Factors Influencing Health Professionals' Decisions Regarding the Indication of Infant Formula: A Qualitative Exploration in Uruguay.

BACKGROUND: Health systems are fundamental to the promotion and protection of breastfeeding. Health professionals have a pivotal influence on families' infant feeding decisions and may act as facilitators or barriers to adequate breastfeeding practices. RESEARCH AIM: To explore factors influencing health professionals' decisions regarding the indication of infant formula in Montevideo, the capital of Uruguay, an emerging Latin American country. METHOD: This was a qualitative study based on semi-structured interviews with 30 health professionals (neonatologists, pediatricians, family doctors, and nurses) working in primary and secondary care in both private and public health institutions. The interviews were audio-recorded, transcribed, and analyzed using content analysis based on deductive-inductive coding. RESULTS: The narratives of the participants identified maternity wards as the healthcare sites where the indication of infant formula occurs most frequently. Motives underlying the indication of infant formula by health professionals were diverse. The type of birth and the conditions of the child and the mother were the most relevant in secondary care, whereas maternal work was the main determining factor in primary care. A wide range of factors encouraging and discouraging the indication of infant formula were identified by health professionals in primary and secondary healthcare locations, which were related to all the levels of influence of the socioecological model. CONCLUSIONS: Strategies to reduce the use of infant formula in Uruguay should include improving the support and guidance provided to families in the maternity ward, strengthening the implementation and monitoring of the Baby-Friendly Hospital Initiative, and improving the current maternity leave regulations.

The relationship between female orgasmic disorder, attention-deficit/hyperactivity disorder, and depression in Dominican women.

BACKGROUND: Female orgasmic disorder is listed in the DSM-5 and is defined as the persistent or recurrent inability to have an orgasm. Many depressed women may experience sexual dysfunction, including female orgasmic disorder. AIM: The study sought to analyze the relationship between depressive disorders and attention-deficit/hyperactivity disorder (ADHD) and their influence on the development of female orgasmic disorder. METHODS: A total of 221 Dominican women participated in this case-control study. The case group consisted of 107 women diagnosed with female orgasmic disorder, while the control group consisted of 114 women without any sexual dysfunction. OUTCOMES: The diagnosis of ADHD was obtained from the participants' medical records, previously conducted using the DSM-5-TR criteria. The Beck Depression Inventory II was used to assess the severity of depressive symptoms in both groups. RESULTS: There was a significant relationship between female orgasmic disorder and ADHD and depression. The results of multiple logistic regression indicated that the highest risk of female orgasmic disorder was observed in women with ADHD (odds ratio [OR], 4.91; 95% confidence interval [CI], 2.46-9.20; P < .001), women with severe depression (OR, 2.50; 95% CI, 1.08-6.96; P = .04), and women who had sexual intercourse that focused on penetration (OR, 2.02; 95% CI, 1.03-3.98; P = .04). CLINICAL IMPLICATIONS: These findings may have important implications for the prevention and treatment of sexual disorders in women. STRENGTHS AND LIMITATIONS: This design selected all diagnosed cases of female orgasmic disorder and did not select a specific subgroup. However, some limitations must be considered. This study was conducted in a single clinic, although it should be noted that it is the main clinic for the treatment of sexual dysfunction in the country. A further limitation could be that this type of study design does not allow for statements about causality to be made. CONCLUSION: There is an increased risk of female orgasmic disorder in women with ADHD, with severe depression, and who engage in penetrative sex.

Palliative care for children with central nervous system tumors: results of a Spanish multicenter study.

