"nem sempre funciona, mas ajuda": percepções parentais sobre a exposição do bebê às telas / "it doesn't always work, but it helps": parental perceptions of baby's screen exposure

RESUMO. Frente ao número crescente de crianças menores de dois anos expostas às telas, preocupações com o desenvolvimento dos bebês têm emergido e sido foco de discussões acadêmicas e clínicas. Para buscar compreender as razões que levam os pais a disponibilizarem as mídias digitais aos bebês, entrevistas foram conduzidas com mães e pais de crianças com idades entre dez e 17 meses, domiciliados na região metropolitana de Porto Alegre, Brasil. Apesar das orientações das sociedades de pediatria, verifica-se discrepância entre a divulgação deste conteúdo e o acesso a ele. Os pais, por desconhecimento e também por necessidade, disponibilizam diferentes mídias ao bebê, que é percebida em diversas situações como positiva e facilitadora nos cuidados com a criança; os pais alegam que o acesso precoce pelo bebê é importante para aprimorar a destreza cognitiva e capaz de gerar interação familiar. Por outro lado, apresentam preocupações diante do uso de telas em detrimento de outras formas de brincar. Evidencia-se que os pais precisam de orientações e suporte, assim como os profissionais devem considerar as necessidades das famílias ao elaborar diretrizes a fim de orientá-los.

RESUMEN Frente al creciente número de niños menores de dos años expuestos a las pantallas, preocupaciones sobre el desarrollo de los bebés han sido el foco de discusiones académicas y clínicas. Para comprender porque madres y padres exponen a sus hijos a tecnologías digitales se han realizado entrevistas en profundidad con madres y padres de bebés con edades entre 10 y 17 meses, domiciliadas en la región metropolitana de Porto Alegre, Brasil. A pesar de las pautas recomendadas por las sociedades pediátricas sobre al acceso a las pantallas, los padres muestran discrepancia acerca de las mismas. Los progenitores, debido tanto a la falta de conciencia, como a la necesidad comparten sus dispositivos con los bebés. Los padres afirman estar preocupados por el futuro de los niños y perciben el acceso temprano a la tecnología como una herramienta importante para mejorar las habilidades cognitivas y fortalecer los lazos familiares. También señalaron que las potencialidades en el uso para generar interacciones familiares, destacando la supervisión de los padres. Por otro lado, los padres manifiestan preocupación ante el uso de la tecnología a expensas de otras formas de juego. Los progenitores necesitan orientación y apoyo, al igual que los profesionales deben considerar las necesidades de las familias al formular recomendaciones.

ABSTRACT. Considering the large number of children under the age of two that are constantly exposed to digital screens, concerns about child development have been emerging and becoming the focus of academic and clinical discussions. In order to understand the reasons why parents expose their infants to digital technologies, we conducted in-depth interviews with mothers and fathers of infants aged between 10 and 17 months living in the metropolitan region of Porto Alegre, Brazil. Despite the guidelines of local pediatric societies, our data points to divergences between what is recommended by the board of pediatrics and the patterns of screen exposure documented in our study. Parents, out of unawareness and/or urgent need, introduce their babies to digital technologies. Parents claimed to be concerned with the future of children and perceived early access to digital technology as an important tool to improve cognitive skills and to strength family bonds. Conversely, parents had concerns in face of technology at the expense of other forms of play. Our findings highlight that parents need additional guidance and support, while professionals should weight needs and daily challenges experienced by families when formulating guidelines.

Discrimination of dyslipidemia types with ATR-FTIR spectroscopy and chemometrics associated with multivariate analysis of the lipid profile, anthropometric, and pro-inflammatory biomarkers.

