Brecha digital en cuidadores de pacientes pediátricos de 0 a 12 años. Diseño y validación de un cuestionario / The digital divide among caregivers of pediatric patients aged 0 to 12 years. Design and validation of a questionnaire

Introducción. Las estrategias sanitarias basadas en tecnologías de la información y la comunicación (TIC) podrían perpetuar la inequidad en salud, especialmente en poblaciones vulnerables. Existen escasas herramientas validadas para evaluar el acceso a las TIC en pediatría en nuestro medio. Objetivos. Construir y validar un cuestionario para evaluar el acceso a las TIC para cuidadores de pacientes pediátricos. Describir las características de acceso a las TIC y evaluar si existe correlación entre los tres niveles de la brecha digital. Población y métodos. Construimos y validamos un cuestionario que luego administramos a cuidadores de niños entre 0 y 12 años. Las variables de resultado fueron las preguntas del cuestionario para los tres niveles de brecha digital. Además, evaluamos variables sociodemográficas. Resultados. Administramos el cuestionario a 344 cuidadores. El 93 % poseía celular propio y el 98,3 % utilizaba internet por red de datos. El 99,1 % se comunicaba a través de mensajes de WhatsApp. El 28 % había realizado una teleconsulta. La correlación entre las preguntas fue nula o baja. Conclusión. Por medio del cuestionario validado, evaluamos que los cuidadores de pacientes pediátricos de 0 a 12 años poseen en su mayoría celular, se conectan por red de datos, se comunican principalmente a través de WhatsApp y obtienen pocos beneficios a través de TIC. La correlación entre los diferentes componentes del acceso a las TIC fue baja.

Introduction. Health care strategies based on information and communication technologies (ICTs) may perpetuate health inequity, especially among vulnerable populations. In our setting, there are few validated tools to assess access to ICTs in pediatrics. Objectives. To develop and validate a questionnaire to assess ICT access among caregivers of pediatric patients. To describe the characteristics of ICT access and assess whether there is a correlation among the three levels of the digital divide. Population and methods. We developed and validated a questionnaire and then administered it to the caregivers of children aged 0­12 years. The outcome variables were the questions in the three levels of the digital divide. We also assessed sociodemographic variables. Results. We administered the questionnaire to 344 caregivers. Among them, 93% had their own cell phone and 98.3% had Internet access via a data network; 99.1% communicated via WhatsApp messages; 28% had had a teleconsultation. The correlation among the questions was null or low. Conclusion. The validated questionnaire allowed us to establish that the caregivers of pediatric patients aged 0­12 years mostly own a mobile phone, access the Internet via a data network, communicate mainly through WhatsApp, and obtain few benefits through ICTs. The correlation among the different components of ICT access was low.

Experiencias del cuidador familiar con la utilización de las Tecnologías de la Información y la Comunicación: Implementación de una intervención educativa / Experiences of the family caregiver with the use of Information and Communication Technologies: Implementation of an educational intervention

Introducción: Las Tecnologías de la Información y Comunicación (TICs) son un recurso a través del cual los profesionales de la salud pueden proporcionar apoyo y asesoría a distancia. Objetivo: Describir las experiencias de una cuidadora familiar (CF) con el uso de las TICs en la implementación de una intervención educativa como apoyo para su autocuidado y el cuidado del adulto mayor (AM). Metodología: Estudio de caso con abordaje cualitativo. Una pasante de la licenciatura en Enfermería y Obstetricia implementó una intervención educativa en una CF del 15 diciembre 2020 al 25 junio 2021, periodo de pandemia por COVID-19. La recolección de datos se realizó a partir de entrevistas a profundidad, mensajes de texto y voz de WhatsApp, así como por observación. Se realizó análisis de contenido tipo temático según de Souza Minayo. Resultados: Se identificó el teléfono celular como el dispositivo más utilizado, las funciones de videollamada y mensaje de voz de WhatsApp como las herramientas más útiles y preferidas por la CF, y las infografías y videos como los materiales educativos más adecuados para esta población. Limitaciones: Solo se incluyó una CF y un AM, lo cual puede generar un sesgo de respuesta, ya que la CF quizás estuvo más motivada y dispuesta a participar que otros cuidadores hipotéticos. Valor: Implementar un nuevo canal de comunicación entre el profesional de enfermería, el AM, la CF y otros familiares. Conclusiones: El uso de las TICs fue aceptado por la CF para recibir capacitación en su autocuidado y cuidado del AM.

Introduction: Health professionals can use Information and Communication Technologies (ICTs) to provide support and advice at a distance. Objective: Description of the experiences of a family caregiver (FC) with the use of ICTs in the implementation of an educational intervention to support her self-care and the care of the Older Adult (OA). Methodology: Case study with qualitative approach. An undergraduate intern in Nursing and Midwifery implemented an educational intervention with a FC from December 15, 2020 to June 25, 2021, during the covid-19 pandemic. Data collection was gathered with in-depth interviews, Whatsapp text and voice messages, as well as direct observation. Thematic type content analysis was performed according to de Souza Minayo. Results: The cell phone was identified as the most used device, Whatsapp video call and voice message functions as the most useful and preferred tools by the FC, and infographics and videos as the most appropriate educational materials for this population. Limitations: Only one female FC and one male OA were included in this study. This may generate response bias, as the FC was perhaps more motivated and willing to participate than other hypothetical caregivers. Value: Implementation of a new communication channel between the nursing professional, the OA, the FC, and other family members. Conclusions: Training in the use of ICTs was accepted by the FC to improve her self-care and care of the OA.