BACKGROUND: Brain tumors represent the most common cause of cancer-related death in children. Few studies concerning the palliative phase in children with brain tumors are available. OBJECTIVES: (i) To describe the palliative phase in children with brain tumors; (ii) to determine whether the use of palliative sedation (PS) depends on the place of death, the age of the patient, or if they received specific palliative care (PC). METHODS: Retrospective multicenter study between 2010 and 2021, including children from one month to 18 years, who had died of a brain tumor. RESULTS: 228 patients (59.2% male) from 10 Spanish institutions were included. Median age at diagnosis was 5 years (IQR 2-9) and median age at death was 7 years (IQR 4-11). The most frequent tumors were medulloblastoma (25.4%) and diffuse intrinsic pontine glioma (DIPG) (24.1%). Median number of antineoplastic regimens were 2 (range 0-5 regimens). During palliative phase, 52.2% of the patients were attended by PC teams, while 47.8% were cared exclusively by pediatric oncology teams. Most common concerns included motor deficit (93.4%) and asthenia (87.5%) and communication disorders (89.8%). Most frequently prescribed supportive drugs were antiemetics (83.6%), opioids (81.6%), and dexamethasone (78.5%). PS was administered to 48.7% patients. Most of them died in the hospital (85.6%), while patients who died at home required PS less frequently (14.4%) (p = .01). CONCLUSION: Children dying from CNS tumors have specific needs during palliative phase. The optimal indication of PS depended on the center experience although, in our series, it was also influenced by the place of death.

Experiences of Dyspareunia in Dominican Women with a History of Sexual Abuse: A Phenomenological Study.

INTRODUCTION: Dyspareunia refers to painful sexual intercourse that negatively affects a person's psychological well-being and quality of life and can also have an impact on their partner, family, and social circle. The objective of this study was to understand the experiences of women with dyspareunia and a history of sexual abuse in the Dominican Republic. METHODS: This was a qualitative study based on Merleau-Ponty's hermeneutic phenomenology. Fifteen women with a diagnosis of dyspareunia and a history of sexual abuse participated. The study was carried out in Santo Domingo, Dominican Republic. RESULTS: In-depth interviews were conducted for data collection. Through inductive analysis using ATLAS.ti, 3 main themes were developed that represent women's experiences of dyspareunia and sexual abuse: (1) a history of sexual abuse as a background to dyspareunia, (2) living in fear in a society that revictimizes the survivor, and (3) the sexual consequences of dyspareunia. DISCUSSION: In some Dominican women, dyspareunia stems from their history of sexual abuse, which was unknown to their families and partners. The participants experienced dyspareunia in silence and found it difficult to seek help from health care professionals. In addition, their sexual health was marked by fear and physical pain. There are individual, cultural, and social factors that influence the occurrence of dyspareunia; a better understanding of these factors is vital for planning innovative preventive strategies that reduce the progression of sexual dysfunction and its impact on the quality of life of people with dyspareunia.

First-trimester ventriculomegaly in fetuses with callosal agenesis: Cause or association?

The sonographic findings in four fetuses presenting with ventriculomegaly at first-trimester ultrasound that were subsequently diagnosed as having agenesis of the corpus callosum (ACC) are described. The diagnosis of early ventriculomegaly was suspected subjectively by identification of increased cerebrospinal fluid within the lateral ventricles and confirmed by measuring choroid plexus-to-lateral ventricle length and area ratios. Subsequent scans revealed complete ACC in two cases and partial ACC in the other two. This report adds to the increasing evidence suggesting that first-trimester ventriculomegaly is a strong sonographic marker of underlying brain anomalies, including less evident malformations such as ACC. Detailed second-trimester fetal neurosonography in those women continuing their pregnancies should be performed.

The Idealization of Infant Formula: A Longitudinal Analysis of Labels in Uruguay.

