Representações sociais sobre maternidade na reprodução humana assistida: discursos de mulheres inférteis / Social representations of motherhood in assisted human reproduction: discourses of infertile women / Representaciones sociales de la maternidad en la reproducción humana asistida: relatos de mujeres infértiles

Este trabalho tem o objetivo de analisar as concepções de maternidade para mulheres inférteis de diferentes níveis socioeconômicos que estão em tratamento de reprodução assistida. Trata-se de um estudo qualitativo, descritivo, que utilizou como instrumento uma entrevista semiestruturada e contemplou temas como o significado de família, desejo/expectativas sobre filho e gestação e expectativas sobre a maternidade. Participaram da pesquisa 48 mulheres inférteis acima de 35 anos que usam tecnologias de reprodução assistida de alta complexidade em instituições privada e pública. Os dados foram tratados pela análise de conteúdo em que emergiram os temas: representações sociais da família; representações sociais da maternidade; expectativas com a gestação e os modelos maternos; e o filho imaginado. As participantes representaram a família de forma positiva, como um sistema de suporte, de fundação e origem de amor, configurando-a como um laço social. Por outro lado, as concepções de família com base na consanguinidade também estiveram presentes, representando a família pela perpetuação da espécie e pela importância do laço biológico. A maternidade foi marcada por significativa idealização, sendo vista como um papel gratificante e de realização da feminilidade. O peso da cobrança social para procriar também foi sentido como um dever a cumprir e que, na impossibilidade de se realizar, gera sentimentos de inferioridade, menos-valia, impotência e inadequação perante a sociedade, o que reforça o estigma da infertilidade. Tais resultados apontam a importância de reflexões sobre o papel da mulher na nossa cultura, visto que a maternidade é ainda utilizada como medida para o sucesso ou fracasso feminino. Faz-se necessário também refletir sobre a possibilidade da maior inserção do trabalho psicológico na reprodução assistida, visto a carga emocional e social envolvidas nesse processo.(AU)

This study aimed to analyze the conceptions of motherhood for infertile women from different socioeconomic levels who are undergoing assisted reproduction treatment. This is a qualitative and descriptive study that used a semi-structured interview as an instrument and included topics such as the meaning of family and desires/expectations about the child, pregnancy, and motherhood. A total of 48 infertile women over 35 years of ages using high-complexity assisted reproductive technologies in private and public institutions participated in this research. The data were treated by content analysis in which the following themes emerged: family social representations; social representations of motherhood; expectations with pregnancy and maternal models; and the imagined son. Participants represented the family in a positive way as a support system and the foundation and origin of love, embracing the family as a social bond. On the other hand, the family concepts based on inbreeding were also present, representing the family by perpetuation of the species and the importance of biological bonds. Motherhood was marked by significant idealization, being seen as a gratifying role and the fulfillment of femininity. The weight of the social demand to procreate was also felt as a duty to be fulfilled that, in the impossibility of carrying it out, generates feelings of inferiority, worthlessness, impotence, and inadequacy toward society, which reinforce the stigma of infertility. Results point to the necessary reflections on the role of women and our culture since Motherhood is still used as a measure of female success or failure. They also point to a reflection on the possibility of greater inclusion of psychological work in assisted reproduction given the emotional and social burden involved in this process.(AU)

Este estudio tuvo como objetivo analizar las concepciones de maternidad de mujeres infértiles, de diferentes niveles socioeconómicos, que se encuentran en tratamiento de reproducción asistida. Se trata de un estudio cualitativo, descriptivo, que utilizó como instrumento una entrevista semiestructurada e incluyó temas como el sentido de la familia, deseos/expectativas sobre el hijo y el embarazo y expectativas sobre la maternidad. Participaron en la investigación un total de 48 mujeres infértiles, mayores de 35 años, usuarias de tecnologías de reproducción asistida de alta complejidad en instituciones públicas y privadas. Los datos se sometieron a análisis de contenido del cual surgieron los temas: representaciones sociales familiares; representaciones sociales de la maternidad; expectativas con el embarazo y modelos maternos; hijo imaginado. Las participantes representaron a la familia de manera positiva, como sistema de apoyo, fundamento y origen del amor, configurándola como vínculo social. Por otro lado, también estuvieron presentes las concepciones familiares basadas en la consanguinidad, representando a la familia para la perpetuación de la especie y la importancia del vínculo biológico. La maternidad estuvo marcada por una importante idealización, vista como un rol gratificante y de realización de la feminidad. También se sintió el peso de la demanda social de procrear como un deber que cumplir y que, ante la imposibilidad de realizarlo, genera sentimientos de inferioridad, desvalorización, impotencia e inadecuación en la sociedad, lo que refuerza el estigma de la infertilidad. Por tanto, son necesarias reflexiones sobre el papel de la mujer en nuestra cultura, ya que la maternidad se sigue utilizando como medida del éxito o fracaso femenino. También se reflexiona sobre la posibilidad de una mayor inclusión del trabajo psicológico en la reproducción asistida dada la carga emocional y social que implica este proceso.(AU)

Delays in accessing antenatal care services in a developing nation tertiary health center

Background: Delay in seeking medical care is common and constitutes a major unresolved public health problem. It could contribute immensely to maternal mortality, especially in developing countries, where access and availability of functional health­care facility have remained a challenge. Objective: This study aimed at identifying the forms of delays encountered by pregnant women seeking antenatal care (ANC) services and also factors responsible for such delays. Materials and Methods: This was a cross­sectional study among women attending antenatal care clinic of our hospital. Data were obtained through an interviewer­administered questionnaire and were analyzed by the Statistical Package for the Social Sciences version 17. Results: The mean age of the respondents was 28.6 (standard deviation [SD] ± 5.44) years. About a third (31.5%) experienced Type II delays due to inaccessibility to the mode of transportation and traffic deadlock; while majority (77.1%) experienced intrahospital delays due to delay in retrieving cases notes, seeing an obstetrician, inadequate health personnel, and consulting rooms. The average waiting time was 3.1 ± 0.91 SD hours (188 min). The waiting time was not statistically associated with time of arrival to the clinic. Conclusion: Most women experience intrahospital delays while seeking ANC. Intervention by policymakers and adequate staffing coupled with provision of necessary health­care amenities will go a long way in reducing patients waiting time