Exposición a pantallas de niñas, niños y adolescentes: recomendaciones, límites y controversias en el marco del distanciamiento social obligatorio: un estudio cualitativo / Child and Teenage Screen Exposure: Recommendations, Limits,and Controversies in the Context of Enforced Social Distancing: a Qualitative Study

Introducción: la utilización de pantallas durante la niñez y la preocupación por su potencial daño aumentaron en los últimos años. La recomendación de no superar dos horas diarias de uso resultó controvertida durante la pandemia por COVID-19. El objetivo principal de esta investigación fue explorar las opiniones y actitudes de los profesionales con respecto al uso de pantallas y comprender cómo se modificaron durante dicha pandemia. Materiales y métodos: estudio exploratorio con enfoque cualitativo y estrategia de teoría fundamentada, realizado entre 2020 y 2021.Participaron 23 profesionales (pediatras y generalistas) en cuatro grupos focales. Se realizaron lecturas del material desgrabado para interpretación del contenido. El análisis incluyó la generación de códigos que fueron agrupados en cinco ejes temáticos. Resultados: los ejes resultantes fueron: 1) temática de las pantallas en la consulta ambulatoria de niños sanos, 2) percepción sobre daños, 3) percepción sobre beneficios, 4) pantallas en épocas de ASPO (Aislamiento Social Preventivo y Obligatorio) y 5) pensamientos y acciones contradictorios sobre el uso de pantallas. Discusión: a la hora de recomendar sobre exposición a pantallas, en nuestros entrevistados predominó la intuición personal por sobre la evidencia científica disponible. Reconocieron que el contexto de ASPO visibilizó algunos beneficios asociados a la conectividad que brindan estos dispositivos. Conclusión: nuestros resultados muestran que la percepción sobre las pantallas se está volviendo cada vez más neutral en términos del balance entre sus riesgos y beneficios, conduciendo a que los profesionales sean más flexibles en sus recomendaciones al respecto. (AU)

Introduction: screen use during childhood and potential harm concerns have increased in recent years. Advice not to allow more than two hours of screen use per day was contested during the COVID-19 pandemic. The primary purpose of this research was to probe the opinions and attitudes of professionals regarding the use of screens and to understand how these changed during the pandemic. Materials and methods: this exploratory study, with a qualitative approach and theory-based strategy, was made between 2020 and 2021, and involved the participation of 23 professionals (pediatricians and general practitioners) in four focus groups. The recorded material was analyzed for content interpretation. The analysis included generating codes that were grouped into five thematic areas. Results: the resulting axes were: 1) the issue of screens in the outpatient practice of healthy children; 2) perception of harm; 3) perception of benefits; 4) screens in times of Preventive and Compulsory Social Isolation (ASPO, for its acronym in Spanish); and 5) contradictory thoughts and actions on the use of screens. Discussion: when making recommendations regarding screen exposure, the interviewees' intuition predominated over available scientific evidence. They recognized that the ASPO context highlighted some of the benefits associated with the connectivity provided by these devices. Conclusion: our results show that awareness of screen displays is becoming increasingly neutral concerning the trade-off between their risks and benefits, prompting practitioners to become more flexible in their recommendations. (AU)

Mobile phones of anesthesiologists as reservoirs of nosocomial bacteria in a quaternary teaching hospital: an observational study

Abstract Background: Mobile phones in hospital settings have been identified as an important source of cross-contamination because of the low frequency with which mobile phones are cleaned by health workers and cyclical contamination of the hands and face. The aim of this study was to investigate whether the mobile phones of the anesthesia team at a teaching hospital are potential reservoirs of nosocomial bacteria. In addition, differences in device sanitization and hand hygiene habits between attending and resident anesthesiologists were correlated with mobile phone colonization. Methods: A prevalence study was conducted over a 6-month period from 2017 to 2018 that involved the collection of samples from the mobile phones of the anesthesiology team and culturing for surveillance. A questionnaire was administered to assess the mobile phone sanitization and hand washing routines of the anesthesia team in specific situations. Results: Bacterial contamination was detected for 86 of the 128 mobile phones examined (67.2%). A greater presence of Micrococcus spp. on devices was correlated with a higher frequency of mobile phone use (p = 0.003) and a lower frequency of sanitization (p = 0.003). The presence of bacteria was increased on the mobile phones of professionals who did not perform handwashing after tracheal intubation (p = 0.003). Conclusion: Hand hygiene and device sanitization habits were more important than the use behavior, as a higher presence of bacteria correlated with poorer hygiene habits. Furthermore, handwashing is the best approach to prevent serious colonization of mobile devices and the possible transmission of pathogens to patients under the care of anesthesiologists.

Development and application syndromic surveillance and early warning system in border area in Yunnan Province / 中华流行病学杂志

Objective: To establish a dynamic syndromic surveillance system in the border areas of Yunnan Province based on information technology, evaluate its effectiveness and timeliness in the response to common communicable disease epidemics and improve the communicable disease prevention and control in border areas. Methods: Three border counties were selected for full coverage as study areas, and dynamic surveillance for 14 symptoms and 6 syndromes were conducted in medical institutions, the daily collection of information about students' school absence in primary schools and febrile illness in inbound people at border ports were conducted in these counties from January 2016 to February 2018 to establish an early warning system based on mobile phone and computer platform for a field experimental study. Results: With syndromes of rash, influenza-like illness and the numbers of primary school absence, the most common communicable disease events, such as hand foot and mouth disease, influenza and chickenpox, can be identified 1-5 days in advance by using EARS-3C and Kulldorff time-space scanning models with high sensitivity and specificity. The system is easy to use with strong security and feasibility. All the information and the warning alerts are released in the form of interactive charts and visual maps, which can facilitate the timely response. Conclusions: This system is highly effective and easy to operate in the detection of possible outbreaks of common communicable diseases in border areas in real time, so the timely and effective intervention can be conducted to reduce the risk of local and cross-border communicable disease outbreaks. It has practical application value.

