Home language environment in relation to language outcome in Brazilian toddlers who are hard of hearing and controls with typical hearing - a pilot study including reliability analyses of the LENA recording system / Ambiente doméstico de linguagem em relação ao resultado de linguagem em crianças brasileiras com deficiência auditiva e controles com crianças com audição típica - um estudo piloto incluindo análises de confiabilidade do sistema de gravação LENA

ABSTRACT Purpose The purpose of this pilot study was to explore the home language environment and language outcome of Brazilian toddlers who were hard of hearing, (HH) and controls with typical hearing (TH), and investigate the reliability of using the LENA recording system within a Brazilian Portuguese context. Methods Fourteen families participated in the study (seven children who were HH and seven controls with TH. Each family contributed with one all-day recording. A smaller portion of the recordings of the typically hearing toddlers were manually transcribed by two transcribers. An interrater agreement was conducted, and then the human transcript results were compared against the LENA-generated data for three measures: Adult Words (AW), Child Vocalizations (CV) and Conversational Turns (CT). Results Data analyses revealed a moderate to strong interrater agreement for CV and AW. Weak to moderate agreement was found between the LENA estimates and the means of the human counts for CV and AW. Seemingly, LENA overestimated human counts for AW and underestimated numbers of CV. Comparative analysis suggested similarities in the language and listening environment of the two groups (TH vs. HoH). Children's language development was supported by higher numbers of parent-child interactions (CT). Conclusion The findings imply that LENA may contribute as an ecologically valid tool in preventive family-centered intervention programs for Brazilian toddlers who are hard of hearing and their families, although further validation studies are needed.

RESUMO Objetivo O objetivo deste estudo piloto foi explorar o ambiente da língua doméstica e os resultados linguísticos de crianças brasileiras com deficiência auditiva comparando com crianças ouvintes e investigar a confiabilidade do uso do sistema de registro LENA no contexto do português brasileiro. Método Quatorze famílias participaram do estudo (sete com deficiência auditiva e sete controles com audição típica). Cada família contribuiu com uma gravação durante o tempo de vigilia. Uma parte menor das gravações das crianças com audição normal foi transcrita manualmente por dois transcritores. Um acordo entre avaliadores foi realizado e, em seguida, os resultados da transcrição humana foram comparados com os dados gerados pelo LENA para três medidas: Palavras de Adultos (PA), Vocalizações Infantis (VI) e Turnos de Conversação (TC). Resultados As análises de dados revelaram uma concordância entre avaliadores moderada a forte para VI e PA. Foi encontrada concordância de fraca a moderada entre as estimativas de LENA e as médias das contagens humanas para VI e AW. Aparentemente LENA superestimou contagens humanas para PA e subestimou números de VI. A análise comparativa sugeriu semelhanças na linguagem e no ambiente auditivo dos dois grupos. O desenvolvimento da linguagem das crianças foi apoiado por um maior número de interações pais-filhos (TC). Conclusão Os achados sugerem que o LENA pode contribuir como uma ferramenta ecologicamente válida em programas de intervenção preventiva centrada na família para crianças brasileiras com deficiência auditiva e suas famílias, embora mais estudos de validação sejam necessários.

Exposure to wood smoke pollution during pre-gestational period of rat has effects on placenta volume and fetus size / La exposición a la contaminación por humo de leña durante el período pregestacional de la rata tiene efectos sobre el volumen de la placenta y el tamaño del feto

SUMMARY: Studies in humans showed that prenatal exposure to urban air pollution (AP) influences fetal development, and increases the incidence of adverse pregnancy outcomes and some diseases in postnatal life. However, most of these were performed in environments where the main source of environmental particulate matters (PM) emission is diesel combustion by motor vehicles and industries, thereby ignoring the effects produced by wood smoke pollution. We hypothesized that morphological changes in the placenta could contribute to the reduction in fetal size associated with different periods of exposure to AP produced by wood smoke pollution prior to and during pregnancy. The objective of the study was to investigate the quantitative effects of long-term exposure to environmental levels of wood smoke pollution on the macroscopic and microscopic morphology of the placenta in rats. To test this, pregnant rats were exposed during pregestational and gestational periods to wood smoke pollution in indoor and outdoor environments. At 19 days of gestation, the placentas were obtained by caesarean and were prepared for histological, planimetric and stereological analysis. The volume and proportions of the placental compartments were estimated. In addition, stereological estimators in fetal capillaries were calculated in the labyrinth region. Crown rump length, fetus weight and litter weight were influenced by pregestational and gestational exposure periods. Exposure to wood smoke pollution during pregestational period has significant effect on the volume of the placenta, and consequently on fetal height. In conclusion, this study demonstrated that long-term outdoor exposure to wood smoke pollution from residential heating affects fetal health, decreasing the absolute volume of the entire placenta and the placental interface between the mother and fetus, decreasing the total volume of blood vessels present in the labyrinth region ofthe placenta and affecting the size of the fetus.

