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Background: Theophylline was an orally administered xanthine used for treatment of apnea of prematurity and Bronchopulmonary Dysplasia in ambulatory follow-up of Low-Birth-Weight infants (LBWI) with oxygen-dependency in the outpatient Kangaroo Mother Care Program (KMCP). Theophylline's main metabolic product is caffeine; therefore, it was an alternative due to the frequent lack of ambulatory oral caffeine in low and middle-income countries. Objective: To assess the effectiveness of oral theophylline in decreasing days with oxygen and to describe frequency of adverse related events. Methods: Quasi-experiment before and after withdrawal of theophylline given systematically to LBWI with ambulatory oxygen in two KMCPs. Results: 729 patients were recruited; period 1: 319 infants when theophylline was given routinely and period 2: 410 infants when theophylline was no longer used. The theophylline cohort had less gestational age, less weight at birth, more days in Neonatal Intensive Care Unit, more days of oxygen-dependency at KMCP admission, and more frequencies of Intrauterine Growth Restriction and apneas. After adjusting with propensity score matching, multiple linear regression showed that nutrition was associated with days of oxygen-dependency, but theophylline treatment not. No differences were found in frequencies of readmissions up to 40 weeks, intraventricular hemorrhage or neurodevelopmental problems. Participants in period 2 had more tachycardia episodes. Conclusions: We did not find association between oral theophylline treatment and the reduction of days with ambulatory oxygen. For the current management of oxygen-dependency in LBW infants, the importance of nutrition based on exclusive breast feeding whenever possible, is the challenge.

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The cow-calf bonding is a process that must be developed within the first six hours after calving. Both the buffalo dam and the newborn calf receive a series of sensory cues during calving, including olfactory, tactile, auditory, and visual stimuli. These inputs are processed in the brain to develop an exclusive bond where the dam provides selective care to the filial newborn. The limbic system, sensory cortices, and maternal-related hormones such as oxytocin mediate this process. Due to the complex integration of the maternal response towards the newborn, this paper aims to review the development of the cow-calf bonding process in water buffalo (Bubalus bubalis) via the olfactory, tactile, auditory, and visual stimuli. It will also discuss the neuroendocrine factors motivating buffalo cows to care for the calf using examples in other ruminant species where dam-newborn bonding has been extensively studied.

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Introducción: La duración de la lactancia materna es crucial para la salud infantil, sin embargo, la prevalencia ha disminuido en los últimos años, situando a los niños en una población de riesgo. Objetivo: Determinar los factores asociados a la duración de la lactancia materna en niños menores de 2 años en el Perú 2021-2022. Metodología: Estudio analítico transversal, a través del análisis secundario de datos de la Encuesta Demográfica y de Salud Familiar (ENDES) del año 2021 y 2022. El tamaño muestral fue de 4951 niños/niñas con sus respectivas madres. Se evaluaron factores infantiles y maternos utilizando el Estadístico F corregida para el análisis bivariado con una significancia estadística p<0,05 y un intervalo de confianza al 95%. Finalmente, para medir la asociación se calculó la razón de prevalencia cruda (RPc) y la razón de prevalencia ajustada (RPa) mediante la Regresión de Poisson con varianza robusta. Resultados: El 85,3% tuvo una duración de 0-6 meses y solo el 14,7% tiene una duración hasta los 23 meses. El no contacto piel a piel precoz bebe-madre (p <0,01) (RPa 1,19) y el consumo de bebidas diferentes a la leche materna los primeros 3 días de nacido (p <0,01) (RPa 0,66) se asociaron con una duración hasta los 6 meses de lactancia materna. Las madres adolescentes tuvieron un 30,7% de duración de lactancia materna de 6 meses (p<0,01) (RPa 2,49), por el contrario, el lugar de residencia rural, el grado no superior y un menor ingreso económico permiten una lactancia materna por más de 6 meses. Discusión: Los resultados asocian no recibir contacto piel a piel precoz bebe-madre, edad materna igual o menor de 18 años, grado superior, lugar de residencia urbano y mayor ingreso económico con una menor duración de lactancia materna en niños menores de 2 años.

Introduction: The duration of breastfeeding is crucial for child health; however, the prevalence has decreased in recent years, placing children in a population at risk. Objective: To determine the factors associated with the duration of breastfeeding in children under 2 years of age in Peru 2021-2022. Methodology: Cross-sectional analytical study, through the secondary analysis of data from the Demographic and Family Health Survey (ENDES) of 2021 and 2022. The sample size was 4951 children with their respective mothers. Infant and maternal factors were evaluated using the F-statistic corrected for bivariate analysis with a statistical significance of p<0.05 and a 95% confidence interval. Finally, to measure the association, the crude prevalence ratio (cPR) and the adjusted prevalence ratio (aPR) were calculated using Poisson regression with robust variance. Results: 85.3% had a duration of 0-6 months and only 14.7% had a duration of up to 23 months. Early baby-mother skin-to-skin non-contact (p <0.01) (aPR 1.19) and consumption of beverages other than breast milk in the first 3 days of birth (p <0.01) (aPR 0.66) were associated with a duration of breastfeeding up to 6 months. Adolescent mothers had a 30.7% duration of breastfeeding of 6 months (p<0.01) (aPR 2.49), on the contrary, the place of rural residence, the non-higher grade and a lower economic income allow breastfeeding for more than 6 months. Discussion: The results were associated with not receiving early skin-to-skin contact between the baby and the mother, maternal age equal to or less than 18 years, higher grade, urban place of residence and higher economic income with a shorter duration of breastfeeding in children under 2 years of age.

