Quality of mother-infant interaction, breastfeeding, and perinatal mental health.

INTRODUCTION: The quality of mother-infant interactions is crucial for child development. Studies show that breastfeeding contributes to maternal sensitivity and the development of a positive mother-infant bond. Maternal mental health difficulties negatively impact both maternal sensitivity and breastfeeding. Thus, it is unclear whether breastfeeding contributes to the quality of mother-infant interactions independent from mental health. The purpose of this study is to examine the contribution of exclusive breastfeeding at 3 months postpartum to the quality of the mother-infant relationship at 6 months postpartum, controlling for maternal mental health in a community sample of mothers in Chile. MATERIALS AND METHOD: Eighty women completed self-report measures of mental health and breastfeeding during the third trimester of pregnancy and 3 and 6 months postpartum. At 6 months after childbirth, the mother-infant interaction was assessed by coding a free-play session between mothers and infants. Logistic regression analysis was used to examine the contribution of breastfeeding practices and mental health to the quality of mother-infant interactions. RESULTS: Exclusive breastfeeding at 3 months postpartum increased the likelihood of displaying positive mother-infant interactions controlling for maternal mental health. Mothers who continued to breastfeed at 6 months postpartum reported less symptoms of antenatal depression and anxiety and higher levels of sensitivity and cooperation towards their infants. CONCLUSION: Breastfeeding contributes to maternal sensitivity and cooperation even when controlling for maternal mental health. Implications for health practitioners and limitations due to the sample characteristics are discussed.

The role of interpersonal emotional regulation on maternal mental health.

PURPOSE: Symptoms of depression and anxiety during the perinatal period have a negative impact on mothers and their developing children. A significant body of research has demonstrated an association between mental health and both individual and interpersonal emotion regulation. Yet, this association has not been studied during the perinatal period. The aim of this study was to explore the association between emotion regulation, maternal mental health, and interpersonal emotion regulation during the transition to motherhood in a sample of Chilean women. METHODS: Women in their third trimester of pregnancy (n = 253) provided self-reports of emotion regulation and symptoms of depression and anxiety during pregnancy and three months postpartum. Additional self-reports of interpersonal emotion regulation were obtained from individuals who were identified as social support persons by these women. Results: Maternal emotion regulation contributed to maternal symptoms of depression and anxiety during pregnancy and after childbirth. The association between emotion regulation and maternal mental health was moderated by specific interpersonal emotion regulation strategies reported by the participant's social support persons. Strategies including modulating the emotional response, situation modification, attentional deployment and cognitive change, modified the association between poor regulation strategies and anxiety symptoms. Also, an infrequent use of these interpersonal emotion regulation strategies strengthened the association between these maternal emotional regulation difficulties and anxiety symptoms. CONCLUSION: Our findings suggest that interpersonal emotional regulation strategies impact the association of maternal emotional regulation strategies and maternal emotional wellbeing.

Avaliação do controle da asma em universitários no sul do Brasil / Evaluation of asthma control in university students in southern Brazil

RESUMO: Objetivo: Mensurar o nível de controle da asma em estudantes com relato de chiado no peito no último ano através do Asthma Control Test (ACT). Método: Estudo transversal descritivo realizado com ingressantes na Universidade Federal de Pelotas (UFPel) em 2017, incluindo 1.865 universitários com 18 anos ou mais. Resultados: Cerca de 19% dos universitários apresentaram chiado no peito nos 12 meses que antecederam a entrevista. Destes, 14% apresentaram asma não controlada (ACT ≤18 pontos). A maior prevalência de asma não controlada foi observada no sexo feminino, em indivíduos com 24 anos ou mais, com a cor da pele parda, em um quarto dos universitários pertencentes às classes D e E, e naqueles que não fumam e não consomem bebida alcoólica. Conclusão: Apesar de a população estudada ser composta por universitários, observou-se uma prevalência expressiva de asma não controlada.

ABSTRACT: Objective:To measure the level of asthma control in students who have reported wheezing in the last year throughthe Asthma Control Test (ACT). Method:A cross-sectional study was carried out with students for the University Federal of Pelotas (UFPel) in 2017, including 1865 university students aged 18 years or over. Results: About 19% of the interviewees reported wheezing in the last year. Of these, 14% had uncontrolled asthma (ACT ≤ 18 points).The highest prevalence of uncontrolled asthma was observed among females, in individuals aged 24 years or older, with brown skin color, in one quarter of university students in class D and E, and who did not smoke and did not consume alcohol. Conclusion: Although the population studied was composed by university students, a considerable percentage of them had uncontrolled asthma.