BACKGROUND: Labels are a key element of the marketing strategies of infant formula companies, and often include text or images that idealize their use, undermining efforts to promote breastfeeding. RESEARCH AIMS: To evaluate the prevalence of marketing cues that idealize infant formula on labels of products commercialized in Uruguay and to assess changes after a periodic monitoring of compliance with the International Code of Marketing of Breast-Milk Substitutes (IC). METHOD: This study is a descriptive, observational, and longitudinal assessment of the information included on infant formula labels. The first data collection was in 2019, as part of a periodic assessment to monitor the marketing of human-milk substitutes. In 2021, the same products were purchased to evaluate changes in their labels. Thirty-eight products were identified in 2019, of which 33 were still available in 2021. All information available on the labels was analyzed through content analysis. RESULTS: Most products included at least one textual or visual marketing cue idealizing infant formula in both 2019 (n = 30, 91%) and 2021 (n = 29, 88%). This represents a violation of both the IC and national regulations. References to nutritional composition were the most frequent marketing cue, followed by references to child growth and development. No relevant changes were observed after the periodic assessment conducted by the Uruguayan government. CONCLUSIONS: Monitoring compliance with the IC per se cannot be expected to trigger changes in the marketing strategies of infant formula companies. More explicit regulations and strong enforcement mechanisms are needed to end the inappropriate marketing practices on infant formula labels.

Basic sonographic examination of the fetal brain at 11-13 weeks' gestation: Rationale for a simple and reliable four-step technique.

The widespread incorporation of first-trimester scanning between 11 and 13 weeks' gestation has shifted from the screening of chromosomal abnormalities, mainly by measuring nuchal translucency thickness and visualization of the nasal bone, to a more detailed study of the fetal anatomy leading to early detection of several structural congenital anomalies. This goal can be improved by the routine and focused sonographic assessment of specific anatomic planes and the identification of distinctive landmarks that can help disclosing a particular, non-evident condition. In this article we present the basis for a basic, early examination of the fetal brain during screening using a four-step technique, which can be readily incorporated during the first-trimester scan. The technique includes the focused visualization of the cranial contour, choroid plexuses of the lateral ventricles and midline, aqueduct of Sylvius, brainstem, fourth ventricle, and the choroid plexus of the fourth ventricle. The rationale for this approach is presented and discussed.

The Impact of COVID-19 on the Monitoring of Pregnancy and Delivery of Pregnant Women in the Dominican Republic.

Pregnancy monitoring is vital to guaranteeing that both the foetus and the mother are in optimal health conditions. WHO protocols recommend at least eight medical examinations during the pregnancy period. While the cancellation or reduction of appointments during pregnancy due to the pandemic may help reduce the risk of infection, it could also negatively influence perinatal outcomes and the birthing process. The aim of this research was to analyse the differences in perinatal outcomes and birth characteristics in two groups of pregnant women: women who gave birth before and during the pandemic, and whether these differences are due to changes in pregnancy monitoring because of the COVID-19 situation. A retrospective study was carried out from July 2018 to December 2021, at the Santo Domingo Hospital (Dominican Republic). A total of 1109 primiparous pregnant women were recruited for this study during the birthing process and perinatal visits. The results describe how women who gave birth before the pandemic had greater control and monitoring of their pregnancy, more doctor visits (p = 0.001), fewer caesarean sections (p = 0.006), and more skin-to-skin contact after birth (p = 0.02). During the COVID-19 pandemic, pregnant women's attendance at routine pregnancy monitoring, both doctor visits and ultrasound scans, has decreased, leading to an increase in the number of caesarean and instrumental deliveries. At the perinatal level, processes such as skin-to-skin contact after birth between mother and newborn or the introduction of early breastfeeding in the delivery room have also been reduced.

Parental Burnout Assessment (PBA) in Different Hispanic Countries: An Exploratory Structural Equation Modeling Approach.

Parental burnout is a unique and context-specific syndrome resulting from a chronic imbalance of risks over resources in the parenting domain. The current research aims to evaluate the psychometric properties of the Spanish version of the Parental Burnout Assessment (PBA) across Spanish-speaking countries with two consecutive studies. In Study 1, we analyzed the data through a bifactor model within an Exploratory Structural Equation Modeling (ESEM) on the pooled sample of participants (N = 1,979) obtaining good fit indices. We then attained measurement invariance across both gender and countries in a set of nested models with gradually increasing parameter constraints. Latent means comparisons across countries showed that among the participants' countries, Chile had the highest parental burnout score, likewise, comparisons across gender evidenced that mothers displayed higher scores than fathers, as shown in previous studies. Reliability coefficients were high. In Study 2 (N = 1,171), we tested the relations between parental burnout and three specific consequences, i.e., escape and suicidal ideations, parental neglect, and parental violence toward one's children. The medium to large associations found provided support for the PBA's predictive validity. Overall, we concluded that the Spanish version of the PBA has good psychometric properties. The results support its relevance for the assessment of parental burnout among Spanish-speaking parents, offering new opportunities for cross-cultural research in the parenting domain.