Maternal mobile phone screen time during pregnancy and children's internalizing and externalizing behavioral problems / 中华预防医学杂志

The behavioral problems of children and adolescents are becoming more and more serious, and the prevalence rate is increasing year by year. The overall trend is increasing, which has become one of the important public health issues of global concern. There are many influencing factors for behavioral problems in children and adolescents, including genetic, psychosocial, family and early life environment. Among them, maternal screen exposure during pregnancy is a contributing factor that deserves attention and has practical intervention significance. This study systematically evaluated the association between maternal mobile phone screen time during pregnancy and children's internalizing and externalizing behavioral problems, its potential biological mechanisms and relevant intervention measures, in order to create a good intrauterine environment for fetal neurodevelopment and further reduce the occurrence of children's behavioral problems.

Maternal mobile phone screen time during pregnancy and children's internalizing and externalizing behavioral problems / 中华预防医学杂志

The behavioral problems of children and adolescents are becoming more and more serious, and the prevalence rate is increasing year by year. The overall trend is increasing, which has become one of the important public health issues of global concern. There are many influencing factors for behavioral problems in children and adolescents, including genetic, psychosocial, family and early life environment. Among them, maternal screen exposure during pregnancy is a contributing factor that deserves attention and has practical intervention significance. This study systematically evaluated the association between maternal mobile phone screen time during pregnancy and children's internalizing and externalizing behavioral problems, its potential biological mechanisms and relevant intervention measures, in order to create a good intrauterine environment for fetal neurodevelopment and further reduce the occurrence of children's behavioral problems.

Exposure to Electromagnetic Fields from Mobile Phones and Fructose consumption Coalesce to Perturb Metabolic Regulators AMPK/SIRT1-UCP2/FOXO1 in Growing Rats / 生物医学与环境科学（英文）

OBJECTIVE@#In this study, the combined effect of two stressors, namely, electromagnetic fields (EMFs) from mobile phones and fructose consumption, on hypothalamic and hepatic master metabolic regulators of the AMPK/SIRT1-UCP2/FOXO1 pathway were elucidated to delineate the underlying molecular mechanisms of insulin resistance.@*METHODS@#Weaned Wistar rats (28 days old) were divided into 4 groups: Normal, Exposure Only (ExpO), Fructose Only (FruO), and Exposure and Fructose (EF). Each group was provided standard laboratory chow ad libitum for 8 weeks . Additionally, the control groups, namely, the Normal and FruO groups, had unrestricted access to drinking water and fructose solution (15%), respectively. Furthermore, the respective treatment groups, namely, the ExpO and EF groups, received EMF exposure (1,760 MHz, 2 h/day x 8 weeks). In early adulthood, mitochondrial function, insulin receptor signaling, and oxidative stress signals in hypothalamic and hepatic tissues were assessed using western blotting and biochemical analysis.@*RESULT@#In the hypothalamic tissue of EF, SIRT1, FOXO 1, p-PI3K, p-AKT, Complex III, UCP2, MnSOD, and catalase expressions and OXPHOS and GSH activities were significantly decreased ( P < 0.05) compared to the Normal, ExpO, and FruO groups. In hepatic tissue of EF, the p-AMPKα, SIRT1, FOXO1, IRS1, p-PI3K, Complex I, II, III, IV, V, UCP2, and MnSOD expressions and the activity of OXPHOS, SOD, catalase, and GSH were significantly reduced compared to the Normal group ( P < 0.05).@*CONCLUSION@#The findings suggest that the combination of EMF exposure and fructose consumption during childhood and adolescence in Wistar rats disrupts the closely interlinked and multi-regulated crosstalk of insulin receptor signals, mitochondrial OXPHOS, and the antioxidant defense system in the hypothalamus and liver.

Mobile phone application in the management of maternal and young child malnutrition: a review

Background: Malnutrition is one of the leading causes of maternal and young child mortality in underdeveloped countries, particularly during pregnancy and delivery. The effects of malnutrition in pregnant women include low birth weight, preterm birth, intrauterine growth restriction, nutrient deficiencies and reduced breast milk production. Mobile phone applications are widely used with features such as portability, ease of communication, storage at relatively low cost that makes such technology attractive to nutritionists. Objective: To assess if mobile phone applications can be beneficial in maternal and young child malnutrition intervention. Methods: Zotero reference management software was used to ensure the rigor and reproducibility of the review process. Based on defined key words, a search was conducted on Google Scholar, ScienceDirect, PubMed and Springer databases to retrieve all publications on mobile phone applications in maternal and young child malnutrition interventions. The study used ten articles from unique studies that met the study criteria and are reported in terms of authors, year, sample size, study design and outcome measure. Results: The articles revealed that mobile phone applications were highly useful in maternal and young child malnutrition intervention, prompting nutrition information seeking and facilitating communication with healthcare providers. Conclusion: Mobile phone applications are widely acknowledged, and beneficial in maternal and neonatal malnutrition management, they have the potential to improve maternal and young child nutritional status through self-monitoring. Given the low uptake of current mobile phone application, it should be given a significant consideration as a potential strategy for managing maternal and young child malnutrition.

The utility of mobile telephone-recorded videos as adjuncts to the diagnosis of seizures and paroxysmal events in children with suspected epileptic seizures

Background. Epilepsy is often diagnosed through clinical description, but inter-observer interpretations can be diverse and misleading. Objective. To assess the utility of smartphone videos in the diagnosis of paediatric epilepsy.Methods. The literature was reviewed for evidence to support the use of smartphone videos, inclusive of advantages, ethical practice and potential disadvantages. An existing adult-based quality of video (QOV) scoring tool was adapted for use in children. A pilot study used convenience sampling of videos from 25 patients, which were reviewed to assess the viability of the adapted QOV tool against the subsequent diagnosis for the patients with videos. The referral mechanism of the videos was reviewed for the source and consent processes followed. Results. A total of 14 studies were identified. Methodologies varied; only three focused on videos of children, and QOV was formally scored in three. Studies found that smartphone videos of good quality assisted the differentiation of epilepsy from non-epileptic events, especially with accompanying history and with more experienced clinicians. The ethics and risks of circulation of smartphone videos were briefly considered in a minority of the reports. The pilot study found that the adapted QOV tool correlated with videos of moderate and high quality and subsequent diagnostic closure.Conclusions. Data relating to the role of smartphone video of events in children is lacking, especially from low- and middle-income settings. Guidelines for caregivers to acquire good-quality videos are not part of routine practice. The ethical implications of transfer of sensitive material have not been adequately addressed for this group. Prospective multicentre studies are needed to formally assess the viability of the adapted QOV tool for paediatric videos.