Comparative Behavioral Correlation of High and Low-Performing Mice in the Forced Swim Test

Behavioral analysis in mice provided important contributions in helping understand and treat numerous neurobehavioral and neuropsychiatric disorders. The behavioral performance of animals and humans is widely different among individuals but the neurobehavioral mechanism of the innate difference is seldom investigated. Many neurologic conditions share comorbid symptoms that may have common pathophysiology and therapeutic strategy. The forced swim test (FST) has been commonly used to evaluate the “antidepressant” properties of drugs yet the individual difference analysis of this test was left scantly investigated along with the possible connection among other behavioral domains. This study conducted an FST-screening in outbred CD-1 male mice and segregated them into three groups: high performers (HP) or the active swimmers, middle performers (MP), and low performers (LP) or floaters. After which, a series of behavioral experiments were performed to measure their behavioral responses in the open field, elevated plus maze, Y maze, three-chamber social assay, novel object recognition, delay discounting task, and cliff avoidance reaction. The behavioral tests battery revealed that the three groups displayed seemingly correlated differences in locomotor activity and novel object recognition but not in other behaviors. This study suggests that the HP group in FST has higher locomotor activity and novelty-seeking tendencies compared to the other groups. These results may have important implications in creating behavior database in animal models that could be used for predicting interconnections of various behavioral domains, which eventually helps to understand the neurobiological mechanism controlling the behaviors in individual subjects.

Temporal discounting and attention-deficit/hyperactivity disorder in childhood: reasons for devising different tasks / Desconto do futuro e o transtorno de déficit de atenção/hiperatividade: razões para o desenvolvimento de diferentes tarefas

Abstract Introduction: Temporal discounting (TD) describes how a certain reward is seen as less valuable the more its delivery is postponed. There are two main types of TD tasks, hypothetical and real, both of which use monetary rewards. Over the last few years, however, variants of these tasks have been adjusted to assess clinical groups of children showing impulsivity as found in attention-deficit/hyperactivity disorder (ADHD). Objective: To review and discuss studies conducted over the last 10 years on the use of TD tasks in the assessment of pediatric patients with ADHD. Method: For this literature review, articles were non-systematically selected from PubMed, MEDLINE and SciELO databases to include experimental studies on the use of at least one TD paradigm to assess and distinguish ADHD and non-ADHD groups. Results: Of the studies assessed, 76.19% used hypothetical tasks, followed by real tasks (28.57%), and, finally, tasks using different types of reward, such as toys or rewarding activities (14.28%). Conclusions: Although assessed in few studies, real and alternative tasks appeared to be effective in differentiating clinical groups and suitable for investigating hot executive functions in childhood.

Resumo Introdução: O desconto do futuro (DF) é um processo no qual uma determinada recompensa é vista como menos valiosa à medida que sua entrega é postergada. Existem dois tipos principais de tarefas de DF, hipotéticas e reais, sendo que ambas usam recompensas monetárias. Nos últimos anos, no entanto, variantes dessas tarefas têm sido adaptadas para avaliar grupos clínicos de crianças que apresentam comportamento impulsivo, como no caso do transtorno de déficit de atenção/hiperatividade (TDAH). Objetivo: Revisar e discutir os estudos realizados nos últimos 10 anos sobre o uso de tarefas de DF na avaliação de pacientes pediátricos com TDAH. Método: Para esta revisão de literatura, os artigos foram selecionados de forma não sistemática nas bases de dados PubMed, MEDLINE e SciELO, de forma a incluir estudos experimentais sobre o uso de ao menos um paradigma de DF para a avaliação e distinção de grupos com e sem TDAH. Resultados: Dos estudos avaliados, 76,19% utilizaram tarefas hipotéticas, seguidas de tarefas reais (28,57%) e, finalmente, de tarefas com diferentes tipos de recompensa, como brinquedos ou atividades recompensadoras (14,28%). Conclusões: Embora avaliadas em poucos estudos, tarefas reais e alternativas parecem ser eficazes na diferenciação de grupos clínicos e adequadas para investigação de funções executivas quentes na infância.

Separate Neural Networks for Gains and Losses in Intertemporal Choice / 神经科学通报·英文版

An important and unresolved question is how human brain regions process information and interact with each other in intertemporal choice related to gains and losses. Using psychophysiological interaction and dynamic causal modeling analyses, we investigated the functional interactions between regions involved in the decision-making process while participants performed temporal discounting tasks in both the gains and losses domains. We found two distinct intrinsic valuation systems underlying temporal discounting in the gains and losses domains: gains were specifically evaluated in the medial regions, including the medial prefrontal and orbitofrontal cortices, and losses were evaluated in the lateral dorsolateral prefrontal cortex. In addition, immediate reward or punishment was found to modulate the functional interactions between the dorsolateral prefrontal cortex and distinct regions in both the gains and losses domains: in the gains domain, the mesolimbic regions; in the losses domain, the medial prefrontal cortex, anterior cingulate cortex, and insula. These findings suggest that intertemporal choice of gains and losses might involve distinct valuation systems, and more importantly, separate neural interactions may implement the intertemporal choices of gains and losses. These findings may provide a new biological perspective for understanding the neural mechanisms underlying intertemporal choice of gains and losses.