Alexithymia and Insecure Attachment among Male Intimate Partner Violence Aggressors in the Dominican Republic.

The complexity of intimate partner violence and the impossibility of understanding it from single factors have been studied from different biological, psychological, and socio-cultural factors. A cross-sectional study was conducted on 187 men involved in legal proceedings for problems of violence in their intimate partner relationships in the Dominican Republic in order to explore whether insecure attachment represents a risk factor for alexithymia in men with violent behaviors. The attachment style was determinate by the Casullo and Fernández-Liporace Attachment Styles Scale, and alexithymia was assayed using the Latin American Consensual Toronto Alexithymia Scale (LAC TAS-20), a modification of the Toronto Alexithymia Scale (TAS-20). Chi-square test and multiple binary logistic regression analysis were performed to explore the phenomena of alexithymia and attachment styles in the context of a confinement center for male intimate partner offenders in the Dominican Republic. The results showed that insecure attachment represents a risk factor for alexithymia, being highest for avoidant attachment in the population studied. The results also highlight the influence of other factors such as education and maternal-familial relationships as a factor risk for alexithymia.

Rhizobia and endophytic bacteria isolated from rainforest fragments within an iron ore mining site of the Eastern Brazilian Amazon.

The aim of the present study was to isolate and evaluate the diversity of rhizobial and endophytic bacterial strains from undisturbed native rainforests within an iron ore mining site of the Serra Norte de Carajás in the Eastern Brazilian Amazon region to assess their biotechnological utility in reclamation of areas. Experiments were conducted to capture strains from samples of the soil of these forests at the sites Arenito II, Noroeste II, and Sul IV using Macroptilium atropurpureum and Mimosa acutistipula var. ferrea as trap host plants. Only M. atropurpureum nodulated, and the different bacterial strains were isolated from its nodules. There was no difference in the number of nodules among the areas, but the Arenito II bacterial community was the most efficient, indicated by the aboveground biomass production and suitable shoot mass/root mass ratio. Fifty-two (52) bacterial isolates were obtained, distributed in five groups, including nodulating and endophytic bacteria: 32 from Arenito II, 12 from Noroeste II, and 8 from Sul IV. The nodulating Bradyrhizobium genus was common to the three areas, whereas Paraburkholderia was found only in Arenito II. The nodD1 gene was amplified in all the strains of both nodulating genera. Strains of the nodulating genus Methylobacterium were also isolated from the three areas; however, they did not nodulate the host of origin, and their nodD1 gene was not amplified. Endophytic strains were also isolated from the genera Paenibacillus, Pantoea, and Leifsonia in Arenito II, Leifsonia in Noroeste I, and Paenibacillus in Sul IV. The greater nodulation and rhizobial and endophytic bacterial diversity observed in Arenito II were probably due to the more suitable edaphic properties of the area. The isolated strains were incorporated in the collection of the Department of Soil Science of UFLA and will be investigated in relation to their symbiotic characteristics with native host plants, as well as their ability to perform other biological processes.