How did South Africans with disabilities experience COVID-19? Results of an online survey

Background: People with disabilities are a large, disadvantaged minority, comprising approximately 12% of the population. The South African government has ratified international and regional disability treaties but deals with disability rights within general anti-discrimination legislation. There are no specific frameworks to monitor justice for people with disabilities. The study aims to inform further development of disability inclusive mechanisms relating to crises including pandemics. Objectives: This study explored the perceptions of South Africans with disabilities, to understand their experiences during coronavirus disease 2019 (COVID-19), focussing on socioeconomic, well-being and human rights aspects. Method: An online survey tool generated quantitative and qualitative data. Widespread publicity and broad recruitment were achieved through project partners networks. Participants responded via mobile phone and/or online platforms. Results: Nearly 2000 people responded, representing different genders, impairments, races, socio-economic status, education and ages. Findings include: (1) negative economic and emotional impacts, (2) a lack of inclusive and accessible information, (3) reduced access to services, (4) uncertainty about government and non-government agencies' support and (5) exacerbation of pre-existing disadvantages. These findings echo international predictions of COVID-19 disproportionally impacting people with disabilities. Conclusion: The evidence reveals that people with disabilities in South Africa experienced many negative impacts of the pandemic. Strategies to control the virus largely ignored attending to human rights and socioeconomic well-being of this marginalised group. Contribution: The evidence will inform the development of the national monitoring framework, recognised by the South African Government and emphasised by the United Nations as necessary to ensure the realisation of the rights of people with disabilities during future crises including pandemics.

Análise de aplicativos móveis voltados para controle parental: revisão narrativa / Analysis of mobile applications aimed at parental control: narrative review / Análisis de aplicaciones móviles orientadas al control parental: revisión narrativa

Crianças e adolescentes usam a tecnologia móvel para diversas finalidades, como lazer, entretenimento, estudos e comunicação. No entanto, faz-se necessário o controle e mediação parental pois o uso inadequado pode gerar danos à saúde. Existem aplicativos voltados para esta tarefa e com funcionalidades e características variadas. Diante disso, este estudo teve como objetivo analisar as aplicações móveis disponíveis para download na plataforma Google Play Store por meio de uma revisão narrativa e com auxílio do software IRAMUTEQ para revisão dos dados, analisar os comentários deixados pelos usuários. Foram investigadas as informações de 138 aplicativos, boa parte deles realizam funções essenciais, como controlar o tempo de acesso, bloquear sites e apps indesejados, porém, há muitas críticas relacionadas a problemas técnicos, aplicabilidade e prejuízos gerados pelo excessivo controle dos pais. A investigação mostrou que cinco softwares para o controle parental apresentavam as principais funções de acordo com a aplicabilidade (limite de tempo, filtros, localizador GPS, monitoramento de chamadas e mensagens), nota acima de 3,0 e ano de atualização em 2021. A análise dos comentários feita pelo software IRAMUTEQ, destacou as palavras "App" (referente à aplicativo), "filho", "celular", "bloquear", "funcionar", "criança", "instalar" e "desinstalar" como as mais importantes pelos usuários.

Children and teenagers use mobile technology for different purposes, such as leisure, entertainment, studies and communication. However, parental control and mediation is necessary, as inappropriate use can cause health damage. There are applications aimed at this task and with varied functionalities and characteristics. Therefore, this study aimed to analyze the mobile applications available for download on the Google Play Store platform through a narrative review and with the help of the IRAMUTEQ software to review the data, analyze the comments left by users. Information from 138 applications was investigated, most of which perform essential functions, such as controlling access time, blocking unwanted websites and apps, however, there are many criticisms related to technical problems, applicability and damage caused by excessive parental control. The investigation showed that five parental control software had the main functions according to applicability (time limit, filters, GPS locator, call and message monitoring), grade above 3.0 and year of update in 2021. The analysis of the comments made by the IRAMUTEQ software, highlighted the words "App" (referring to the application), "son", "cell phone", "block", "work", "child", "install" and "uninstall" as the most important for users.

Los niños y adolescentes utilizan la tecnología móvil para diferentes fines, como el ocio, el entretenimiento, los estudios y la comunicación. Sin embargo, es necesario el control y la mediación parental, ya que un uso inadecuado puede causar daños a la salud. Existen aplicaciones destinadas a esta tarea y con funcionalidades y características variadas. Por lo tanto, este estudio tuvo como objetivo analizar las aplicaciones móviles disponibles para su descarga en la plataforma Google Play Store a través de una revisión narrativa y con la ayuda del software IRAMUTEQ para revisar los datos, analizar los comentarios dejados por los usuarios. Se investigó la información de 138 aplicaciones, la mayoría de las cuales cumplen funciones esenciales, como controlar el tiempo de acceso, bloquear sitios web y apps no deseadas, sin embargo, existen muchas críticas relacionadas con problemas técnicos, de aplicabilidad y daños causados por el excesivo control parental. La investigación mostró que cinco programas de control parental tenían las funciones principales según aplicabilidad (límite de tiempo, filtros, localizador GPS, monitorización de llamadas y mensajes), grado superior a 3.0 y año de actualización en 2021. El análisis de los comentarios realizados por el software IRAMUTEQ, destacó las palabras "App" (refiriéndose a la aplicación), "hijo", "móvil", "bloquear", "trabajar", "niño", "instalar" y "desinstalar" como las más importantes para los usuarios.