Longitudinal Association Between Diet Quality and Asthma Symptoms in Early Adult Life in a Brazilian Birth Cohort.

BACKGROUND: The role of diet in the etiology of asthma is still inconclusive. This paper evaluated the longitudinal association between diet quality and chest wheezing in young adults. METHODS: This is a longitudinal study with follow-up information from 18- and 22-year-olds (18y and 22y) of the 1993 Pelotas (Brazil) Birth Cohort. Chest wheezing occurrence and number of events in the last year were reported at 22y. Diet quality was measured with a revised version of the Healthy Eating Index (IQD-R) for the Brazilian population at 18y and 22y by food frequency questionnaire referring to the last 12 months. The diet quality continuity was classified as good (always 1st IQD-R tertile), intermediate (always 2nd tertile/change tertile) and poor (always 3rd tertile). RESULTS: A total of 2986 young individuals were evaluated; 51.4% were female. Prevalence of wheezing at 22y was 10.1% (95% CI: 9.1-11.2), and of these patients, 10% reported at least one event in the past year. Better IQD-R score, both at 18y and at 22y, the lower the odds of wheezing in the past year. Regarding the diet quality continuity from 18y to 22y, staying on a poor diet increased by more than three-fold the odds of chest wheezing (OR=3.28; 95% CI: 1.84-5.84) and of wheezing events (OR=3.32; 95% CI: 1.89-5.85) compared to staying on a good diet, after adjustment for confounding variables. CONCLUSION: The overall quality of the diet seems to be more important than the individual components in the effect on asthma symptoms. Low-quality diet persistence increased the odds of chest wheezing and the number of events.

Lattice Light-Sheet Microscopy Multi-dimensional Analyses (LaMDA) of T-Cell Receptor Dynamics Predict T-Cell Signaling States.

Lattice light-sheet microscopy provides large amounts of high-dimensional, high-spatiotemporal resolution imaging data of cell surface receptors across the 3D surface of live cells, but user-friendly analysis pipelines are lacking. Here, we introduce lattice light-sheet microscopy multi-dimensional analyses (LaMDA), an end-to-end pipeline comprised of publicly available software packages that combines machine learning, dimensionality reduction, and diffusion maps to analyze surface receptor dynamics and classify cellular signaling states without the need for complex biochemical measurements or other prior information. We use LaMDA to analyze images of T-cell receptor (TCR) microclusters on the surface of live primary T cells under resting and stimulated conditions. We observe global spatial and temporal changes of TCRs across the 3D cell surface, accurately differentiate stimulated cells from unstimulated cells, precisely predict attenuated T-cell signaling after CD4 and CD28 receptor blockades, and reliably discriminate between structurally similar TCR ligands. All instructions needed to implement LaMDA are included in this paper.

Prevención e intervenciones tempranas en salud mental: una perspectiva internacional / Prevention and early interventions in mental health: an international perspective / Prevenção e intervenções precoces em saúde mental: uma perspectiva internacional

Las enfermedades mentales son comunes, crónicas y discapacitantes, y representan un problema de salud pública importante en nuestro país y en todo el mundo. Para las enfermedades mentales más comunes, disponemos actualmente de intervenciones médicas y psicosociales con eficacia probada. Sin embargo, estas aún son insuficientes, y su disponibilidad no se condice con la alta morbilidad y mortalidad que encontramos para las enfermedades mentales. En respuesta a esto, en los últimos 15 años se ha realizado un esfuerzo considerable para desarrollar técnicas de detección temprana, para personas con alto riesgo clínico de desarrollo de enfermedad mental, e intervenciones precoces para prevenir o retrasar la progresión a la enfermedad completa. Un mayor énfasis en la salud mental y la integración de la atención a la salud mental en todos los programas de desarrollo pertinentes, fortalecerán el esfuerzo general de desarrollo, así como garantizará, por primera vez, la atención sostenida de la inversión y la investigación al principal contribuyente mundial de la pérdida de productividad y carga de enfermedad.

Mental diseases are common, chronic and disabling, representing a problem in public health of importance in our country and in the world. For most common mental diseases, currently we dispose of medical and psycho social interventions with proven efficacy. Nevertheless, these are not sufficient yet, and their availability does not diminish the morbidity and mortality produced by mental diseases. In order to solve this, a considerable effort has been carried out in the last 15 years to develop techniques of early detection for persons with high clinical risk to develop mental illness and precocious interventions to prevent or delay the progression of full illness. A greater emphasis in mental health and integrating mental health care in all relevant development programs will strengthen the general development effort, as well as it will ensure, for the first time, sustained attention to investment and research to the main world contributor to loss of productivity and disease burden.