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Background: Coronavirus disease 2019 (COVID-19) novel severe acute respiratory syndrome affected the world population with an infectious condition for which therapeutic forms are limited and vascular sequelae are major challenges. Pregnant women are physiologically immunocompromised and can be more affected by the pandemic than the general population. Extra precaution measures against COVID-19 during and after the outbreak are essential to ensure the safety of the newborn. The aim of the present study was to report the cesarean birth of a female child with Klippel-Trenaunay of a mother currently infected by COVID-19. Case Description: A newborn of a 21-year-old mother with COVID-19 in the final stage of the disease was born through a cesarean section at full term. The physical examination at birth revealed substantial edema of the left lower limb associated with port-wine stains on the limb and left torso. The ultrasound revealed venous-lymphatic malformation affecting the entire left lower limb, suprapubic region and ipsilateral abdominal region. Two evaluations for COVID-19 were performed and both were negative. Infants of mothers with active COVID-19 infection during the birth period have a low probability of being positive for the disease, but precautions should be taken. Conclusions: The association with malformations, such as the rare Klippel-Trenaunay syndrome (KTS), constitutes another challenge regarding the diagnosis and proper conduct to be taken with these children.

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Abstract Objective: To evaluate exclusive breastfeeding at discharge and hospital length-of-stay in pre-term infants undergoing or not the Kangaroo-Mother Care Method (KMC). Methods: A retrospective cohort study was conducted including preterm infants < 1800 g admitted to the neonatal unit of a KMC reference center. The infants were grouped into the KMC group and the non-KMC group. Multiple logistic and Poisson regressions were performed to evaluate the association between the KMC and two outcomes, exclusive breastfeeding at discharge, and hospital length-of-stay, adjusted for potential confounders. Results: 115 mother-infant dyads were included, 78 in the KMC group and 37 in the non-KMC group. In the bivariate analysis, the KMC group had a lower prevalence of maternal adverse conditions (6% vs. 32%, p < 0.001), a higher number of prenatal visits (median 6 vs. 3.5, p < 0.001), higher gestational ages (median 32 vs. 31 weeks, p < 0.05), higher birth weights (median 1530 vs. 1365 g, p < 0.01), a lower prevalence of necrotizing enterocolitis (3.8% vs. 16.2%, p < 0.05), parenteral nutrition (50% vs. 73%, p < 0.05), and deep vascular access (49.7% vs. 78.4%, p < 0.01), a higher prevalence of exclusive breastfeeding (65% vs. 8%, p < 0.001) and a shorter length of hospital stay (median 28 vs. 42 days, p < 0.001). In the multiple regression analysis, the KMC group was 23 times more likely to be exclusively breastfed at discharge (OR = 23.1; 95% CI = 4,85-109,93) and had a 19% reduction in the hospital length-of-stay (IDR = 0.81; 95% CI = 0.76-0.86) compared to the non-KMC group. Conclusions: The KMC is associated with better short-term neonatal outcomes and should be encouraged in all Brazilian maternity hospitals.

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Resumen Objetivo: en Colombia, existe una brecha importante entre la reglamentación relacionada con el reconocimiento de derechos, inclusión y mecanismos para la protección de los niños con discapacidad y la implementación de la norma. En este contexto, el objetivo de este estudio fue explorar las representaciones sociales de la parálisis cerebral en madres de niños con parálisis cerebral. Metodología: se realizó un estudio cualitativo bajo el enfoque estructuralista de las representaciones sociales para caracterizar el contenido y la organización de las representaciones sociales de la parálisis cerebral de madres de niños con parálisis cerebral que consultaron a un centro de neurorrehabilitación en Cali, Colombia entre enero y febrero de 2022. Como técnicas de recolección se utilizaron el listado libre y el cuestionario de pares. Resultados: para las madres la parálisis cerebral es la alteración de movimiento que junto con la dificultad de aprendizaje y comunicación generan gran demanda de atención por parte del cuidador acompañado de sentimientos de resignación ante las secuelas de la lesión en el cerebro y la discriminación social percibida. Conclusiones: las representaciones sociales sobre la parálisis cerebral dejan percibir una visión negativa y poco esperanzadora de recuperación, así como resiliencia por parte de los cuidadores.

Abstract Objective: In Colombia, there is a significant gap between the regulations related to the recognition of rights, inclusion, and mechanisms for the protection of children with disabilities and the implementation of the law. In this context, the aim of this study was to explore the social representations of cerebral palsy in mothers of children with cerebral palsy. Methodology: We collected information from mothers with children with cerebral palsy who consulted a neurorrehabilitation center in Cali, Colombia between January and February 2022 using the free list and the peer questionnaire. Results: For mothers, cerebral palsy is a movement disorder that, together with learning and communication difficulties, generates a great demand for care by the caregiver, accompanied by feelings of resignation in the face of the consequences of the brain injury and perceived social discrimination. Conclusions: The social representations on cerebral palsy reveal a negative and hopeless view of recovery, as well as resilience on the part of caregivers.

Resumo Objetivo: Na Colômbia, existe uma brecha importante entre a regulamentação relacionada ao reconhecimento de direitos, inclusão e mecanismos para a proteção dos meninos com deficiência e a implementação da norma. Neste contexto, o objetivo deste estúdio pode explorar as representações sociais da paralisia cerebral em mães de crianças com paralisia cerebral. Metodologia: Recolha a informação das madres com crianças com paralisia cerebral que consulte um centro de neurorreabilitação em Cali, Colômbia entre enero e febrero de 2022 usando o listado livre e o guia de pares. Resultados: Para as mães a paralisia cerebral é a alteração de movimento que se junta com a dificuldade de aprendizagem e comunicação gera grande demanda de atenção por parte do cuidador acompanhado de sentimentos de resignação antes das seqüelas da lesão no cérebro e na discriminação percepção social. Conclusões: Las representaciones sociales sobre la paralisis cerebral dejan ver una visão negativa y poco esperanzadora de recuperação, así como resiliência de parte de los cuidadores.

