Occupational Health and Toxicology; Exposure to Nanoparticles; Assessment and Risk Management; Occupational Safety; Exposure to Bioaerosols; Environment and Sustainability; Food Safety and Public Health.
- Applied research on environmental and occupational health in hospital contextPublication . Carvalhais, Carlos; Xavier, Ana; Vieira Da Silva, Manuela; Santos, JoanaHospital facilities are normally, very complex, which combined with patient requirements promote conditions for potential development of uncomfortable working conditions. The work in hospitals is likely to damage health resulting in occupational accidents and diseases. In this sense, a project focused on Environmental and Occupational Health in Hospital Context was developed to be a contribution to understand the risk factors to which health professionals and patients are exposed in these environments and how this exposure can be reduced. This research line resulted in 34 publications and 11 oral/poster communications: 6 articles in international scientific journals, 3 book chapters, 13 articles/abstracts in books of international congress proceedings, 4 technical reports, 1 doctoral thesis and 7 final course works. The project allowed the study of data about occupational exposure and accidents in hospital environments in the North of Portugal
- Assessment and characterization of sound pressure levels in Portuguese neonatal intensive care unitsPublication . Santos, Joana; Alberto Alves Carvalhais, Carlos; Xavier, Ana; Vieira Da Silva, ManuelaIn NICU, systematic exposure to sound pressure levels above the recommended can affect both neonates and staff. This study aimed to evaluate the sound pressure levels in three Portuguese NICU and the noise perception of staff. The measurements were performed with a sound level meter, considering the location of the main sources of noise and the layout of the units. A questionnaire was applied to assess noise perception of professionals. The staff classified the environment (regarding noise) as ―slightly uncomfortable‖ (41.1%) and 48.4% considered it as ―acceptable‖. In addition, the majority (55.5%) considered ―equipment‖ as the most annoying source of noise. The results showed that noise levels were excessive in all the evaluated areas of the NICUs, exceeding international guidelines, with the levels ranging between 48.7 dBA to 71.7 dBA. Overall, there is a need for more research in order to verify the effectiveness of some actions and strategies to reduce the impact of noise in NICU.
- 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.
- Good Practices to Reduce Noise Levels in the Neonatal Intensive Care UnitPublication . Alberto Alves Carvalhais, Carlos; Vieira Da Silva, Manuela; Xavier, Ana; Santos, JoanaIndoor environmental conditions in neonatal intensive care units, such noise levels above the recommended, may induce some risks, not only for preterm infants’ development, but also for health care staff. The aim of this work is to summarize some good practices guidelines that can be followed by health care staff in a daily basis, which are intended to promote noise reduction in neonatal intensive care units. It is expected some initial resistance to the implementation of some recommendations, but evidence shows that in general, with training, health care staff should recognize the need of changes.
- Integração de estudantes em projetos I&D em Saúde Ambiental: o caso do projeto NeoNoisePublication . Carvalhais, Carlos; Xavier, Ana; Vieira Da Silva, Manuela; Santos, JoanaA exposição ao ruído em unidades de cuidados intensivos tem sido reconhecida como um fator de interferência no bem-estar dos ocupantes e na recuperação dos pacientes. Neste contexto, o projeto ‘NeoNoise: Integrated Approach to Minimize Sound Pressure Levels in Neonatal Intensive Care Units’, pretende contribuir para a compreensão do papel de fatores educacionais, ambientais e infraestruturais na redução do ruído e promoção da saúde em unidades de cuidados intensivos neonatais (UCIN) considerando dois grupos de risco: prematuros e profissionais. Os objetivos específicos são: caracterizar os níveis de ruído em diferentes locais da UCIN; determinar a sua influência na saúde e bem-estar de prematuros e profissionais; desenvolver um guia de boas práticas objetivando reduzir a produção de ruído. Paralelamente, o NeoNoise teve a intenção de criar condições de estímulo ao início da atividade científica e desenvolvimento de sentido crítico e autonomia dos estudantes da licenciatura em Saúde Ambiental, através da sua integração em projetos I&D. De facto, os membros integrados do projeto estão envolvidos não apenas na lecionação de unidades curriculares (UC) de 1º/2º ciclo, como também na coordenação/participação científica de projetos de investigação. A dupla condição de docente e investigador que caracteriza os membros intervenientes, é um fator importante na reflexão sobre as potencialidades de cruzamento entre uma ação que envolve ensino-aprendizagem e outra que passa pelo desenvolvimento de investigação. O NeoNoise teve a particularidade de aliar as componentes científico-pedagógica, pois parte das atividades desenvolvidas pelos estudantes decorreu no âmbito da UC Projeto de Investigação da licenciatura em Saúde Ambiental.