BACKGROUND: Obesity, dyslipidemia, and low-grade inflammatory state form a triad of self-sustaining metabolic dysfunction. Attenuated total reflection Fourier transform infrared (ATR-FTIR) spectroscopy is a simple, rapid, and non-destructive technique that generates spectral fingerprints of biomolecules that can be correlated with metabolic changes. We verified the efficiency of ATR-FTIR spectroscopy in blood plasma (n = 74) to discriminate the types of dyslipidemias and suggest metabolic inflammatory changes. METHODS: Principal Component Analysis (PCA) was performed on the biochemical and anthropometric data to verify whether the dyslipidemia types share a similar biochemical profile plausible of discrimination in chemometric modeling. To discriminate the types of dyslipidemias based on spectral data, Orthogonal Partial Least-Squares Discriminant Analysis (OPLS-DA) was used and validated with leave-one-out cross-validation. RESULTS: Although no significant difference was obtained between the types of dyslipidemia and normal subjects by CRP, leptin, and cfDNA, there was a significant difference between normal subjects vs combined hyperlipidemia (CH) + hypercholesterolemia (HCL) + hypertriglyceridemia (HTG) (p < 0.05) by the 1245 cm-1 peak [νas(PO2-)] (possible indication of chronic inflammation by increased cfDNA). The area under the curve of the region between 1770 and 1720 cm-1 was significantly increased for CH in relation to other dyslipidemias and normal subjects. Furthermore, there were significant differences for the main representative peaks of lipids, proteins, carbohydrates, and nucleic acids between the types of dyslipidemias and between the types of dyslipidemias and normal subjects. The OPLS-DA model achieved 100 % accuracy with 1 latent variable and Standard Error of Cross-Validation (SECV) < 0.004 for all types of dyslipidemia  and the control group. CONCLUSIONS: Our results suggest that ATR-FTIR spectroscopy associated with chemometric modeling is a plausible applicant for screening the types of dyslipidemias. However, more extensive studies should be conducted to verify the real applicability in clinical analysis laboratories or medical clinics.

Detection of metabolic syndrome with ATR-FTIR spectroscopy and chemometrics in blood plasma.

Metabolic Syndrome (MetS) is a constellation of 3 or more risk factor (abdominal obesity, high triglycerides, low HDL-c, high blood pressure, and elevated blood glucose) for atherosclerotic cardiovascular disease. Considering these systemic metabolic changes in the biochemical pathways of all biomolecules, Attenuated Total Reflection-Fourier Transform Infrared (ATR-FTIR) spectroscopy is a rapid, low-cost, and reagent-free alternative technique capable of identifying spectral biomarkers that differentiate subjects with MetS from control. In this study, plasma samples from 74 subjects (14 MetS, 60 control) were analyzed on the ATR-FTIR spectrophotometer. The objective was to differentiate subjects with MetS from control with supervised chemometrics modeling (Orthogonal Partial Least Squares-Discriminant Analysis, OPLS-DA). Additionally, the inflammatory status of subjects with MetS and control (supervised by C-reactive protein - CRP, leptin, and cell-free DNA - cfDNA) was verified. The OPLS-DA model achieved 100% sensitivity and specificity in cross-validation. For 1 latent variable (93.4% of variance), RMSECV < 0.002, PRESS CV < 0.0001, and R2 > 0.9999 was obtained. Significant spectrochemical differences (p < 0.05) were found between MetS and control subjects in the following biomolecular regions (cm-1): 1717-1703 [ν(CO) and δ(NH)], 1166-1137 [ν(C-OH) + ν(CO) and ν(CC) + Î´(OH) + ν(CO)], 1113-1040 [ν(PO2-) and ν(C-OH)], and 1027-1008 [ν(CO) and v(CH2OH)]. In the OPLS-DA model loadings, amide I [1720-1600 cm-1, ν(CO)] and amide II [1570-1480 cm-1, δ(NH) + ν(CH)] had significantly greater weight than all other regions. There was a significant difference in inflammatory status between MetS patient and control (p < 0.05 for CRP and leptin, and p < 0.01 for cfDNA).