As enfermidades mentais são comuns, crônicas e descapacitantes, e representam um problema de saúde pública importante em nosso país e em todo o mundo. Para as enfermidades mentais mais comuns dispomos atualmente de intervenções médicas e psicossociais com eficácia comprovada. Entretanto, estas ainda são insuficientes, e sua disponibilidade não condiz com a alta morbidade e mortalidade que encontramos para as enfermidades mentais. Em resposta a isto, nos últimos 15 anos foi realizado um esforço considerável para desenvolver técnicas de detecção precoce para pessoas com alto risco clínico de desenvolvimento de enfermidade mental, e intervenções precoces para prevenir ou atrasar a progressão da enfermidade completa. Uma maior ênfase na saúde mental e a integração da atenção à saúde mental em todos os programas de desenvolvimento pertinentes, fortalecerão o esforço geral de desenvolvimento, assim como garantirá, pela primeira vez, a atenção sustentada no investimento e na pesquisa do principal contribuinte mundial da perda de produtividade e carga de enfermidade.

The feasibility and acceptability of a preventive intervention programme for children with depressed parents: study protocol for a randomised controlled trial.

BACKGROUND: One of the most important risk factors for childhood depression is being the child of a depressed parent. These at-risk children have two to four times the probability of having an affective episode compared with their peers. Preventive interventions such as Beardslee's Preventive Intervention Program (PIP) that are targeted at children of depressed parents have proven effective in many countries. The PIP is a family-based approach that works by promoting resilience in children and increasing positive interactions within the family. In this pilot randomised controlled trial (RCT), we will determine the acceptability and feasibility of an adapted version of this intervention in Chile. METHODS/DESIGN: We are conducting a pilot RCT with a manualized intervention. The intervention will be delivered in seven weekly sessions at the family home. It is targeted mostly at parents but will also measure outcomes among the children. Control subjects will follow their treatment as usual. Feasibility and acceptability will be assessed by recruitment, adherence, dropout and level of missing data, as well as the burden of scales and measurement tools. Families will be followed for 11 months. DISCUSSION: Given the negative lifelong consequences of depression and the burden they represent, preventive programmes are not only feasible but necessary. Despite the successful implementation of this intervention in different countries, an adaptation to the Chilean reality will be prerequisite. The results of this pilot study will inform a definitive trial that will make the case for its national implementation. TRIAL REGISTRATION: Clinicaltrials.gov trial identifier: NCT02593266 . Registration date: 30 Octo 2015.

Monitoreo de anticuerpos anti-HLA en pacientes con insuficiencia renal crónica en lista de espera para trasplante / Anti-hla antibodies monitoring in patients with chronic re- nal failure on waiting list for renal transplant in Paraguay

INTRODUCCIÓN: El estudio de anticuerpos anti-HLA en el suero del paciente en lista de espera para trasplante renal es fundamental para optimizar la elección de un donante así como el esquema de inmunosupresión de inducción y mantenimiento acorde al riesgo inmunológico. Estos anticuerpos pueden Encontrarse de manera preexistente al trasplante como resultado de exposición del individuo a transfusiones sanguíneas, embarazos y trasplantes previos. El objetivo del estudio fue determinar la incidencia de inmunización frente a antígenos de HLA, los factores asociados y su impacto en pacientes en espera de un trasplante renal. MATERIAL Y MÉTODOS: En este estudio, observacional retrospectivo de corte trasversal, fueron incluidos 254 pacientes en lista de espera para trasplante renal que acudieron al Laboratorio Central de Salud Pública en el período comprendido entre julio de 2013 y julio de 2015. RESULTADOS: De los 254 pacientes estudiados, 30% presentaron anticuerpos anti-HLA. El evento sensibilizante más significativo fue la exposición a un trasplante previo, presentando anticuerpos anti-HLA el 84% de los candidatos a retrasplante (p<0,05). En segundo lugar se encontraron las mujeres multíparas, presentando un PRA (Panel Reactivo de Anticuerpos) positivo el 69% de ellas (p<0,05). Por último, el 24% de los pacientes poli-transfundidos presentaron anticuerpos anti HLA (p<0,05). CONCLUSIONES: En el trascurso de los dos años de estudio, 51 pacientes fueron trasplantados, de los cuales un solo paciente presentaba anticuerpos anti-HLA antes del trasplante. Esto indica claramente que la inmunización frente a antígenos de HLA representa una barrera para el acceso al trasplante