Using location history data from cell phones of infectious patients for disease surveillance / Usando dados do histórico de localização de telefones celulares de pacientes infecciosos para vigilância de doenças

Infectious diseases significantly contribute to global morbidity and mortality, highlighting the critical need for robust disease surveillance systems. The rapid and accurate identification of infection hotspots is crucial for effective disease control and eliminating vector reservoirs. Traditional methods, reliant on patient-reported data, are vague, slow, and non-integrative, presenting substantial barriers to fully understanding the underlying causes of infection transmission. The widespread usage of smartphones presents a unique opportunity to access, analyze, and monitor digital data. Particularly, location data can offer potential insights into infectious disease dynamics, which has remained largely unexplored. Firstly, the present study leverages location history data from smartphones of malaria patients in Manaus, Amazonas region, to pinpoint mosquito-breeding sites. Upon quantifying the location data, the primary transmission hotspots were identified to be concentrated on the outskirts of the city of Manaus. Additionally, the quantification and hotspot validation confirmed that newly visited locations during the exposure period were potential sources of infection transmission. Secondly, the current study also employs a novel digital contact investigation method for a human-to-human transmission infection such as tuberculosis to measure the exposure risk between the active index cases and their close contacts. The digital contact investigation revealed varied exposure durations between the recruited paired index and close contact participants based on the outcome of close contact. To summarize, the present study determines distinct mobility patterns associated with both these infectious diseases, potentially aiding in drafting targeted public health strategies and policies for digital epidemiological surveillance

As doenças infecciosas são um dos principais contribuintes para a morbidade e a mortalidade globais, enfatizando a necessidade crítica de sistemas robustos de vigilância de doenças. A identificação rápida e precisa dos pontos críticos de infecção é fundamental para o controle eficaz de doenças e a eliminação de reservatórios de vetores. Os métodos tradicionais, que dependem de dados relatados por pacientes, são vagos, lentos e não integrativos, apresentando barreiras significativas para a compreensão total das causas subjacentes da transmissão de infecções. O uso generalizado de dispositivos móveis apresenta uma oportunidade única de acessar, analisar e monitorar dados digitais. Especialmente, dados de localização podem oferecer informações úteis sobre a dinâmica de doenças infecciosas, que permanecem em grande parte inexploradas. Primeiramente, o presente estudo utiliza dados de histórico de localização de smartphones de pacientes com malária em Manaus, na região do Amazonas, para identificar locais de reprodução de mosquitos. Ao quantificar os dados de localização, identificaram-se os principais pontos de transmissão concentrados nos arredores da cidade de Manaus. Além do mais, a quantificação e a validação em campo confirmaram que os locais recém-visitados durante o período de exposição eram potenciais fontes de transmissão da infecção. Em segundo lugar, o estudo atual também emprega um inovador método de investigação digital de contato para uma infecção por transmissão de humano para humano, como a tuberculose, a fim de medir o risco por exposição entre os casos índice ativos e seus contatos próximos. A investigação digital de contato revelou períodos de exposição variados entre os participantes recrutados em pares de casos índice e contatos próximos, com base no resultado do contato próximo. Em resumo, o presente estudo identifica padrões distintos de mobilidade associados a ambas essas doenças infecciosas, auxiliando potencialmente na elaboração de estratégias e políticas de saúde pública direcionadas para a vigilância epidemiológica digital

Telas na infância: postagens de especialistas em grupos de cuidadores no facebook / Screens in childhood: posts of specialists in caretakers' groups in the facebook / Pantallas en la infancia: las publicaciones de expertos en grupos de cuidadores en facebook

Apesar das crescentes investigações sobre uso de telas na infância, essa é uma temática complexa e ainda recente, que traz diversos desafios para pesquisadores e cuidadores. Comunidades virtuais em redes sociais são utilizadas por mães e pais para esclarecer dúvidas e receber conselhos acerca da parentalidade e saúde infantil, podendo, simultaneamente, assumir uma função prescritiva e normativa quanto ao seu modo de agir. Sendo assim, este artigo pretende compreender como o uso de telas na infância vem sendo abordado por especialistas em grupos de mães e pais no Facebook. Foi realizado um estudo qualitativo envolvendo 49 postagens de especialistas, sobretudo psicólogos e educadores, extraídas de cinco grupos públicos de mães e pais nessa rede social. Os textos das publicações foram verificados por meio de análise temática e discutidos com base no referencial teórico psicanalítico. Os resultados mostraram que os especialistas destacam os possíveis prejuízos do uso de telas na infância, além de fornecer orientações aos pais sobre como lidar com sua presença no cotidiano das crianças e de suas famílias. Concluiu-se que apesar dos grupos de cuidadores no Facebook serem uma ferramenta de divulgação de informações acerca do uso de telas na infância, cabe não naturalizar a presença de especialistas nesses espaços virtuais criados por pais e mães, interpondo-se nos saberes e nas trocas horizontalizadas entre os cuidadores.(AU)

Although investigations on the use of screens in childhood are increasing, this is a complex and recent topic, which poses several challenges for researchers and caregivers. Virtual communities in social networks are used by mothers and fathers to clarify doubts and receive advice regarding parenting and child health, at times, simultaneously, assuming a prescriptive and normative role on their way of acting. Therefore, this study aimed to understand how the use of screens in childhood has been approached by experts in groups of mothers and fathers on Facebook. A qualitative study was carried out involving 49 posts from specialists, mainly psychologists and educators, extracted from five public groups of mothers and fathers in this social network. The publications' texts were verified via thematic analysis and discussed based on the psychoanalytical theoretical framework. The results showed that experts highlight the possible damage of the use of screens in childhood, in addition to providing guidance to parents on how to deal with the presence of digital technology in the daily lives of children and families. It was concluded that, although caregivers' groups on Facebook are a tool for disseminating information about the use of screens in childhood, it is important not to naturalize the presence of specialists in these virtual spaces created by fathers and mothers, interposing in the horizontally interchanges that occur between the caregivers.(AU)