Relación entre parámetros cardiovasculares y el Índice de Masa Corporal en mujeres perimenopáusicas / Relationship between cardiovascular parameters and body mass index in perimenopausal women

Introducción: Las enfermedades cardiovasculares (ECV) son la causa de muerte más frecuente en las mujeres en todo el mundo. La deficiencia de estrógenos debido a la menopausia se asocia con un mayor riesgo a padecer esta patología.Objetivo: Analizar los factores de riesgo cardiovascular en mujeres perimenopausicas con al menos un factor de riesgo cardiovascular modificable mayor (diabetes, hipertensión, dislipemia) con edades comprendidas entre los 45 y 60 años de dos servicios de atención primaria urbanos.Metodología: Estudio descriptivo transversal en dos centros de salud de la ciudad de Ourense (Centro de Salud Novoa Santos y Centro de Salud A Ponte). Las variables analizadas fueron: Actividad estrogénica, tratamiento farmacológico, hábito tabáquico, calidad de vida, índice de masa corporal (IMC), colesterol total, lipoproteína de alta densidad (cHDL), lipoproteína de baja densidad (cLDL) y triglicéridos, tensión arterial sistólica (TAS), tensión arterial diastólica (TAD), frecuencia cardíaca (FC). El estudio contó con la aprobación del Comité Ético de Galicia. El análisis de los datos se efectuó a través del software libre R.Resultados: Participaron 316 mujeres, de las cuales el 64,9% eran menopáusicas. La edad media de la muestra fue de 53,35 ± 4,35 años. El valor medio del IMC fue de 28,125 ± 5,54 Kg/m2. Un 27,8% afirmó presentar hábito tabáquico. El 77,2% de las mujeres de la muestra presentaban niveles de colesterol total ≥200 mg/dl. En relación al cLDL, en el 72,6% de la población estudiada era ≥130 mg/dl. Se observó una correlación estadísticamente significativa entre el IMC y los niveles de triglicéridos, cHDL, TAS, TAD y FC.Conclusiones: Las mujeres perimenopáusicas presentaban una elevada prevalencia hábito tabáquico, obesidad y sobrepeso, a pesar de sufrir al menos un factor de riesgo cardiovascular. Por otra parte mostraron una baja calidad de vida tanto en la dimensión física como mental

Introduction: Cardiovascular disease (CVD) is the most common cause of death in women worldwide. Estrogen deficiency due to menopause is associated with an increased risk of this pathology.Objective: To analyze cardiovascular risk factors in perimenopausal women with at least one major modifiable cardiovascular risk factor (diabetes, hypertension, dyslipemia) between the ages of 45 and 60 of two urban primary care services.Methodology: Cross-sectional descriptive study in two health centers in the city of Ourense (Novoa Santos Health Center and A Ponte Health Center). The variables analyzed were: estrogenic activity, pharmacological treatment, smoking habit, quality of life, body mass index (BMI), total cholesterol, high density lipoprotein (cHDL), low-density lipoprotein (cLDL) and triglycerides, systolic blood pressure (TAS), diastolic blood pressure (TAD), heart rate (FC). The study was approved by the Ethics Committee of Galicia. Data analysis was performed through the free R software.Results: 316 women participated, of whom 64.9% were menopausal. The average age of the sample was 53.35 ± 4.35 years. The average BMI value was 28,125 ± 5.54 Kg/m2. 27.8% said they had a smoking habit. 77.2% of the women in the sample had total cholesterol levels ≥200 mg/dL. In relation to the cLDL, in 72.6% of the population studied it was ≥130 mg/dL. A statistically significant correlation was observed between BMI and triglyceride, cHDL, TAS, TAD and FC levels.Conclusion: Perimenopausal women had a high prevalence of smoking habit, obesity and overweight, despite suffering at least one cardiovascular risk factor. On the other hand they showed a low quality of life in both the physical and mental dimensión.

The social representations of complementary feeding.

