The first year of the child's life can be overwhelming. One of the major problems faced by parents relates to the infant's crying and sleeping habits, potentially leading to exhaustion, with implications for their health. Information is crucial, so our aim was to assess the relevance and impact of parental education on children's sleep problems in the first year of life. To this end, we conducted a systematic review, using as keywords references to "parental education, " "parenting, " "sleep hygiene, " "infant, " and "newborn, " looking for original articles published over the past 10 years in English and Portuguese. We found nine original articles. Results suggest that preventive intervention improves infants' sleep quality. Parental education programmes included infant sleep patterns, parental behaviour, and strategies facilitating self-soothing. Placing down the infant while still awake, and minimising parental responsiveness by active extinction and graduated extinction techniques, were shown to be the most successful strategies. Cognitive-behavioural interventions proved to improve both parents' and infants' symptoms. Incorporating formal parental education into children's sleeping pattern and parents' behaviours in children's health routines in regular medical practice is a cost-effective strategy for increasing the empowerment of families to deal with the problem.

Background Echocardiography has been traditionally performed in echo labs and the potential benefits of its use by primary care physicians (PCPs) are still unexplored. We present a case where POCUS (point-of-care ultrasound) was used as a complement of physical examination by a family doctor, allowing a prompt clinical decision in a heart failure (HF) patient. Case summary An 85-year-old woman, living independently, asks her family doctor for a home consultation due to increasing dyspnoea. On examination, severe dyspnoea and bilateral ankle oedema was noted and a point-of-care echocardiogram was performed by the primary care physician, who observed: severely compromised left ventricular systolic function, moderate mitral and tricuspid regurgitation, and severe dilation of the inferior vena cava. As a result, the diagnosis of HF with decreased ejection fraction was formed supporting the therapeutic decision. Discussion This case represents an elderly patient with dyspnoea, without previous HF diagnosis. The primary care physician, used portable ultrasound as a complement of physical examination, which confirmed a HF diagnosis, allowing a prompt decision-making on therapy. POCUS, can be a powerful tool to expedite treatment in different settings, including the home consultations by PCPs.

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BACKGROUND Alongside with the development of hand held equipment, echo is becoming more accessible to nontraditional settings. General and family medicine (GPs) are at the forefront of any health system, but the use of cardiac echo by GPs is still unexplored. PURPOSE: This study aims to evaluate the accuracy of echocardiography assessment performed as an extension of the physical exam by GPs. METHODS: Two GPs underwent standard echocardiography training for 6 months. Subsequently, patients with diabetes or arterial hypertension were submitted to an echocardiogram performed by their GPs using a pocket ultrasound. Views obtained (with and without color Doppler) were parasternal long and short axis, apical and subcostal, with measurements of the posterior wall (PW), interventricular septum (IVS), left ventricle (LV), left atrium (LA), aorta and inferior vena cava (IVC). Studies were reviewed at the workstation and measured by two experts who classified the exams according to the image quality. RESULTS: Sixty echocardiograms were analyzed (mean age of 61y, 42% females and 58% males). In 50% the image quality was considered sufficient, 42% considered good and 8% considered bad. There were statistically significant differences between the GPs and expert measurements on the sinus of Valsalva (30.3 ± 3 to 28.8 ± 3.1mm, p = 0.001), LV in systole (p < 0.001, 28[24,31] for 31[29,34]mm), IVS (p = 0.001, 10.9 ± 1.7 for 10.1 ± 1.5mm), PW (p = 0.018, 8.7 ± 1.1 to 9.2 ± 1.6mm) and TAPSE (p = 0.021, 20.9 ± 2.3 to 20.1 ± 2.7mm). There were no significate differences in the measurements of the ascending aorta, LA, LV in diastole and IVC. Agreement between the GPs and the experts was moderate for the evaluation of LVH (k = 0.48). The concordance was substantial for evaluation of LV function (k = 0.66) and excellent for evaluation of pericardial effusion (k = 1) and right ventricular function (k = 1). Concordance was excellent for mitral insufficiency (k = 0.83) and substantial for aortic insufficiency (k = 0.68) and tricuspid insufficiency (k = 0.61). A case of mitral stenosis was identified by both. GPs signalized a case of mild aortic stenosis that the expert did not consider. CONCLUSION: GPs trained in echocardiography, using pocket ultrasound, can obtain cardiac images with sufficient quality for interpretation by experts in the majority of cases. In this study, differences in dimensions might be explained by interobserver variability and/or by the performance of measurements in different environments, mobile vs workstation. Overall the differences were minor and clinically meaningless.

Este artículo se propone a analizar escenas de parto exhibidas en telenovelas brasilerasa lo largo de cuatro décadas, criteriosamente seleccionadas, con el objetivo de identificar las relaciones de género en ellas inscriptas, explicitas o veladas. Para eso, optamos por dos métodos complementarios, el Análisis de Contenido y el Análisis de la Imagen en Movimiento. Para la discusión, hemos considerado especialmente autores de los Estudios de Género y del campo de la Comunicación Social centrados en la teledramaturgia, así como aquellos que se dedican al objeto de esta investigación, el parto como evento social y su representación ficcional. Como resultado, identificamos tres ejes centrales que, al convergieren, encarcelan la parturiente y la convierte en un cuerpo biológicamente necesario y destituido de su derecho/poder de dar a luz. La falta de problematización sobre las desigualdades de género que circundan el parto en la ficción, de forma sintomática, contribuye para su naturalización.