A pesar de las crecientes investigaciones sobre el uso de pantallas en la infancia, este es un tema complejo y aún reciente, que plantea varios desafíos para investigadores y cuidadores. Las comunidades virtuales en las redes sociales son utilizadas por madres y padres para aclarar dudas y recibir consejos sobre educación y salud infantil, pudiendo, al mismo tiempo, asumir un rol prescriptivo y normativo sobre su forma de actuar. Por lo tanto, este estudio tuvo como objetivo comprender cómo el uso de las pantallas en la infancia ha sido abordado por especialistas en grupos de madres y padres en Facebook. Se realizó un estudio cualitativo a partir de 49 publicaciones de especialistas, principalmente de psicólogos y educadores, extraídas de cinco grupos públicos de madres y padres en esta red social. Se realizó en los textos de las publicaciones un análisis temático y se utilizó el marco teórico psicoanalítico. Los resultados mostraron que los expertos destacan posibles daños que provoca el uso de pantallas en la infancia, además de orientar a los padres sobre cómo afrontar esta presencia de la tecnología digital en el día a día de los niños y sus familias. Se concluyó que, a pesar de que los grupos de cuidadores en Facebook son una herramienta de difusión de información sobre el uso de pantallas en la infancia, es importante no naturalizar la presencia de especialistas en estos espacios virtuales creados por padres y madres que se interpone entre los saberes e intercambios horizontales de los cuidadores.(AU)

Seguridad de dispositivos móviles y aplicaciones en función de la educación en tiempos de COVID-19 / Security of mobile devices and applications as a function of education in times of COVID-19

Introducción: En tiempos de COVID-19 constituye una necesidad utilizar dispositivos y aplicaciones móviles para el desarrollo del proceso docente-educativo en la Universidad de Ciencias Médicas de Sancti Spíritus, sin descuidar elementos de seguridad que permiten garantizar la preservación de la confidencialidad de los datos personales de estudiantes y profesores. Objetivo: Identificar el estado de preparación inicial de estudiantes y profesores de la carrera Licenciatura en Sistemas de Información en Salud, en temas orientados a la seguridad de dispositivos y aplicaciones móviles en función de la educación. Métodos: Estudio exploratorio realizado en los cursos académicos 2019-2020 y 2020-2021. Se trabajó con una muestra probabilística de 50 estudiantes y profesores. Se emplearon métodos teóricos, empíricos y estadístico-matemático. Se estructuró la variable dependiente en tres dimensiones y seis indicadores, y se definieron las fuentes de información y los principios éticos. Resultados: Se identificaron los conocimientos teórico-prácticos de estudiantes y profesores en seguridad de dispositivos y aplicaciones móviles en función de la educación; adicionalmente, la actitud y motivación que manifestaron en cuanto al uso de métodos técnicos de seguridad y superación. Conclusiones: Existen insuficientes métodos de seguridad técnica en dispositivos y aplicaciones móviles, y falta de cultura tecnológica orientada al uso de las redes de la Empresa de Telecomunicaciones de Cuba para el acceso a internet; de ahí la importancia de proteger los datos personales almacenados en dispositivos y aplicaciones móviles. Asimismo, desconocimiento de avisos y políticas de privacidad de las aplicaciones móviles, e insuficientes acciones formativas orientadas al uso correcto de las aplicaciones y la protección de los datos personales(AU)

Introduction: In times of COVID-19 it constitutes a necessity to use mobile devices and applications for the development of the teaching-educational process at the University of Medical Sciences of Sancti Spíritus, without neglecting security elements that allow guaranteeing the preservation of the confidentiality of personal data of students and teachers. Objective: To identify the state of initial preparation of students and teachers of the Bachelor's Degree in Health Information Systems, in topics oriented to the security of mobile devices and applications in terms of education. Methods: Exploratory study conducted in the academic years 2019-2020 and 2020-2021. We worked with a probability sample of 50 students and teachers. Theoretical, empirical and statistical-mathematical methods were used. The dependent variable was structured in three dimensions and six indicators, and the sources of information and ethical principles were defined. Results: Theoretical-practical knowledge of students and teachers in security of mobile devices and applications as a function of education was identified; additionally, the attitude and motivation they manifested regarding the use of technical methods of security and self-improvement. Conclusions: There are insufficient technical security methods in mobile devices and applications, and lack of technological culture oriented to the use of the networks of the Cuban Telecommunications Company for Internet access; hence the importance of protecting personal data stored in mobile devices and applications. Likewise, lack of knowledge of privacy notices and policies of mobile applications, and insufficient training actions oriented to the correct use of applications and the protection of personal data(AU)

Asociación entre tiempo de uso de teléfono celular, nivel de actividad física y rendimiento académico en universitarios / Association between time spent on a cell phone, physical activity level, and academic performance in college students

Introducción: El aumento del uso de teléfono celular y la baja actividad física en universitarios se han asociado a un bajo rendimiento académico. Objetivo: Analizar la relación entre tiempo de uso del teléfono celular, el nivel de actividad física y rendimiento académico en estudiantes universitarios. Materiales y métodos: Estudio de alcance correlacional y temporalidad longitudinal. Participaron 36 estudiantes universitarios, a quienes se evaluó durante un semestre, el tiempo que destinaron al uso de teléfono celular, a través de la aplicación "Moment" y la actividad física mediante la aplicación "Pacer". Se registró el rendimiento académico con el promedio de notas. Resultados: Durante el semestre, los hombres realizaron mayor actividad física y utilizaron por mayor tiempo el teléfono. En periodos de evaluación, las mujeres tuvieron mayor actividad física y menor uso del teléfono celular (p=0,019 y p=0,033, respectivamente). Además, los hombres que tuvieron mejores notas promedio hacían un menor número de pickups diarios (p=0,032). Conclusiones: Los hombres universitarios son físicamente más activos y usan más el celular durante el semestre, aunque en periodo de evaluaciones las mujeres tienden a ser más activas y usar menos tiempo su celular. Los universitarios que usan menos el teléfono celular tienen mejor rendimiento académico.