The social representations of complementary feeding are expected to shape parents' decisions and to provide justification or legitimization for their practices. The aims of the present work were: i) to explore the social representations of complementary feeding in parents and health professionals, ii) to evaluate if the onset of complementary feeding modify social representations in parents, and iii) to compare the representations of parents and pediatricians. Three groups of participants were considered: 170 parents of children who had not started complementary feeding (1-4 months old), 170 parents of children who had started complementary feeding (7-10 months old) and 212 pediatricians. Parents were recruited in health facilities in Montevideo (Uruguay), whereas pediatricians were recruited at the National Pediatrics Conference. Participants were asked to complete a word association task with "the first meals of a baby". All the responses provided by participants were grouped into categories using content analysis. The structure of the social representations was assessed considering the frequency of mention and the average rank of appearance of the categories. Results showed that the social representations of complementary feeding for both parents and pediatricians were extremely narrow and mainly focused on specific foods: puree and a small set of vegetables and fruits. None of the categories showed high frequency of mention and low rank of appearance, indicating that the structure of the social representations did not include any element in the first periphery. According to the theory of social representations, results from the present work suggest that the social representations of complementary feeding for Uruguayan parents and pediatricians are deeply rooted and resistant to change.

Role of Tonsillar Chronic Inflammation and Commensal Bacteria in the Pathogenesis of Pediatric OSA.

Immune responses at the boundary between the host and the world beyond are complex and mucosal tissue homeostasis relies on them. Obstructive sleep apnea (OSA) is a syndrome suffered by children with hypertrophied tonsils. We have previously demonstrated that these tonsils present a defective regulatory B cell (Breg) compartment. Here, we extend those findings by uncovering the crucial role of resident pro-inflammatory B and T cells in sustaining tonsillar hypertrophy and hyperplasia by producing TNFα and IL17, respectively, in ex vivo cultures. Additionally, we detected prominent levels of expression of CD1d by tonsillar stratified as well as reticular epithelium, which have not previously been reported. Furthermore, we evidenced the hypertrophy of germinal centers (GC) and the general hyperplasia of B lymphocytes within the tissue and the lumen of the crypts. Of note, such B cells resulted mainly (IgG/IgM)+ cells, with some IgA+ cells located marginally in the follicles. Finally, by combining bacterial culture from the tonsillar core and subsequent identification of the respective isolates, we determined the most prevalent species within the cohort of OSA patients. Although the isolated species are considered normal oropharyngeal commensals in children, we confirmed their capacity to breach the epithelial barrier. Our work sheds light on the pathological mechanism underlying OSA, highlighting the relevance taken by the host immune system when defining infection versus colonization, and opening alternatives of treatment.

The idealisation of bottle feeding: content analysis of feeding bottles and teats packages in Uruguay.

OBJECTIVE: The information displayed on the packages of feeding bottles and teats commercialised in Montevideo (Uruguay) was analysed using content analysis with the goal of identifying key marketing practices that may discourage breast-feeding. DESIGN: The study was conducted as part of the periodic assessment performed by the Uruguayan government to monitor the marketing of breast milk substitutes. All the feeding bottles and teats sold in forty-four retail outlets selling breast milk substitutes were purchased. The information available on the packages was analysed using content analysis and descriptive statistics. SETTING: Montevideo, Uruguay. RESULTS: A total of 197 feeding bottles and 71 teats were found. The majority of the packages included information to enable caregivers to adequately use the products, including recommended age, instructions on how to use the products and instructions on the use of hygienic practices. However, the packages frequently included information that implied that bottle feeding was equivalent to breast-feeding, particularly from a physiological perspective, or that idealised product use. Idealisations included ability to reduce colic, improvements in the feeding experience and improvements in children's health, well-being and development. Statements on the superiority of breast-feeding were infrequent. CONCLUSIONS: The results from the present work showed the high prevalence of marketing practices on the packages of feeding bottles and teats that may discourage breast-feeding. Stricter and more detailed regulations seem necessary to enable caregivers to make informed feeding decisions for infants.

Infección por citomegalovirus y Helicobacter pylori, en un niño con enfermedad de Ménétrier / Citomegalovirus and Helicobacter pylori infection in a child with Ménétrier´s disease

Resumen La enfermedad de Ménétrier es una entidad clínica rara, de etiología no clara, caracterizada por hiperplasia foveolar gástrica asociada con pérdida secundaria de proteínas. En niños se presenta con edema, que puede ser generalizado, sin compromiso renal ni hepático y difiere de la forma adulta por la persistencia del edema y la remisión espontánea. En la mayoría de casos publicados, se relaciona con infecciones, usualmente por cytomegalovirus y Helicobacter pylori. Aquí se presenta el caso de un niño de 9 años, que consulta por un mes de evolución de edema y dolor abdominal. Al examen físico se documenta anasarca, y estudios de laboratorio revelaron hipoalbuminemia sin proteinuria.