Impressões de pais e educadores sobre a exposição do bebê às telas: um relato de experiência / Caregivers' impressions about baby's screen exposure: an experience report / Impresiones de los cuidadores cerca de la exposición del bebé a pantallas: un relato de experiencia

Os bebês, hoje, vêm sendo expostos às telas já durante o primeiro ano de vida. Essa exposição é possibilitada pelos adultos, que por diferentes razões, disponibilizam para as crianças seus próprios smartphones ou outros dispositivos. E o que será que pais e profissionais da educação infantil pensam sobre a exposição do bebê às telas? Para explorar a percepção dos cuidadores de bebês com até 3 anos sobre como as novas tecnologias permeiam as rotinas familiar e escolar e afetam o desenvolvimento infantil, assim como propiciar um espaço de escuta, psicoeducação e reflexão, uma intervenção clínica foi proposta. Foram realizados encontros com cuidadores de bebês em uma escola de educação infantil na região metropolitana de Porto Alegre, RS, Brasil. Os encontros transcorreram na modalidade roda de conversa e possibilitaram importantes reflexões sobre um tema que reverbera na saúde mental das crianças e nas interações com seus cuidadores.

It is already known that babies are often exposed to screens during their first year of life. This exposure is mediated by adults, who hand their smartphones or other devices to children for several reasons. What do parents and school caregivers think about a baby's screen exposure? To explore the perceptions of caregivers of babies up to 3 years old about how new technologies pervade family and school routines, affecting children's development, and to provide an opportunity for listening, psychoeducation and reflections, a clinical intervention was proposed. The intervention took place in a kindergarten school located in the metropolitan region of Porto Alegre, RS - Brazil, during three group sessions, using a conversation wheel. The group intervention enabled caregivers to discuss an important theme, which affects the baby's development and relationships.

La exposición de los bebés a pantallas generalmente ocurre durante el primer año de vida del bebé y es facilitada por los adultos. Teniendo en cuenta lo anterior, ¿qué piensan padres, madres y profesores? Para responder a esa cuestión una intervención clínica buscó explorar lo que piensan padres, madres y profesores de niños hasta 3 años acerca de las nuevas tecnologías en la rutina doméstica y escolar, como también proponer un espacio de escucha, psicoeducación y reflexión. La práctica ocurrió en una escuela infantil en la región metropolitana de Porto Alegre, RS, Brasil, usando la modalidad de conversaciones grupales. La intervención permitió a los padres y profesores reflexionar un tema que repercute en la salud mental de los niños y en las relaciones entre los bebés y sus cuidadores.

High rates of double-stranded RNA viruses and Mycoplasma hominis in Trichomonas vaginalis clinical isolates in South Brazil.

Trichomonas vaginalis is the etiological agent of trichomoniasis, the most common non-viral sexually transmitted disease (STD) in world, with 276.4 million new cases each year. T. vaginalis can be naturally infected with Mycoplasma hominis and Trichomonasvirus species. This study aimed to evaluate the prevalence of T. vaginalis infected with four distinct T. vaginalis viruses (TVVs) and M. hominis among isolates from patients in Porto Alegre city, South Brazil. An additional goal of this study was to investigate whether there is association between metronidazole resistance and the presence of M. hominis during TVV infection. The RNA expression level of the pyruvate ferredoxin oxidoreductase (PFOR) gene was also evaluated among metronidazole-resistant and metronidazole-sensitive T. vaginalis isolates. A total of 530 urine samples were evaluated, and 5.7% samples were positive for T. vaginalis infection. Among them, 4.51% were isolated from female patients and 1.12% were from male patients. Remarkably, the prevalence rates of M. hominis and TVV-positive T. vaginalis isolates were 56.7% and 90%, respectively. Most of the T. vaginalis isolates were metronidazole-sensitive (86.7%), and only four isolates (13.3%) were resistant. There is no statistically significant association between infection by M. hominis and infection by TVVs. Our results refute the hypothesis that the presence of the M. hominis and TVVs is enough to confer metronidazole resistance to T. vaginalis isolates. Additionally, the role of PFOR RNA expression levels in metronidazole resistance as the main mechanism of resistance to metronidazole could not be established. This study is the first report of the T. vaginalis infection by M. hominis and TVVs in a large collection of isolates from South Brazil.