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Objetivo: Identificar los patrones alimentarios de las madres y el estado nutricional de los lactantes de una zona periurbana de la sierra central del Perú. Métodos: El estudio fue observacional, transversal y prospectivo. La población censal fueron 93 madres y sus lactantes, se aplicó un cuestionario de patrones alimentarios; para medir el peso y la talla de los lactantes se aplicaron instrumentos mecánicos. Se aplicó la prueba de Fisher y Rho de Spearman, considerándose p < 0,05. Resultados: Los patrones alimentarios de las madres, fueron adecuados 95,7 % (89). Al valorar el estado nutricional de los lactantes, en el peso para la edad, la mayoría tuvo la condición de normal con 79,6 % (74); 15,1 % (14) tuvieron sobrepeso, un 5,4 % (5) tuvieron desnutrición global; en el peso para la talla, 64,5 % (60) tuvieron el diagnóstico de normal, seguido de los desnutridos agudos 24,7 % (23), sobrepeso 7,5 % (7) fueron el 3,2 % (3). Y, en la talla para la edad, 77,4 % (72) fueron normales. A mayor cantidad de miembros en la familia el estado nutricional del lactante era peor (Rho = -0,294; p-valor = 0,004) y la talla para la edad del lactante tuvo relación con la visita de la madre al nutricionista (p-valor = 0,018). Conclusión: A mayor cantidad de miembros en la familia, el estado nutricional del lactante era peor, en el peso para la edad y la talla para la edad del lactante se halló relación con la visita al nutricionista.

Objective: Identify the dietary patterns of mothers and the nutritional status of nursing children of a peri-urban zone of the central highlands of Perú. Methodology: The study was observational, cross-sectional and prospective. Census population were 93 mothers and their nursing children, It was applied a dietary patterns questionnaire; to measure the weight and height of the nursing children was applied machanics instruments. It was applied Fisher y Rho de Spearman test, considering p<0,05. Results: The dietary patterns of mothers were proper 95,7 % (89). To value the nutritional status of nursing children; in the weight for age, the most of them had the normal condition with 79,6 % (74); 15.1 % (14) al lof them had overweight, 5,4 % (5) underweight; in weight-for-height, 64,5 % (60) had the normal diagnosis, followed by acuate malnutrition 24,7 % (23), overweight 7,5 % (7) were 3,2 % (3). And, in height for age, 77,4 % (72) were normals. The higher the amount of family members the nutritional status of nursing children was worse (Rho = -0,294; p-value = 0,004) and the height for age of nursing children had relation with the mother visit had to the nutricionist (p-value = 0,018). Conclusion: The higher amount of members family, the nutritional status of nursing children was worse, in weight for age and height for age of nursing children was found relation with the visit to the nutritionist.

Objetivo: Identificar os padrões alimentares das mães e o estado nutricional dos bebês em uma área periurbana do planalto central do Peru. Métodos: O estudo foi observacional, transversal e prospectivo. A população censitária foi de 93 mães e seus bebês, foi aplicado um questionário sobre padrões alimentares; Instrumentos mecânicos foram aplicados para medir o peso e a altura dos bebês. Foi aplicado o teste Rho de Fisher e Spearman, considerando p < 0,05. Resultados: O padrão alimentar das mães estava adequado em 95,7% (89). Ao avaliar o estado nutricional dos lactentes, em peso para idade, a maioria apresentou estado normal com 79,6% (74); 15,1% (14) apresentavam excesso de peso, 5,4% (5) apresentavam desnutrição global; no peso para estatura, 64,5% (60) tiveram o diagnóstico de normalidade, seguido de desnutrição aguda 24,7% (23), excesso de peso 7,5% (7) foram 3,2% (3). E, na altura para idade, 77,4% (72) eram normais. Quanto maior o número de familiares, pior o estado nutricional do lactente (Rho = -0,294; p-valor = 0,004) e a altura do lactente para a idade esteve relacionada com a visita da mãe ao nutricionista (p-valor = 0,018). Conclusão: Quanto maior o número de membros na família pior o estado nutricional do lactente. No peso para idade e altura para idade do lactente foi encontrada relação com a visita ao nutricionista.

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Objetivo: identificar los patrones alimentarios de las madres y el estado nutricional de los lactantes de una zona periurbana de la sierra central del Perú. Métodos: el estudio fue observacional, transversal y prospectivo. La población censal fueron 93 madres y sus lactantes, se aplicó un cuestionario de patrones alimentarios; para medir el peso y la talla de los lactantes se aplicaron instrumentos mecánicos. Se aplicó la prueba de Fisher y Rho de Spearman, considerándose p < 0,05. Resultados: los patrones alimentarios de las madres, fueron adecuados 95,7 % (89). Al valorar el estado nutricional de los lactantes, en el peso para la edad, la mayoría tuvo la condición de normal con 79,6 % (74); 15,1 % (14) tuvieron sobrepeso, un 5,4 % (5) tuvieron desnutrición global; en el peso para la talla, 64,5 % (60) tuvieron el diagnóstico de normal, seguido de los desnutridos agudos 24,7 % (23), sobrepeso 7,5 % (7) fueron el 3,2 % (3). Y, en la talla para la edad, 77,4 % (72) fueron normales. A mayor cantidad de miembros en la familia el estado nutricional del lactante era peor (Rho = -0,294; p-valor = 0,004) y la talla para la edad del lactante tuvo relación con la visita de la madre al nutricionista (p-valor = 0,018). Conclusión: a mayor cantidad de miembros en la familia, el estado nutricional del lactante era peor, en el peso para la edad y la talla para la edad del lactante se halló relación con la visita al nutricionista.