Abstract Ménétrier disease is a rare disorder characterized by gastric foveolar hyperplasia associated with secondary protein loss. In children, this condition presents as an edematous syndrome without renal or hepatic impairment and differs from the adult form by the constant presence of edema and spontaneous remission. It has been related to infections in most published cases, especially to cytomegalovirus and Helicobacter pylori. Here we analyze the case of a 9 year old boy, complaining of one month of edema and abdominal pain. Physical exam revealed a patient with anasarca and laboratory results documented hypoalbumenemia without proteinuria.

Educación a distancia: reflexiones desde la obra del Dr. Juan Virgilio López Palacio / Distance learning: reflections from the work of Ph D. Juan Virgilio López Palacio

RESUMEN Introducción: refiere la importancia del uso de las tecnologías de la informática y las comunicaciones en la educación a distancia, considerando las reflexiones del Dr. Juan Virgilio López Palacio, Profesor de Mérito de la Universidad Central "Marta Abreu" de Las Villas, quien apuesta por la calidad de la educación en esta modalidad. Objetivo: fundamentar el uso de las tecnologías de la información y las comunicaciones en la educación a distancia, atendiendo a las reflexiones del Dr. Juan Virgilio López Palacio. Métodos: se realizó una revisión bibliográfica entre enero-marzo 2019. Se consideraron artículos originales y de revisión en textos digitales e impresos, en español. Los artículos en soporte digital fueron seleccionados en las bases de datos SciELO, Dialnet y Google Académico. Se tuvieron como criterios de inclusión: mención al uso de las tecnologías de la información y las comunicaciones y la educación a distancia. Desarrollo: se exponen criterios de varios autores, y en especial las reflexiones del Dr. Juan Virgilio López Palacio; se fundamentan el desarrollo de la ciencia y la tecnología en Cuba y su influencia en el campo educativo, su aplicación en la pedagogía desde el punto de vista teórico y práctico, y las características de la educación a distancia y sus perspectivas en el contexto educacional cubano. Conclusiones: el uso de estas tecnologías sustenta hoy el trabajo con la modalidad a distancia en la educación superior; constituye un enfoque renovador que favorece el estudio autónomo e independiente de los estudiantes en formación.

ABSTRACT Introduction: it refers to the importance of the use of information and communication technologies in distance learning, considering the reflections of Ph D. López Palacio, Professor of Merit of "Marta Abreu" Central University of Las Villas, who has committed himself with the quality of education in this modality. Objective: to base the use of information and communication technologies in distance learning, according to the reflections of Ph D. López Palacio. Methods: a literature review was carried out from January to March 2019. Original and review articles in electronic and printed texts, in Spanish, were considered. Electronic articles were selected in SciELO, Dialnet and Google Scholar databases. The following criteria were included: mention of the use of information and communication technologies and distance learning. Development: criteria of several authors are presented, and especially the reflections of Ph D. López Palacio; the development of science and technology in Cuba and its influence in the educational field, its application in pedagogy from a theoretical and practical point of view, and the characteristics of distance learning and its perspectives in the Cuban educational context are based. Conclusions: the use of these technologies at present supports the work with the distance learning modality in higher education; it constitutes a renewal approach that favors the autonomous and independent study of students in training.

Social representations of breastfeeding and infant formula: An exploratory study with mothers and health professionals to inform policy making.