Repercussões do cenário contemporâneono ato de compartilhar refeições em família / The influence of the contemporary scenario on the meal sharing amid families

O presente artigo teve por objetivo discutir as transformações que o ato de se alimentar em família sofreu nas últimas décadas. Com este propósito, discorre-se sobre as influências econô-micas e tecnológicas que provocaram variações de comportamento e dos valores na sociedade e, por consequência, na organização do grupo familiar, envolvendo, entre outros processos, a alimentação. Buscou-se fazer leituras que primeiramente auxiliassem a compreensão do ato de alimentar-se, considerando a influência de fenômenos de ordem cultural e histórica, como a industrialização, a crescente urbanização e até mesmo as guerras. A literatura tem sinalizado modificações importantes na família, especialmente em hábitos relacionados à alimentação e aos aspectos emocionais devido às mudanças na sociedade contemporânea. Muito embora esteja claro para os pesquisadores que a comensalidade exerça um papel protetivo para a saúde física e mental dos indivíduos, o que se constata é um crescente aumento da alimentação em restaurantes e lanchonetes, ou seja, fora de casa, o que, em geral, é inadequado e nocivo à saúde. Percebe-se que as famílias convivem com um excesso de informações sobre alimentação saudável e não saudável e têm rotinas desregradas em função de elevadas e crescentes demandas sociais e profissionais. Pesquisadores apontam que os encontros familiares reduziram e este fato pode repercutir nas escolhas e práticas alimentares. Programas interdisciplinares de intervenção com famílias que considerem o cenário atual ainda são escassos, mas extremamente necessários. Sugestões para investigações futuras são apresentadas e discutidas.(AU)

This paper aimed to discuss the transformations that the habit of eating with the family suffered in the last decades. For this purpose, technological and economic influences responsible for society behaviors and values variations, as well as accounting for changes in family organization involving eating are described. The readings focused on the comprehension of the eating act, taking into account the influence of cultural and historical phenomena as industrialization, growing urbanization and even wars. The literature presents significant changes in families nowadays, especially in relation to eating habits and emotional aspects, due to contemporary society changes. Therefore it is already a consensus to researchers that commensality is a protective factor to human’s physical and mental health, what one observes is an increase of the habit of eating at restaurants and snack bars, in other words, outside home, what is inadequate and risky for health. Something observed is that families receive excessive information about healthy and non healthy habits and have disorderly routines because of increasing social and professional demands. Researchers evidenced that familiar reunions are not so common nowadays and that this fact may reverberates in the eating choices and practices. Interdisciplinary programs for families that take into account the actual scenario are still rare although extremely necessary. Suggestions for future investigations are presented and discussed.(AU)

Repercussões do cenário contemporâneono ato de compartilhar refeições em família / The influence of the contemporary scenario on the meal sharing amid families

O presente artigo teve por objetivo discutir as transformações que o ato de se alimentar em família sofreu nas últimas décadas. Com este propósito, discorre-se sobre as influências econô-micas e tecnológicas que provocaram variações de comportamento e dos valores na sociedade e, por consequência, na organização do grupo familiar, envolvendo, entre outros processos, a alimentação. Buscou-se fazer leituras que primeiramente auxiliassem a compreensão do ato de alimentar-se, considerando a influência de fenômenos de ordem cultural e histórica, como a industrialização, a crescente urbanização e até mesmo as guerras. A literatura tem sinalizado modificações importantes na família, especialmente em hábitos relacionados à alimentação e aos aspectos emocionais devido às mudanças na sociedade contemporânea. Muito embora esteja claro para os pesquisadores que a comensalidade exerça um papel protetivo para a saúde física e mental dos indivíduos, o que se constata é um crescente aumento da alimentação em restaurantes e lanchonetes, ou seja, fora de casa, o que, em geral, é inadequado e nocivo à saúde. Percebe-se que as famílias convivem com um excesso de informações sobre alimentação saudável e não saudável e têm rotinas desregradas em função de elevadas e crescentes demandas sociais e profissionais. Pesquisadores apontam que os encontros familiares reduziram e este fato pode repercutir nas escolhas e práticas alimentares. Programas interdisciplinares de intervenção com famílias que considerem o cenário atual ainda são escassos, mas extremamente necessários. Sugestões para investigações futuras são apresentadas e discutidas.