Objective: identify the dietary patterns of mothers and the nutritional status of nursing children of a peri-urban zone of the central highlands of Perú. Methodology: the study was observational, cross-sectional and prospective. Census population were 93 mothers and their nursing children, It was applied a dietary patterns questionnaire; to measure the weight and height of the nursing children was applied machanics instruments. It was applied Fisher y Rho de Spearman test, considering p<0,05. Results: the dietary patterns of mothers were proper 95,7 % (89). To value the nutritional status of nursing children; in the weight for age, the most of them had the normal condition with 79,6 % (74); 15.1 % (14) al lof them had overweight, 5,4 % (5) underweight; in weight-for-height, 64,5 % (60) had the normal diagnosis, followed by acuate malnutrition 24,7 % (23), overweight 7,5 % (7) were 3,2 % (3). And, in height for age, 77,4 % (72) were normals. The higher the amount of family members the nutritional status of nursing children was worse (Rho = -0,294; p-value = 0,004) and the height for age of nursing children had relation with the mother visit had to the nutricionist (p-value = 0,018). Conclusion: the higher amount of members family, the nutritional status of nursing children was worse, in weight for age and height for age of nursing children was found relation with the visit to the nutritionist.

Objetivo: identificar os padrões alimentares das mães e o estado nutricional dos bebês em uma área periurbana do planalto central do Peru. Métodos: o estudo foi observacional, transversal e prospectivo. A população censitária foi de 93 mães e seus bebês, foi aplicado um questionário sobre padrões alimentares; Instrumentos mecânicos foram aplicados para medir o peso e a altura dos bebês. Foi aplicado o teste Rho de Fisher e Spearman, considerando p < 0,05. Resultados: o padrão alimentar das mães estava adequado em 95,7% (89). Ao avaliar o estado nutricional dos lactentes, em peso para idade, a maioria apresentou estado normal com 79,6% (74); 15,1% (14) apresentavam excesso de peso, 5,4% (5) apresentavam desnutrição global; no peso para estatura, 64,5% (60) tiveram o diagnóstico de normalidade, seguido de desnutrição aguda 24,7% (23), excesso de peso 7,5% (7) foram 3,2% (3). E, na altura para idade, 77,4% (72) eram normais. Quanto maior o número de familiares, pior o estado nutricional do lactente (Rho = -0,294; p-valor = 0,004) e a altura do lactente para a idade esteve relacionada com a visita da mãe ao nutricionista (p-valor = 0,018). Conclusão: quanto maior o número de membros na família pior o estado nutricional do lactente. No peso para idade e altura para idade do lactente foi encontrada relação com a visita ao nutricionista.

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Mother-infant bonding is influenced by several risk and protective factors, and the literature has investigated the relationships between these factors independently. This study aimed to verify the interrelationships of some of these factors and how they influence mother-infant bonding in Brazil. In this study, 361 mothers participated, and the outcome variable of mother-infant bonding was assessed using the Postpartum Bonding Questionnaire (PBQ). Multivariate regression analysis was performed using a hierarchical model with three blocks structured according to the influence exerted on mother-infant bonding. The PBQ's factor scores were estimated and used in the subsequent analyses to decrease measurement error. The variable "violence experienced by mothers" was statistically significant for explaining the second block model but not significant for the third block. Network analysis was performed after multiple regression, showing that the violence experienced by mothers does not directly influence mother-infant bonding but rather is mediated by postpartum depression. This explains why violence is not significant in the hierarchical multiple regression when maternal depression is added to the model. This study's strengths lie in its utilization of PBQ factor scores and network analysis, enabling the estimation of conditional relationships among variables. This approach provides deeper insights into factors affecting mother-infant bonding.

Varios factores de riesgo y de protección ejercen influencia sobre la unión afectiva madre­infante; la literatura disponible ha investigado las relaciones entre estos factores de una manera independiente. Este estudio se propuso verificar las interrelaciones de algunos de estos factores y cómo ellos influyen en la unión afectiva madre­infante. Se consultó un total de 361 madres y el variable resultado de afectividad madre­infante se evaluó por medio del Cuestionario de Afectividad de Postparto (PBQ). Se llevaron a cabo análisis de regresión multivariados usando un modelo jerárquico con tres estructuras de bloques de acuerdo con la influencia ejercida sobre la unión afectiva madre­infante. Se estimaron y usaron los puntajes de factores del PBQ en los análisis subsecuentes para disminuir el error en la medida. La variable "violencia experimentada por las madres" fue estadísticamente significativa para explicar el segundo modelo de bloque, pero no significativa para el tercer bloque. Se llevó a cabo un análisis de interrelaciones después de la regresión múltiple, demostrando que la violencia experimentada por las madres no influye directamente la afectividad madre­infante, sino que la misma es mediada por la depresión posterior al parto. Esto explica por qué la violencia no es significativa en la jerárquica regresión múltiple cuando la depresión materna se le agrega al modelo. Entre los puntos fuertes de este estudio se incluye el uso de los puntajes de factores del PBQ y el análisis de interrelaciones, lo cual permitió que se estimaran las relaciones condicionales existente dentro del grupo de variables, aportando una mayor comprensión de algunos factores que interfieren en la unión afectiva madre­infante.

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Early infant development is a maturation process critically depends on the infant's interaction with primary caregivers. Hence, neonatal units prioritize their proximity. In COVID-19, parental visitation hours were limited, reducing caregivers time with their infants. This follow-up study analyzes and compares levels of maternal depression and stress, infant development, and bonding quality in preterm mother-infant dyads hospitalized, before and during the pandemic. Out of 66 dyads participated, 36 were admitted before COVID-19, and 30 during COVID-19. The assessed was two video-call sessions in which mothers completed selected questionnaires. No significant differences between mothers' levels of depression and stress. However, low birth weight was associated with greater difficulties in children's communication and interpersonal relationships. Furthermore, infants hospitalized in COVID-19 had a higher risk of experiencing delayed communication. No significant differences were observed in bonding quality. Lower infant gestational age and longer breastfeeding time were associated with better bonding quality in both groups. Psychosocial intervention is considered a valuable tool, capable of preventing maternal mental health difficulties and protecting bonding in premature infants and in highly complex healthcare settings. Nevertheless, it is essential to more actively address the socio-affective needs of newborns during their hospital stay to promote adequate development.