INTRODUCTION: Anti-HLA antibodies determination in the serum of patients on a waiting list for renal transplant is essential to optimize donor selection as well as for the induction and maintenance immunosuppression scheme, according to immunological risk. These antibodies could be present before transplantation as a result of being exposed to blood transfusions, pregnancies and previous transplants. The objective of the study was to determine immunization against HLA antigens, associated factors and their impact on the waiting list for a renal transplant. METHODS: In this observational retrospective cross sectional study, 254 patients on the waiting list for renal transplant were included. These patients attended the Public Health central laboratory between July 2013 and July 2015. RESULTS: 30% of the 254 studied patients presented anti-HLA antibodies. The most significant sensitizing event was the exposure to a previous transplant (p=<0.05). Multiparous women were in second place, 69% of them presenting positive PRA (panel reactive antibodies) (p=<0.05). Finally 24% of poly transfused patients presented anti-HLA antibodies (p=<0.05). CONCLUSIONS: During the 2 year of the study, 51 patients were transplanted, presenting only one of them anti-HLA antibodies before transplantation. This results clearly indicate that the immunization against HLA represents a barrier for transplantation access

Sentence comprehensionin Parkinson's disease.

Parkinson's disease (PD) patients with dementia have impairment of syntactic comprehension. Non-demented PD patients also experience difficulties in sentence comprehension and can be particularly impaired in the processing of grammatical characteristics of syntactically complex sentences. OBJECTIVE: The aim of this study was to verify the performance of PD patients without dementia in a syntactic comprehension task compared with normal elderly. METHODS: We studied oral sentence comprehension in fourteen patients with idiopathic PD together with fourteen controls matched for age and education, using the Token Test and Schmitt's Syntactic Comprehension Test (developed in Brazilian Portuguese). RESULTS: For the Token Test, there was no statistically significant difference between the PD group and the control group, whereas on the Syntactic Comprehension Test there was a slight statistically significant difference between the groups only for relatives in subject clauses (p=0.0407). CONCLUSIONS: PD patients differed from controls in the oral comprehension for relatives subject sentences alone. These results did not strictly reproduce those previously reported in the literature, and therefore point to the need for creating tests with diverse syntactic constructions in Portuguese able to produce consistent data regarding language behavior of Brazilian subjects with PD in comprehension tasks.

Pacientes com doença de Parkinson (DP) e demência apresentam prejuízo da compreensão sintática. Pacientes com DP sem demência também apresentam dificuldades na compreensão de sentenças e podem estar particularmente comprometidos na habilidade de processar as características gramaticais de sentenças sintaticamente complexas. OBJETIVO: O objetivo deste estudo foi verificar o desempenho de pacientes com DP sem demência em tarefas de compreensão sintática, comparados a idosos normais. MÉTODOS: Foram estudados quatorze pacientes com DP idiopática e quatorze controles emparelhados por idade e escolaridade, usando o Teste Token e o Teste de Compreensão Sintática de Schmitt (desenvolvido em português do Brasil). RESULTADOS: No Teste Token, não houve diferenças estatisticamente significantes entre os pacientes com DP e o grupo controle. No Teste de Compreensão Sintática, foi encontrada diferença estatisticamente significante entre os grupos apenas nas sentenças relativas de sujeito (p=0.0407). CONCLUSÃO: Os pacientes com DP diferenciam-se do grupo controle apenas na compreensão oral de sentenças relativas de sujeito. Tendo em vista estes resultados, que não reproduzem de forma estrita o que é descrito na literatura, torna-se evidente a necessidade da criação de testes de linguagem com diferentes construções sintáticas em português do Brasil, a fim de obtermos dados consistentes a respeito do comportamento de pacientes brasileiros com DP em tarefas de compreensão sintática.

Estudo comparativo entre o desempenho de pré-escolares de escola pública e de escola privada em relação à produção de frases / Comparative study of phrase production of preschool children from public and private schools

Tema: habilidade para produção de frases em crianças pré-escolares. Objetivo: caracterizar e comparar a emissão de frases evocadas por figuras de objetos de pré-escolares de uma escola privada e de uma pública. Material e Método: de 313 crianças avaliadas participaram deste trabalho somente as que apresentaram adequação das habilidades auditivas de localização de sons e memória para três sons verbais e não-verbais em sequência, que corresponderam a 41 crianças da escola privada e 65 da pública. A habilidade para produzir frases foi estimada considerando-se os aspectos gramticais, o número de itens produzidos em cada frase e o número de frases evocadas. Resultados: este trabalho evidenciou que crianças de cinco e seis anos da escola privada apresentaram maior número de frases evocadas por figuras e com maior complexidade do que crianças da mesma faixa etária da escola pública. Conclusão: a experienciação acústica do indivíduo em desenvolvimento pode não garantir o mesmo desempenho quanto à sua habilidade na produção de frases.