This paper aimed to discuss the transformations that the habit of eating with the family suffered in the last decades. For this purpose, technological and economic influences responsible for society behaviors and values variations, as well as accounting for changes in family organization involving eating are described. The readings focused on the comprehension of the eating act, taking into account the influence of cultural and historical phenomena as industrialization, growing urbanization and even wars. The literature presents significant changes in families nowadays, especially in relation to eating habits and emotional aspects, due to contemporary society changes. Therefore it is already a consensus to researchers that commensality is a protective factor to human’s physical and mental health, what one observes is an increase of the habit of eating at restaurants and snack bars, in other words, outside home, what is inadequate and risky for health. Something observed is that families receive excessive information about healthy and non healthy habits and have disorderly routines because of increasing social and professional demands. Researchers evidenced that familiar reunions are not so common nowadays and that this fact may reverberates in the eating choices and practices. Interdisciplinary programs for families that take into account the actual scenario are still rare although extremely necessary. Suggestions for future investigations are presented and discussed.

Correlação entre infecções genitais e alterações citopatológicas cervicais em pacientes atendidas no sistema de saúde pública de Porto Alegre / Correlation between genital infections and cervical cytopathological changes in patients assisted in Porto Alegre public health system

Introdução: o câncer cervical tem sido apontado como a segunda neoplasia mais comum entre as mulheres, sendo muitas vezes associado a agentes infecciosos (AI) relacionados a doenças sexualmente transmissíveis (DST) ou oportunistas do trato genitourinário. Objetivo: avaliar diferentes variáveis epidemiológicas, assim como a prevalência dos AI encontrados no exame citológico preventivo e correlacioná-las às alterações citológicas cervicais benignas e malignas. Métodos: análise retrospectiva dos laudos de exames citológicos emitidos entre os anos de 2004 e 2009 de pacientes atendidas em 33 Unidades Básicas de Saúde de Porto Alegre. Foram selecionados 850 laudos de diferentes pacientes e analisadas as variáveis: faixa etária, grau de instrução,AI e alterações celulares. Resultados: cerca de 70% das pacientes situam-se na faixa etária entre 14 e 45 anos, predominando o 1o grau incompleto (38,4%).O agente infeccioso que apresentou maior prevalência foi a Gardnerella vaginalis, com 15,6%, seguida de Candida sp. (2,3%) e Trichomonas vaginalis(2,2%). Dentre as alterações celulares cervicais benignas, a que apresentou maior prevalência foi o epitélio inflamatório (67%), sendo a maioria observada na faixa etária mais jovem. Obteve-se correlação estatisticamente significativa entre as alterações celulares cervicais benignas com os agentes infecciosose com a idade, sendo que dos 275 casos de inflamação, 161 (58,5%) apresentavam também algum AI. Em relação às alterações celulares malignas, poucos casos foram detectados, não sendo possível obter qualquer correlação. Conclusão: os resultados observados em nosso estudo sugerem que há correlação dealterações cérvico-vaginais benignas com casos de infecções microbianas concomitantes ou pregressas nas pacientes avaliadas neste estudo.