El desarrollo infantil temprano es un proceso de maduracion que depende críticamente de la interacción del infante consus cuidadores primarios. Por tal razón, en las unidades neonatales priorizan su proximidad. Durante el COVID­19, se limitaron las horas de visitas de los progenitores, lo que redujo el tiempo que los cuidadores con sus bebés. Este estudio de seguimiento analiza y compara el nivel de depresión y estrés materno, el desarrollo infantil y la calidad del vínculo afectivo en díadas madre­bebé prematuro hospitalizado al nacer, antes y durante la pandemia. De las 66 díadas participantes, 36 fueron admitidas antes del COVID­199 y a 30 durante el COVID­19. Se realizaron dos sesiones de vídeo­llamada, en las que las madres completaron los cuestionarios seleccionados. No se encontró ninguna diferencia significativa entre los niveles de depresión y estrés en las madres. Sin embargo, un bajo peso al nacer se asoció con mayores dificultades en la comunicación y las relaciones interpersonales en los niños. Además, los infantes hospitalizados durante el COVID­19 presentaron mayor riesgo de experimentar retrasos en la comunicación. No se observaron diferencias significativas en la calidad del vínculo afectivo. Una menor edad gestacional del infante y mayor tiempo de lactancia materna se asociaron con una mejor calidad del vínculo afectivo en ambos grupos. Se considera la intervención psicosocial como una herramienta de valor, capaz de prevenir dificultades en la salud mental materna y de proteger el vínculo afectivo en infantes nacidos prematuramente y en entornos sanitarios altamente complejos. Sin embargo, es esencial abordarmás activamente las necesidades socioafectivas de los recién nacidos durante su estadía en el hospital para promover un desarrollo adecuado.

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BACKGROUND: Lifestyle and habits, cardiovascular risk factors (CRF), bone and mental health, dietary habits, physical activity, among others are developed in childhood and adolescence. Family environment has shown to play an important role in these outcomes. However, whether the parent-child relationship lifestyle habits and health parameters can be influenced by physical activity patterns still unclear. The objective of this study will be to monitor and investigate the associations between lifestyle habits between parents and their children longitudinally, as well as verify whether in more active parents, the possible associations with lifestyle habits are different from those of parents considered less active. METHODS: The sample will consist of parents (father, mother, or both) and their children /adolescents. The participants will be recruited through public call by flyers spread across all the regions of the city and also through social media. The health parameters will include cardiovascular (cardiac autonomic modulation, blood pressure and resting heart rate), bone mineral density, anthropometric indices, handgrip strength, mental health (quality of life, anxiety and depression symptoms and stress), self-reported morbidities and musculoskeletal pain. Lifestyle habits will include physical activity levels, sedentary behavior, sleep parameters, eating patterns, smoking and alcohol consumption. Sociodemographic variables of age, sex, ethnicity and socioeconomic status will be considered as covariates. The follow-up visits of data collection will be scheduled after a period of 12 months from the baseline assessment during every twelve months. DISCUSSION: The family environment has great potential to determine lifestyle habits in children and adolescents. Based on the results presented in the present study, we hope that health promotion actions can be better designed in the family environment.

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Abstract Objective: Emergence delirium is a common complication in children. Recorded mother's voice, as a non-pharmacological measure, is increasingly used to prevent the emergence of delirium in pediatric patients, but sufficient evidence is still needed to prove its efficacy. Methods: Embase, PubMed, Cochrane Library, Web of Science, CINAHL, and Sinomed databases were searched for randomized controlled trials exploring the efficacy of recorded mother's voice in preventing the emergence of delirium in pediatric patients undergoing general anesthesia. The original data were pooled for the meta-analysis with Review Manager 5.4.1. This study was conducted based on the Cochrane Review Methods. Results: Eight studies with 724 children were included in the analysis. Recorded mother's voice reduced the incidence of emergence delirium when compared with either no voice (RR: 0.45; [95 % CI, 0.34 - 0.61]; p < 0.01; I2 = 7 %) or stranger's voice (RR: 0.51; [95 % CI, 0.28 - 0.91]; p = 0.02; I2 = 38 %) without increasing other untoward reactions. In addition, it shortened the post-anesthesia care unit stay time when compared with no voice (MD = -5.64; [95 % CI, -8.43 to -2.58]; p < 0.01, I2 = 0 %), but not stranger's voice (MD = -1.23; [95 % CI, -3.08 to 0.63]; p = 0.19, I2 = 0 %). It also shortened the extubation time and reduced the incidence of postoperative rescue analgesia. Conclusion: The current analysis indicated that recorded mother's voices could reduce the incidence of emergency delirium, shorten post-anesthesia care unit stay time and extubation time, and decrease the incidence of postoperative rescue analgesia in children.

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Introdução: A Língua Brasileira de Sinais (Libras) é uma língua de natureza visuo-motora com um sistema linguístico e estrutura gramatical próprio e sua aquisição em tempo oportuno é importante para o desenvolvimento cognitivo e comunicativo da criança surda. As famílias ouvintes de crianças surdas devem se engajar no aprendizado dessa língua, uma vez que na ausência do conhecimento da Libras, podem apresentar dificuldades de comunicação e de relacionamento com seu filho surdo. Objetivo: O objetivo deste estudo foi compreender o papel da Libras na comunicação de familiares ouvintes e seus filhos surdos atendidos em um centro de reabilitação. Métodos: Trata-se de um estudo transversal, de caráter qualitativo. Foi aplicado um roteiro de entrevista semiestruturado com 10 questões abertas a pais ouvintes de crianças surdas que participam de atendimentos em um centro de reabilitação. A análise dos dados foi realizada por meio do método análise de conteúdo. Resultados: Ao todo foram entrevistadas 10 mães de crianças surdas. As idades das mães variaram de 21 a 47 anos. Nove mães afirmaram usar a Libras em casa com seus filhos todos os dias e todas relataram usá-la em atividades cotidianas da criança. Todas as mães afirmaram que o uso da Libras trouxe benefícios para o relacionamento na díade mãe-filho. Conclusão: Os achados revelam um importante papel da Libras tanto na comunicação de familiares ouvintes e seus filhos surdos, como no cotidiano desses lares. (AU)