- Is it enough training healthcare staff on noise reduction in Neonatal Intensive Care Units? A pilot study from NeoNoise ProjectPublication . Carvalhais, Carlos; Santos, Joana; Vieira da Silva, Manuela; Xavier, AnaThe noise in the neonatal intensive care units (NICU) is recognized by many researchers as an agent with negative implications on health and well-being of premature infants (Nicolau et al, 2005) and health professionals. Some sources of noise in hospitals include equipment, alarms, pneumatic tube systems, elevator buzzers, printers, ice machines, food carts, paging systems, call bells, telephones, televisions, and staff/visitors conversations. Several studies showed that “team conversation” was perceived by professionals as one of the main noise sources in NICU. Environmental modifications can effectively decrease noise levels, however the process of caring for hospitalized patients needs frequent and ongoing interpersonal dialogues. Minimizing the patient exposure to interpersonal communications between healthcare staff requires a behavior change. A well structured training program (TP) seems to be a low-cost measure to begin a noise reduction process in a hospital environment (Tsunemi, Kakehashi & Pinheiro, 2012).
- Is There Sufficient Training of Health Care Staff on Noise Reduction in Neonatal Intensive Care Units? a Pilot Study From NeoNoise ProjectPublication . Alberto Alves Carvalhais, Carlos; Santos, Joana; Vieira Da Silva, Manuela; Xavier, AnaEvidence indicates that exposure to high levels of noise adversely affects human health, and these effects are dependent upon various factors. In hospitals, there are many sources of noise, and high levels exert an impact on patients and staff, increasing both recovery time and stress, respectively. The goal of this pilot study was to develop, implement and evaluate the effectiveness of a training program (TP) on noise reduction in a Neonatal Intensive Care Units (NICU) by comparing the noise levels before and after the implementation of the program. A total of 79 health professionals participated in the study. The measurements of sound pressure levels took into account the layout of the unit and location of the main sources of noise. General results indicated that LAeq levels before implementation of the training program were often excessive, ranging from 48.7 ± 2.94 dBA to 71.7 ± 4.74 dBA, exceeding international guidelines. Similarly following implementation of the training program noise levels remained unchanged (54.5 ± 0.49 dBA to 63.9 ± 4.37 dBA), despite a decrease in some locations. There was no significant difference before and after the implementation of TP. However a significant difference was found for Lp, Cpeak, before and after training staff, suggesting greater care by healthcare professionals performing their tasks. Even recognizing that a TP is quite important to change behaviors, this needs to be considered in a broader context to effectively control noise in the NICU.
- Is there sufficient training of health care staff on noise reduction in neonatal intensive care units? A pilot study from neonoise projectPublication . Alberto Alves Carvalhais, Carlos; Santos, Joana; Vieira Da Silva, Manuela; Xavier, AnaEvidence indicates that exposure to high levels of noise adversely affects human health, and these effects are dependent upon various factors. In hospitals, there are many sources of noise, and high levels exert an impact on patients and staff, increasing both recovery time and stress, respectively. The goal of this pilot study was to develop, implement, and evaluate the effectiveness of a training program (TP) on noise reduction in a neonatal intensive care unit (NICU) by comparing the noise levels before and after the implementation of the program. In total, 79 health professionals participated in the study. The measurements of sound pressure levels took into account the layout of the unit and locations of the main sources of noise.
- Newborns Safety at Neonatal Intensive Care Units: Are they Exposed to Excessive Noise during Routine Health Care Procedures?Publication . Alberto Alves Carvalhais, Carlos; Vieira Da Silva, Manuela; Xavier, Ana; Santos, JoanaNeonatal Intensive Care Unit (NICU) noise may be stressful to preterm infants. This research evaluated the newborns exposure to noise during several health care activities of two NICU. The measurements of the equivalent continuous A-weighted sound pressure level and peak sound pressure level were carried were performed with a sound level meter, as close as possible of the newborn. The results showed that sound pressure levels were excessive in all the evaluated tasks, exceeding international guidelines. The levels ranged between 46.6 dBA to 74.6 dBA. There is a need for more research in order to verify the effectiveness of specific strategies to reduce the impact of noise in NICU.