Introduction: Low academic performance of college students has been associated with an increase in time spent on cell phones and a low physical activity. Objective: To analyze the relationship between time spent on cell phones, physical activity level, and academic performance in college students. Materials and methods: A study with a correlational and longitudinal temporality approach. During a semester, 36 college students were assessed on the time they spent using cell phones and their physical activity levels through the Moment and Pacer applications, respectively. Academic performance was monitored through report cards. Results: Men engaged in more physical activity and used cell phones more frequently during the analyzed period, while women showed higher physical activity levels and lower cell phone usage during evaluation periods (p=0.019 y p=0.033, respectively). Also, men who had better grade averages showed lower number of daily pickups (p=0.032). Conclusions: College men show higher physical activity levels and longer cell phone usage during the semester, while women tend to be more active and use their cell phones less frequently during evaluation periods. College students who use cell phones less regularly also have a better academic performance.

Fonoaudiologia na comunidade em período de pandemia: relato de experiências de estudantes de graduação / Speech Language Therapy in the community during pandemic: report of experiences of undergraduate students / Terapia del lenguaje en la comunidad en periodo de pandemia: informe de experiencias de estudiantes de pregrado

Introdução: A pandemia de Covid-19 tem exigido adaptações e planejamentos constantes das instituições de ensino para a manutenção das atividades acadêmicas. Houve a substituição das disciplinas presenciais por remotas, através das Tecnologias de Informação e Comunicação (TICs). Como as atividades de cunho prático (como estágios acadêmicos) são fundamentais para os estudantes da Saúde, elas também migraram para a forma remota. Diante disso, modelos assíncronos de fornecimento de serviço foram sugeridos e regulamentados nesse período pandêmico. Objetivo: Relatar a experiência de estagiários do curso de Fonoaudiologia da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo na aplicação de atividades remotas direcionadas a escolares e idosos usuários de serviços de Atenção Primária à Saúde, durante a pandemia. Métodos: Trata-se de um estudo descritivo, do tipo relato de experiência. Resultados: Foram elaboradas ações passíveis de realização no ambiente domiciliar, segmentadas em atividades físicas, de linguagem e de memória, todas com abordagem lúdica, fornecendo oportunidades de interação e estimulação/aprimoramento dessas habilidades. Para os estudantes, as experiências foram fundamentais para o desenvolvimento dessa nova metodologia, estimulando sua criatividade. Conclusão:As atividades remotas dirigidas às crianças e idosos permitiram que essas populações fossem amparadas durante a restrição social. O estabelecimento de contato com o público-alvo e a possibilidade de interação com a comunidade foi muito importante para os estudantes. É possível a replicação das ações propostas a qualquer grupo, desde que sejam adequadas à faixa etária.

Introduction: Covid-19 pandemic has required constant adaptations and planning by educational institutions to preserve academic activities. In-person classes were replaced by remote courses through Information and Communication Technologies (ICTs). Since practical activities (such as academic internships) are essential for students in the Health Areas, they also migrated to remote classes. Thus, asynchronous models of service provision were suggested and regulated during this pandemic period. Objective: reporting the experience of interns at the Speech Language and Audiology Course at the Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo during the development of remote activities aimed at students and elderly users of Primary Health Care services during the pandemic. Methods: This is a descriptive study of the experience report type. Results: Actions that could be performed at home were created, divided into physical, speech and memory activities, all with a playful approach, providing opportunities for interaction and stimulation/improvement of the aforementioned skills. For these students, these experiences were fundamental to the development of this new methodology, stimulating their creativity. Conclusion: Remote activities aimed at children and elderly allowed these populations to be supported during social restriction. The opportunity to establish contact with the target audience and the possibility of keeping up interaction with the community was extremelly important for the students. There is a chance of spreading these actions to any group, if they are adapted according to the group age.

Introducción: La pandemia de Covid-19 ha requerido constantes adaptaciones y planificación de las instituciones educativas para mantener las actividades académicas. Se sustituyeron los cursos presenciales por los remotos, mediante las Tecnologías de la Información y las Comunicaciones (TIC). Como las actividades prácticas (como las prácticas académicas) son fundamentales para los estudiantes de Salud, también ellas han migrado a la forma remota. Por lo tanto, se sugirieron y reglamentaron modelos de prestación de servicios asincrónicos en este período pandémico. Objetivo: Informar la experiencia de los pasantes del Curso de Terapia del Lenguaje de la Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo en la aplicación de actividades a distancia dirigidas a estudiantes y usuarios ancianos de los servicios de Atención Primaria durante la pandemia. Métodos: este es un estudio descriptivo, del tipo relato de experiencia. Resultados: Se desarrollaron acciones que se pueden realizar en el ámbito del hogar, segmentadas en actividades físicas, de lenguaje y de memoria, todas con un enfoque lúdico, brindando oportunidades de interacción y estimulación/mejora de las habilidades mencionadas. Para los pasantes, las experiencias fueron fundamentales para el desarrollo de esta nueva metodología, estimulando su creatividad. Conclusión: Las actividades remotas dirigidas a niños y ancianos permitieron apoyar a estas poblaciones durante la restricción social. Establecer contacto con el público objetivo y la posibilidad de interacción con la comunidad fue muy importante para los estudiantes. Es posible replicar las acciones propuestas a cualquier grupo, siempre que sean adaptadas para el grupo de edad.