Introduction: The Brazilian Sign Language (Libras) is a visual-motor language with its linguistic system and grammatical structure and its timely acquisition is important for deaf children's cognitive and communicative development. Deaf children's hearing families should engage in learning this language, since not knowing Libras may lead to communication and relationship difficulties with their deaf children. Objective: This study aimed to understand the role of Libras in the communication between hearing family members and their deaf children treated at a rehabilitation center. Methods: This cross-sectional qualitative study applied a semi-structured interview with 10 open-ended questions to hearing parents of deaf children who receive care at a rehabilitation center. Data were analyzed with the content analysis method. Results: Altogether, 10 mothers of deaf children were interviewed. Their ages ranged from 21 to 47 years. Nine mothers said they used Libras at home with their children every day, and all reported using it in their child's daily activities. All mothers stated that the use of Libras brought benefits to the mother-child relationship. Conclusion: The findings highlight the important role of Libras in the daily lives and communication of hearing family members and their deaf children. (AU)

Introducción: La Lengua de Señas Brasileña (Libras) es una lengua visomotora con sistema lingüístico y estructura gramatical propios y su adquisición oportuna es importante para el desarrollo cognitivo y comunicativo del niño sordo. Las familias oyentes de niños sordos deben involucrarse en el aprendizaje de este idioma, ya que en ausencia del conocimiento de Libras, pueden tener dificultades en la comunicación y las relaciones con su hijo sordo. Objetivo: El objetivo de este estudio fue comprender el papel de Libras en la comunicación de los familiares oyentes y sus hijos sordos atendidos en un centro de rehabilitación auditiva. Métodos: Se trata de un estudio transversal, cualitativo. Se aplicó un guión de entrevista semiestructurada con 10 preguntas abiertas a padres oyentes de niños sordos que participan en el cuidado en un centro de rehabilitación. El análisis de los datos se realizó mediante el método de análisis de contenido. Resultados: En total, se entrevistaron 10 madres de niños sordos. Las edades de las madres oscilaron entre 21 y 47 años. Nueve madres dijeron que usan Libras en casa con sus hijos todos los días y todas informaron que lo usan en las actividades diarias de sus hijos. Todas las madres afirmaron que el uso de Libras trajo beneficios a la relación madre-hijo. Conclusión: Los hallazgos revelan un papel importante de Libra tanto en la comunicación de los miembros oyentes de la familia y sus hijos sordos, como en la vida diaria de estos hogares. (AU)

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This research reviews the phenomenon of extractive deforestation as a possible trigger for cascade reactions that could affect part of the forest ecosystem and its biodiversity (surface, aerial, and underground) in tropical, subtropical, and boreal forests. The controversy and disparities in criteria generated in the international scientific community around the hypothesis of a possible link between "mother trees" and mycorrhizal networks in coopetition for nutrients, nitrogen, and carbon are analyzed. The objective is to promote awareness to generate more scientific knowledge about the eventual impacts of forest extraction. Public policies are emphasized as crucial mediators for balanced sustainable development. Currently, the effects of extractive deforestation on forest ecosystems are poorly understood, which requires caution and forest protection. Continued research to increase our knowledge in molecular biology is advocated to understand the adaptation of biological organisms to the new conditions of the ecosystem both in the face of extractive deforestation and reforestation. The environmental impacts of extractive deforestation, such as the loss of biodiversity, soil degradation, altered water cycles, and the contribution of climate change, remain largely unknown. Long-term and high-quality research is essential to ensure forest sustainability and the preservation of biodiversity for future generations.

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Objective: To systematically review studies examining the effects of home-visiting preventive parenting programs (HV-PPs) on improving the quality of mother-child interactions in early childhood. Method: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol, we identified 3,586 studies published between 2018 and 2022 by searching the following databases: PubMed, Web of Science, BVS/LILACS, SciELO, and PsycNET/PsycINFO. After applying the eligibility criteria, 17 articles were selected for review. Results: Most studies were conducted in high-income countries (53%) and the remainder were conducted in upper-middle-income countries, predominantly using a randomized controlled trial design and with strong methodological quality. The 17 studies applied 13 different HV-PPs, predominantly using video feedback, based on various dosages and schedules. Most studies (77%) showed significant positive effects on mother-child interactions by improving mainly positive maternal behaviors (e.g., sensitivity and responsiveness). Positive effects occurred independent of the study design, sample characteristics, measures, and constructs assessed. However, the findings suggest that the combination of fewer than six sessions, durations shorter than three months, and a very early start did not impact mother-child interactions, as expected. Few studies have explored negative maternal behaviors, children's behaviors, and dyadic interactions such as mutuality and synchrony. Conclusions: HV-PPs positively impacted mother-child interactions in early childhood despite the large heterogeneity across program designs, outcome measures, and overlapping constructs. Based on the results, we discuss the practical and economic implications of using parenting programs as a preventive approach.

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There is still very limited evidence on the effects of neonatal interventions on infant neurodevelopmental outcomes, including general movements (GMs). This research will primarily assess the effects of a sensory motor physical therapy intervention combined with kangaroo skin-to-skin contact on the GMs of hospitalized preterm newborns. Secondary outcomes include body weight, posture and muscle tone, behavioral state, length of hospital stay, and breastfeeding. This study protocol details a two-arm parallel clinical trial methodology, involving participants with a postmenstrual age of 34-35 weeks admitted to a Neonatal Intermediate Care Unit (NInCU) with poor repertoire GMs. Thirty-four participants will be randomly assigned to either the experimental group, receiving a 10-day sensory motor physical therapy associated with kangaroo skin-to-skin contact, or the control group, which will only receive kangaroo skin-to-skin contact. The study will measure GMs (primary outcome), and body weight, posture and muscle tone, behavioral state, length of hospital stay, and breastfeeding (secondary outcomes). Data collection occurs in the NInCU before and after the intervention, with follow-up measurements post discharge at 2-4 weeks and 12-15 weeks post-term. SPSS will be used for data analyses. The results will provide novel information on how sensory motor experiences may affect early neurodevelopment and clinical variables in preterm newborns.