RESUMEN: Estudios en humanos demostraron que la exposición prenatal a la polución del aire urbano influye en el desarrollo fetal y aumenta la incidencia de resultados adversos de la gestación y algunas enfermedades postnatales. Sin embargo, la mayoría de ellos fueron realizados en entornos donde la principal fuente de emisión de material particulado, fue la combustión de petróleo por vehículos a motor e industrias, ignorando los efectos producidos por el humo de leña producido por la calefacción intradomiciliaria. Hipotetizamos respecto a que los cambios de la placenta contribuirían a la disminución del tamaño fetal relacionado a los períodos de exposición al humo de leña durante los periodos pregestacional y gestacional. El objetivo del estudio fue investigar los efectos cuantitativos de la exposición al humo de leña sobre la morfología macroscópica y microscópica en placenta de ratas. Para probar esto, ratas preñadas fueron expuestas durante los períodos pregestacional y gestacional a la contaminación por humo de leña en ambientes interiores y exteriores. A los 19 días de gestación, las placentas fueron obtenidas por cesárea y fueron preparadas para un análisis histológico, planimétrico y estereológico. Fue estimado el volumen absoluto y las proporciones de los compartimentos placentarios. Además, fueron calculados estimadores estereológicos en capilares fetales del laberinto y trofoblasto. La longitud, el peso del feto y el peso de la camada fueron influenciados por los períodos de exposición pregestacional y gestacional. La exposición a la contaminación por humo de leñá durante el período pregestacional tuvo un efecto significativo en el volumen de la placenta y, en consecuencia, en la altura del feto. En conclusión, este estudio demostró que la exposición a largo plazo al humo de leña afecta la salud del feto, disminuyendo el volumen absoluto de la placenta, además, afecta la interfaz placentaria entre la madre y feto, disminuyendo el volumen total de vasos sanguíneos presentes en la región del laberinto placentario y por consecuente afectando el tamaño del feto.

Daño al ADN en mujeres expuestas al humo de la leña en Chiapas, México / DNA damage in women exposed to firewood fuel smoke in Chiapas, Mexico

Actualmente alrededor de la cuarta parte de la población mexicana, entre 25 y 28 millones de habitantes, cocina con leña. Sin embargo, el humo de la leña contiene una amplia gama de sustancias tóxicas, entre ellas el monóxido de carbono (CO) cuyo impacto en la salud de la población rural debe ser estudiado. Por esto, el potencial daño al ADN asociado con la exposición a CO de 30 mujeres que cocinaban con leña en Chiapas, México, fue evaluado por el ensayo cometa. Los resultados se compararon con 30 controles comparables en edad y condiciones socioeconómicas, quienes cocinaban con gas licuado de petróleo (GLP). Se obtuvieron muestras de sangre total para medir carboxihemoglobina (COHb) y llevar a cabo el ensayo cometa. Se encontró diferencia significativa (P<0,001) en las concentraciones de COHb entre las mujeres que cocinaban con leña (media= 6,6%) y las que lo hacían con GLP (media= 1,8%), siendo 3,6 veces más elevadas en las primeras antes citadas que en las segundas. Se encontraron diferencias significativas en la longitud de cola (media ± DE = 18,5 +/- 4,21 contra 5,97 +/- 1,0 μm, P<0,001) y en el momento de cola (media ± DE = 4,55 +/- 1,5 contra 1,5 +/- 0,40, P<0,001) del cometa entre los dos grupos examinados. Los resultados del presente estudio sugieren fuertemente que la exposición a CO y componentes presentes en el humo de la leña, puede causar daño genotóxico a las mujeres que hacen uso de este combustible, por lo que es necesario implementar medidas que disminuyan esta exposición.

Currently, about a quarter of the Mexican population, between 25 and 28 million people, cook with firewood. However, wood smoke contains a wide range of toxic substances, including carbon monoxide (CO) whose impact on health of the rural population should be studied. Therefore, the potential DNA damage associated with the exposition to CO of 30 women who cooked with wood in Chiapas, Mexico, was assessed using Comet Assay. Results were compared with 30 controls of similarage and socioeconomic status, who cooked with liquefied petroleum gas (LPG). We obtained whole blood samples to measure carboxyhemoglobin (% COHb) and perform the comet assay. There was a significant difference (P <0.001) in the percentages of COHb between women who cooked with wood (mean= 6.6%) and those who did it with LPG (mean=1.8%) being 3.6 times higher in the former compared with the latter. There was a significant difference in comet tail length between the two groups examined (mean 18.5 +/- 4.21 versus 5.97 +/- 1.0 μm, P <0.001) and tail moment (mean 4.55 +/- 1.5 versus 1.5 +/- 0.40, P <0.001). The results of this study strongly suggest that exposure to carbon monoxide and compounds present in wood smoke can cause genotoxic damage to women who use this fuel, so it is necessary to implement measures to reduce this exposure.

Inhalación de humo de leña: una causa relevante pero poco reconocida de Enfermedad Pulmonar Obstructiva Crónica / Wood smoke inhalation: a major cause but little recognized the chronic obstructive pulmonary disease

La enfermedad pulmonar obstructiva crónica (EPOC) es una de las enfermedades más frecuentes a nivel mundial, cuya prevalencia está en aumento y representa una enormecarga de salud para la sociedad. En América Latina, las cifras estimadas de prevalencia varían entre el 7.8% y 19.7%. Si bien el humo de cigarrillo es el factor de riesgo más importante para el desarrollo de esta enfermedad, la exposición al humo de combustiblesde biomasa, especialmente leña, dentro del hogar, para cocinar y calefaccionar, es también una causa relevante aunque poco reconocida de EPOC en los países en vías de desarrollo. Teniendo en cuenta que la mitad de la población mundial, unos 3 mil millones de personas, utilizan combustibles de este tipo, el impacto que pudiera tener sobre la salud de la población expuesta, es un tema de especial consideración.

Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of morbidity and mortality worldwide that is increasing and which represents a substantial economic and social burden. The prevalence of COPD in Latin America ranges from 7.8% to 19.7%.Although smoking tobacco is the leading cause in developing COPD, the use of biomass fuels for cooking or heating is also an important cause of this disease, particularly in developing countries. As half of the world population, around 3 thousand million people, use solid fuels, the impact that the use of such fuels could have on the health of theaffected population is an issue that deserves specific consideration.