Although several efforts to promote breastfeeding have been implemented worldwide, the prevalence of exclusive breastfeeding in the first 6 months of life remains low. One of the factors responsible for this trend is the widespread sales and marketing of breast-milk substitutes. In this context, the present work aimed at exploring mothers and health professionals' social representations of breastfeeding and infant formula. The study was conducted in Montevideo (Uruguay), as part of the periodic assessment performed by the Uruguayan government to monitor the marketing of breast-milk substitutes according to the OMS/UNICEF NetCode toolkit. A total of 330 mothers of children under 24 months old and 154 health professionals were recruited at 33 health care facilities. Participants were asked to complete two word association tasks, one with breastfeeding and the other with infant formula. Inductive coding was used to classify the responses into categories and dimensions. The structure of the social representations was explored considering the frequency of mention and the average rank of appearance of the categories. Results showed that mothers' social representations mainly positioned breastfeeding as a feeding practice, whereas infant formulas were mainly perceived as a complement to breast-milk that provides support. In the case of health professionals, the social representations of breastfeeding and infant formulas were in line with scientific evidence and health recommendations. These results suggest that efforts to promote breastfeeding should focus on raising public awareness of the risks associated with breast-milk substitutes and on overcoming the systemic barriers to breastfeeding, particularly among working mothers.

La Didáctica en la preparación del personal docente: sugerencias del Dr. Juan Virgilio López Palacio / Didactics in the preparation of the teaching staff: suggestions of Ph D. Juan Virgilio López Palacio

RESUMEN Introducción: refiere la importancia de la Didáctica en la preparación del personal docente universitario, teniendo en cuenta las sugerencias del Dr. Juan Virgilio López Palacio, profesor destacado de la Universidad Central "Marta Abreu" de Las Villas, quien reafirma la necesidad de incluir estos programas en todas las carreras universitarias, donde se forman alumnos que más tarde ejercerán como docentes. Objetivo: fundamentar la importancia de la Didáctica en la preparación del personal docente universitario, según las sugerencias del Dr. Juan Virgilio López Palacio. Métodos: se realizó una revisión bibliográfica entre enero-marzo 2019. Se consideraron artículos originales y de revisión en textos digitales e impresos, en español. Los artículos digitalizados se consultaron en SciELO, Dialnet y Google Académico. Se tuvo como criterios de inclusión: mención a la Didáctica y a la formación del personal docente universitario. Desarrollo: se exponen criterios de varios autores y en especial se toman como referente las sugerencias del Dr. López Palacio, sobre la preparación del profesor universitario como una prioridad de la universidad del siglo XXI y la influencia de la Didáctica en su formación, se proponen algunas acciones que demandan su aplicación como ciencia que ofrece al docente una preparación integral, válida para los diferentes niveles de enseñanza. Conclusiones: la preparación docente del profesor universitario debe comenzar desde el inicio de su carrera con la introducción de la Didáctica en sus currículos, y tendrá su continuidad en programas de posgrado para garantizar su actualización permanente y sistemática.

ABSTRACT Background: it refers to the importance of Didactics in the preparation of the university teaching staff, taking into account the suggestions of PhD. López Palacio, an outstanding professor at "Marta Abreu" Central University of Las Villas, who reaffirms the need to include these programs in all university degrees, where students who will later practice as teachers are trained. Objective: to base the importance of Didactics in the preparation of the university teaching staff, according to the suggestions of PhD. López Palacio. Method: a bibliographic review was carried out from January to March 2019. Original and review articles were considered in electronic and printed texts, in Spanish. The scanned articles were consulted on SciELO, Dialnet and Google Scholar. The inclusion criteria were included: mention of Didactics and the training of the university teaching staff. Development: criteria of several authors are presented and in particular the suggestions of PhD. López Palacio are taken as a reference, about the preparation of the university professor as a priority of the university of the 21st century and the role that Didactics plays in its formation, they propose some actions that demand the application of Didactics, as a science that offers the teacher a comprehensive preparation, valid for the different teaching levels. Conclusions: the teaching preparation of the university professor must begin since the beginning of its career with the introduction of Didactics in its curricula, and it will have its continuity in postgraduate programs to guarantee its steady and systematic updating.