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Abstract Introduction: The Kangaroo Baby Massage (KBM) is a technique designed for preterm and low birth weight newborns that eliminates the need for an incubator, providing a practical and beneficial option for mothers at home. Objective: To test the effect of the KBM on perceived maternal self-efficacy favoring the mother-infant interaction at home. Materials and methods: A pragmatic, double-blind, randomized clinical trial was conducted in three phases: 1) KBM integration with Kathryn Barnard's theory, 2) study design, and 3) implementation and outcome evaluation. Two groups were defined: The intervention group (KBM) and the control group (which used the kangaroo position without massage), each group consisted of 34 mother-infant pairs. Recruitment took place within an outpatient kangaroo program in Bogota, Colombia. Implementation and follow-up were conducted via teleconsultation, using the KBM video "Diary of My Kangaroo Baby" and simulators. The perceived maternal self-efficacy questionnaire was conducted at three points in time: prior to the study and on the 7th and 14th day after the study. The questionnaire was analyzed with a statistical design of longitudinal data in F1LDF1 factorial experiments. Results: Homogeneous groups were defined based on sociodemographic variables and maternal-perinatal history. Mothers who applied the KBM technique showed higher scores in perceived maternal self-efficacy at both 7 and 14 days compared to the control group mothers [RTE (lower limit; upper limit) - day 7: control = 0.502 (0.437; 0.567) vs. KBM = 0.503 (0.426; 0.581), and day 14: control = 0.564 (0.482; 0.640) vs. KBM = 0.719 (0.650; 0.776)]. Conclusion: The KBM is a nursing intervention that enhances perceived maternal self-efficacy, fostering greater family involvement and strengthening mother-child interaction.

Resumen Introducción: El masaje al bebé canguro (MBC) es una técnica para recién nacidos pretérmino y bajo peso al nacer que no requiere incubadora y favorece a las madres en el hogar. Objetivo: Probar el efecto del MBC sobre la autoeficacia materna percibida para favorecer la interacción madre-hijo en el hogar. Materiales y métodos: Ensayo clínico aleatorizado pragmático, doble ciego, desarrollado en tres fases: 1) integración MBC y teoría de Kathryn Barnard, 2) diseño del estudio y 3) ejecución y resultados. Se definieron dos grupos: intervención (MBC) y control (posición canguro sin masaje), con 34 diadas madre-hijo en cada grupo. Reclutamiento realizado en un programa canguro ambulatorio de Bogotá, Colombia. La ejecución y el seguimiento fue hecha a través de teleconsulta, el video MBC "Diario de mi bebé canguro" y simuladores. Se aplicó el cuestionario de autoeficacia materna percibida en tres momentos: antes de iniciar el estudio y a los días 7 y 14 después del estudio. Se analizó con un diseño estadístico de datos longitudinales en experimentos factoriales F1LDF1. Resultados: Fueron definidos grupos homogéneos en las variables sociodemográficas y de antecedentes materno-perinatales. Las madres que aplicaron el MBC registraron puntajes más altos de autoeficacia materna percibida a los 7 y 14 días, en comparación con las madres del control [RTE (límite inferior; límite superior) - día 7: control = 0.502 (0.437; 0.567) vs. MBC = 0.503 (0.426; 0.581), y día 14: control = 0.564 (0.482; 0.640) vs. MBC = 0.719 (0.650; 0.776)]. Conclusión: El MBC es una intervención de enfermería que mejoró la autoeficacia materna percibida, favoreciendo la participación de la familia y la interacción madre-hijo.

Resumo Introdução: A massagem no bebê canguru (MBC) é uma técnica para bebês prematuros e de baixo peso que não necessita de incubadora e que dá apoio às mães no domicílio. Objetivo: Testar o efeito da MBC na autoeficácia materna percebida para apoiar a interação mãe-bebê em casa. Materiais e método: Ensaio clínico randomizado, pragmático, duplo-cego, desenvolvido em três fases: i) integração da MBC e da teoria de Kathryn Barnard, ii) desenho do estudo e iii) execução e resultados. Foram definidos dois grupos: intervenção (MBC) e controle (posição canguru sem massagem), com 34 díades mãe-bebê em cada grupo. O recrutamento foi realizado em um programa canguru ambulatorial em Bogotá, Colômbia. A implementação e o acompanhamento foram feitos por meio de teleconsultas, do vídeo MBC "Diário do meu bebê canguru" e de simuladores. O questionário de autoeficácia materna percebida foi aplicado em três momentos: antes do início do estudo e nos dias 7 e 14 após o estudo. Ele foi analisado com um projeto estatístico de dados longitudinais em experimentos fatoriais F1LDF1. Resultados: Foram definidos grupos homogêneos para variáveis sociodemográficas e histórico ma-terno-perinatal. As mães que aplicaram o MBC registraram pontuações mais altas de autoeficácia materna percebida aos 7 e 14 dias, em comparação com as mães do controle [RTE (limite inferior; limite superior) - dia 7: controle = 0,502 (0,437; 0,567) vs. MBC = 0,503 (0,426; 0,581), e dia 14: controle = 0,564 (0,482; 0,640) vs. MBC = 0,719 (0,650; 0,776)]. Conclusões: a MBC é uma intervenção de enfermagem que melhorou a autoeficácia materna percebida, favorecendo o envolvimento familiar e a interação entre mãe e filho.