Introduction: cervical cancer has been considered the second most common malignancy among women, and is often associated with infectious agents (AI) related to sexually transmitted diseases (STDs) or opportunistic of genitourinary tract. Objective: to evaluate the epidemiological variables and correlate them with cytological benign and malignant cervical changes, as well as the prevalence of AI found in cytology preventive exam. Methods: retrospective analysis of cytological reports issued between 2004 and 2009 of patients treated in 33 Basic Health Care Units in Porto Alegre. A total of 850 reports were selected from different patients and the following variables were analyzed: age, education, AI and cellular changes. Results: approximately 70% of women are at the age between 14 and 45 years old, mainly with incomplete primary school (38.4%). The infectious agent that had the highest prevalence wasGardnerella vaginalis with 15.6% followed by Candida sp. (2.3%) and Trichomonas vaginalis (2.2%). Among the benign cervical cell changes with the highest prevalence was inflammatory epithelium (67%), mostly observed in the youngest age group. A statistically significant correlation between the benign cervical cell changes with infectious agents and with age was obtained, and of 275 cases of inflammation, 161 (58.5%) had also some AI. Regarding tomalignant cell changes, few cases were detected; it is not possible to obtain any correlation. Conclusion: the results observed in this study suggest that there is a correlation of cytological changes in cervical-vaginal benign cases with previous or concomitant microbial infections in women evaluated in this study.

Chronic hyperhomocysteinemia induces oxidative damage in the rat lung.

Tissue accumulation of homocysteine occurs in classical homocystinuria, a metabolic disease characterized biochemically by cystathionine ß-synthase deficiency. Vascular manifestations such as myocardial infarction, cerebral thrombosis, hepatic steatosis, and pulmonary embolism are common in this disease and poorly understood. In this study, we investigated the effect of chronic hyperhomocysteinemia on some parameters of oxidative stress (thiobarbituric acid-reactive substances, protein carbonyl content, 2',7'-dichlorofluorescein fluorescence assay, and total radical-trapping antioxidant potent) and activities of antioxidant enzymes (superoxide dismutase, catalase, and glutathione peroxidase) in the rat lung. Reduced glutathione content and glucose 6-phosphate dehydrogenase activity, as well as nitrite levels, were also evaluated. Wistar rats received daily subcutaneous injections of Hcy (0.3-0.6 µmol/g body weight) from the 6th to the 28th days-of-age and the control group received saline. One and 12 h after the last injection, rats were killed and the lungs collected. Hyperhomocysteinemia increased lipid peroxidation and oxidative damage to protein, and disrupted antioxidant defenses (enzymatic and non-enzymatic) in the lung of rats, characterizing a reliable oxidative stress. In contrast, this amino acid did not alter nitrite levels. Our findings showed a consistent profile of oxidative stress in the lung of rats, elicited by homocysteine, which could explain, at least in part, the mechanisms involved in the lung damage that is present in some homocystinuric patients.

Neuroprotective role of lipoic acid against acute toxicity of N-acetylaspartic acid.

N-Acetylaspartic acid (NAA) accumulates in Canavan disease, a severe inherited neurometabolic disorder clinically characterized by mental retardation, hypotonia, macrocephaly, and seizures. The mechanisms of brain damage in this disease remain poorly understood. Recent studies developed by our research group showed that NAA induces oxidative stress in vitro and in vivo in cerebral cortex of rats. Lipoic acid is considered as an efficient antioxidant which can easily cross the blood-brain barrier. Considering the absence of specific treatment to Canavan disease, this study evaluates the possible prevention of the oxidative stress promoted by NAA in vivo by the antioxidant lipoic acid to preliminarily evaluate lipoic acid efficacy against pro-oxidative effects of NAA. Fourteen-day-old Wistar rats received an acute administration of 0.6 mmol NAA/g body weight with or without lipoic acid (40 mg/kg body weight). Catalase (CAT), glutathione peroxidase (GPx), and glucose 6-phosphate dehydrogenase activities, hydrogen peroxide content, thiobarbituric acid-reactive substances (TBA-RS), spontaneous chemiluminescence, protein carbonyl content, total antioxidant potential, and DNA-protein cross-links were assayed in the cerebral cortex of rats. CAT, GPx activities, and total antioxidant potential were significantly reduced, while hydrogen peroxide content, TBA-RS, spontaneous chemiluminescence, and protein carbonyl content were significantly enhanced by acute administration of NAA. Those effects were all prevented by lipoic acid pretreatment. Our results clearly show that lipoic acid may protect against the oxidative stress promoted by NAA. This could represent a new therapeutic approach to the patients affected by Canavan disease.