Adherencia a la medicación mediante el uso del teléfono en pacientes hipertensos crónicos / Use of the telephone to optimize adherence to medication in chronic hypertensive patients

INTRODUCCION: la mitad de los pacientes hipertensos abandona la terapia a partir del primer año del diagnóstico. El uso del teléfono para mejorar la adherencia es aceptado por los pacientes, a través del envío de mensajes a sus celulares o de llamadas telefónicas concertadas, para hacerles recordar la toma de medicación o información sobre su enfermedad. OBJETIVO: evaluar la adherencia al tratamiento mediante recordatorio por teléfono en pacientes hipertensos que retiran sus medicamentos de una Clínica de la seguridad social en Paraguay. METODOLOGÍA: estudio cuasi experimental; aplicando una encuesta y seguimiento mediante contacto telefónico para evaluar la adherencia a la terapia. RESULTADOS: el 50% (n=11) de los pacientes se clasificaron como no adherentes a la terapia farmacológica; al final de las intervenciones se redujo a 9,1%. La causa principal de la falta de adherencia fue el olvido, 90,9%. La adherencia al tratamiento mejoro significativamente luego de las intervenciones. CONCLUSIÓN: la utilización de la tecnología podría constituirse en una herramienta para la prevención primaria en la población con factores de riesgo, y el seguimiento de pacientes con hipertensión arterial.

INTRODUCTION: half of hypertensive patients drop out of therapy from the first year of diagnosis. The use of the telephone to improve adherence is accepted by patients, through sending messages to their cell phones or concerted phone calls, to remind them of taking medication or information about their disease. OBJECTIVE: This work evaluated the use of technology to optimize the adherence of hypertensive patients who withdraw their medicines from a social security clinic in Paraguay. METHODOLOGY: quasi-experimental study; applying a survey and follow-up through telephone contact to evaluate adherence to therapy. RESULTS: 50% (n=11) of patients were classified as non-adherent to drug therapy; at the end of the interventions it was reduced to 9.1%. The main cause of the lack of adherence was forgetfulness, 90.9%. Adherence to treatment improved significantly after interventions. CONCLUSION: the use of technology could be a tool for primary prevention in the population with risk factors, and the monitoring of patients with blood pressure.

Virulence, biofilm formation ability and antimicrobial resistance of staphylococcus aureus isolated from cell phones of university students / Virulência, capacidade de formação de biofilme e resistência antimicrobiana de staphylococcus aureus isolado de telefones celulares de estudantes universitários

INTRODUCTION: Contamination of cell phones can contribute to the dissemination of pathogens in the community and/or hospital environment. OBJECTIVE: To characterize Staphylococcus aureus strains isolated from cell phones of university students. METHODS: Samples were collected from 100 cell phones. Detection of genes associated with virulence factors such as biofilm formation (icaA and icaD), enterotoxins production (SEA, SEB, SEC, and SED), and resistance to methicillin (mecA and mecC) was performed in S. aureus isolates by PCR. Typing mecA gene performed by multiplex PCR. Susceptibility to antimicrobials and biofilm formation rate also evaluated by using disk diffusion test and crystal violet staining. RESULTS: S. aureus was present in 40% of the total samples and about 70% of them belonged to Nursing students. Of the isolates, 85% presented resistance to penicillin and 50% were classified as moderate biofilm producers. In addition, 92.5% of isolates contained the gene icaA and 60% of the gene icaD. Approximately 25% of the isolates presented the mecA gene. Typing of the mecA gene showed the presence of staphylococcal chromosome cassette SCCmec I and c III respectively in 20% and 10% of the isolates. 70% of the samples could not be typed by the technique. Regarding the enterotoxins, the most prevalent gene was SEA (30%) followed by the SEC gene (2.5%). The presence of SED and SEB genes not observed in any of the isolates. CONCLUSION: The cleaning and periodic disinfection of cell phones can contribute to the reduction of the risk of nosocomial infection.

INTRODUÇÃO: A contaminação de celulares pode contribuir para a disseminação de patógenos na comunidade e/ou ambiente hospitalar. OBJETIVO: Caracterizar cepas de Staphylococcus aureus de telefones celulares de estudantes universitários. MÉTODOS: Foram coletadas amostras de 100 telefones celulares. Detecção de genes associados a fatores de virulência quanto a: formação de biofilme (icaA e icaD), produção de enterotoxinas (SEA, SEB, SEC e SED) e resistência à meticilina (mecA e mecC) foi realizada em isolados de S. aureus por PCR. A Tipagem do gene mecA foi realizada por PCR multiplex. A susceptibilidade a antimicrobianos e a taxa de formação de biofilme pelo teste de difusão em disco e coloração com cristal violeta. RESULTADOS: S. aureus esteve presente em 40% do total de amostras, destas, 70% pertenciam a estudantes do curso de enfermagem. Dos isolados, 85% apresentaram resistência à penicilina e 50% foram classificados com moderada formação de biofilme. Além disso, 92,5% dos isolados continham o gene icaA e 60% o gene icaD. Aproximadamente 25% dos isolados apresentaram o gene mecA. A tipagem do gene mecA mostrou a presença do cassete cromossômico estafilocócico SSCmec I e III em respectivamente 20% e 10% dos isolados. 70% das amostras não puderam ser identificadas pela técnica. Das enterotoxinas, o gene mais prevalente foi o SEA (30%), seguido pelo gene SEC (2.5%). A presença dos genes SED e SEB não foi observada nos isolados. CONCLUSÃO: A limpeza e desinfecção periódica dos telefones celulares podem contribuir para a redução do risco de infecção nosocomiais.