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Objetivo: analisar as transformações na prática do cuidado ao recém-nascido e família a partir da disseminação do Método Canguru. Método: pesquisa qualitativa, do tipo história oral, realizada no estado de Santa Catarina, no período de janeiro a novembro de 2019. As fontes foram 12 profissionais de saúde. Os dados foram organizados com software Atlas.tiCloud®, analisados à luz do referencial foucaultiano. Resultados: evidenciou-se mudança de paradigma no cuidado neonatal, sendo o cuidado individualizado e centrado na família um dos pilares do método, com inclusão dos pais e avós na rede de apoio familiar. Os profissionais despertaram para os cuidados relacionados à ambiência da unidade. A educação permanente mostrou-se importante estratégia de monitoramento das ações. Considerações finais: a mudança de paradigma ocorreu de forma processual, influenciando a vida das famílias, com transformações da prática do cuidado neonatal e inclusão dos pais e familiares. A educação permanente fortalece a implementação do método.

Objective: to analyze the transformations in practice of care for newborns and families following the Kangaroo-Mother Care Method dissemination. Method: qualitative research, of the oral history type, carried out in the state of Santa Catarina, from January to November 2019. The sources were 12 healthcare professionals. The data was organized with Atlas.tiCloud® software, analyzed using Foucault's framework. Results: a paradigm shift in neonatal care was evident, with individualized and family-centered care being one of the pillars of the method, with the inclusion of parents and grandparents in the family support network. Professionals woke up to care related to the unit ambiance. Continuing education proved to be an important strategy for monitoring actions. Final considerations: a paradigm shift occurred procedurally, influencing families' lives, with transformations in neonatal care practice and inclusion of parents and family members. Continuing education strengthens the implementation of the method.

Objetivo: analizar las transformaciones en la práctica del cuidado al recién nacido y a las familias a partir de la difusión del Método Madre-Canguro. Método: investigación cualitativa, del tipo historia oral, realizada en el estado de Santa Catarina, de enero a noviembre de 2019. Las fuentes fueron 12 profesionales de la salud. Los datos fueron organizados con el software Atlas.tiCloud®, analizados utilizando el marco foucaultiano. Resultados: se evidenció un cambio de paradigma en la atención neonatal, siendo la atención individualizada y centrada en la familia uno de los pilares del método, con la inclusión de padres y abuelos en la red de apoyo familiar. Los profesionales tomaron conciencia del cuidado relacionado con el ambiente de la unidad. La educación continua resultó ser una estrategia importante para el seguimiento de las acciones. Consideraciones finales: el cambio de paradigma ocurrió de manera procesal, influyendo en la vida de las familias, con transformaciones en la práctica del cuidado neonatal y la inclusión de padres y familiares. La educación continua fortalece la implementación del método.

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Background: Mother's own milk (MOM) provides health benefits for infants with very low birth weight (VLBW). This study aimed to describe the incidence and factors associated with low volumes of MOM (<50% of total diet volume) at discharge for VLBW infants. Methods: A prospective cohort study of infants with VLBW and gestational age of <30 weeks, who survived to discharge and had no contraindication to MOM. We conducted bivariate analyses to investigate associations with the volume of MOM at discharge, using chi-square, t, and Mann-Whitney tests. All p-value analyses were two-tailed. The variables significantly associated with "low volumes of MOM" entered the multivariable analysis. Univariate and multivariate relative risk (confidence interval [CI] 95%) estimates were obtained from Poisson regression with a robust estimate of variance and controlled by the length of hospital stay. Results: Of 414 infants included and followed until discharge, 32.9% (n = 136) received less than 50% of the total daily volume of MOM. This outcome was associated with gestational age <28 weeks, lower birth weight, multiple births, developing bronchopulmonary dysplasia, and longer lengths of stay. After Poisson regression, low volumes of MOM at discharge were associated only with being born multiples (RR 2.01; CI 95% 1.53-2.64, p < 0.001) and with longer length of stay (RR 1.07; CI 95% 1.01-1.14, p = 0.01). Conclusions: Most VLBW infants were discharged home receiving predominantly MOM. Each neonatal intensive care unit (NICU) should acknowledge which clinical characteristics of mothers and VLBW infants are associated with difficulties maintaining MOM volumes until discharge.

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Extensive research has shown that breastfeeding offers many benefits to children, including advantages in lifelong health, physical development, cognitive function, behavior, and brain development, compared to those not breastfed. In the Dominican Republic, the prevalence of exclusive breastfeeding among infants aged 0-6 months remains low, and the lack of a surveillance system has made it challenging to measure the impact of breastfeeding on early childhood development (ECD). This study aims to address the effect of ever breastfeeding on ECD. We conducted secondary data analysis from the Dominican System for Measuring Early Childhood Development (SIMEDID), a screening tool adapted and validated to the Dominican context that measures four areas of development: gross-motor, fine-motor, language, and socioemotional development. The data from SIMEDID can be cross-analyzed with other datasets generated by the National Institute for Early Childhood Comprehensive Care (INAIPI) that include information about breastfeeding. The children were evaluated during the standardization study of SIMEDID. To determine the breastfeeding impact, we: 1) conducted an analysis of covariance using ECD scores as dependent variables and ever breastfed as the independent variable, with age and sex as covariates (previously confirmed with an analysis of variance indicating the relevance of age and sex at birth in ECD); 2) analyzed the relative risk (RR) of developmental delay by breastfeeding status. We studied a sample of 699 Dominican children aged 12-36 months who receive services at INAIPI (the government institution responsible for administering comprehensive early childhood services). The results show that ever breastfed children had higher scores in overall ECD than those who were not; higher scores in language and fine motor development primarily drove this effect. The never breastfed group had a greater risk of developmental delay in fine motor and socioemotional development. These findings underscore the importance of promoting and supporting breastfeeding to improve child neurodevelopmental outcomes. This is particularly relevant in low-resource settings, where mothers may need additional support. Moreover, the study's results provide evidence of SIMEDID's validation, which can help inform future research and evidence-based decision-making toward optimal ECD in similar contexts.

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