Violência Doméstica: Manual de Recursos para a Rede de Intervenção Integrada do Distrito de Évora

A violência doméstica pode entender-se como uma forma de violência entre pessoas que coabitam um determinado espaço. Todavia e para que melhor se compreenda este fenómeno, é conveniente conhecer a evolução conceptual que se tem verificado. Pode dizer-se que a violência doméstica começou a ser objeto de discussão pública cerca da década de 50 do século XX. Numa fase inicial a preocupação predominante era com a forma desumana e por vezes brutal como mulheres e crianças eram tratadas. Todavia, a nomeação deste tipo de violência foi sofrendo alterações, sendo referida de diferentes modos, seja como violência intrafamiliar, violência contra a mulher ou violência doméstica. Atualmente considera-se que qualquer abordagem à problemática da violência ocorrida no âmbito das relações interpessoais deve ser objeto de clarificação conceptual adicional, quer como forma de se explicitar o objeto de estudo/intervenção, quer de os conceitos não serem motivo de dissensões entre os membros de uma Rede, como é o caso.

Sistema de detección precoz de trastornos del desarrollo (SDPTD) Construcción, validación y manual de uso (versión 1.0)

Los trastornos en el desarrollo psicomotor en la primera infancia van a afectar aproximadamente al 10 por ciento de los niños/as (Alvarez, Soria & Galbe, 2009). Éstos van a servir en unas ocasiones sólo como una señal de alerta del estado de salud del niño y en otras, como indicadores del desarrollo futuro. Por ello, las organizaciones profesionales y las entidades públicas responsables de la salud infantil, han desarrollado programas específicos de control del desarrollo en el niño (Council of children with disabilities; Section on Developmental Behavioral Pediatrics, 2006), en los que se especifica la conveniencia de utilizar sistemas de “screening” o detección precoz de forma sistemática y generalizada. El problema radica en la escasez de instrumentos de detección debidamente validados o de la falta de accesibilidad a los mismos. El objetivo del proyecto, recogido en esta publicación, fue construir y validar un sistema de detección de trastornos del desarrollo fácilmente aplicable no sólo por los profesionales, sino también por los padres. Los autores han demostrado empíricamente la validez y fiabilidad de este Sistema de Detección Precoz de Trastornos del Desarrollo (SDPTD), así como la aplicación práctica y accesibilidad de la herramienta, disponible en soporte web y accesible tanto para profesionales como para el entorno familiar (madres, padres y otros cuidadores). Con respecto a las áreas del desarrollo a evaluar, dado que el desarrollo del niño es global, se tomó una muestra de todas las áreas del desarrollo evaluables: área motora, área socio-emocional, área de comunicación y lenguaje y área cognitiva. Es importante destacar que estas son las áreas de evaluación utilizadas en la inmensa mayoría de escalas del desarrollo y predicen en gran medida el desarrollo evolutivo del niño.

Lipidomic analysis of mesenchymal cells candidates for cell therapy

Mesenchymal stromal cells are adult stem cells found mostly in the bone marrow. They have immunosuppressive properties and they have been successfully applied as biological therapy in several clinical trials regarding autoimmune diseases. Despite the great number of clinical trials, MSCs’ action is not fully understand and there are no identified markers that correlate themselves with the immunomodulatory power. A lipidomic approach can solve some of these problems once lipids are one of the major cells’ components. Therefore, in this study cells’ lipidome was analysed and its deviations were evaluated according to the medium of culture and to the presence of pro-inflammatory stimuli, mimicking physiological conditions in which these cells are used. This was the first study ever made that aimed to analyse the differences in the phospholipid profile between mesenchymal stromal cells non-stimulated and stimulated with proinflammatory stimulus. This analysis was conducted in both cells cultured in medium supplemented with animal serum and in cells cultured in a synthetic medium. In cells cultured in the standard medium the levels of phosphatidylcholine (PC) species with shorter fatty acids (FAs) acyl chains decreased under pro-inflammatory stimuli. The level of PC(40:6) also decreased, which may be correlated with enhanced levels of lysoPC (LPC)(18:0) - an anti-inflammatory LPC - observed in cells subjected to TNF-α and IFN-γ. Simultaneously, the relative amounts of PC(36:1) and PC(38:4) increased. TNF-α and IFN- γ also enhanced the levels of phosphatidylethanolamine PE(40:6) and decreased the levels of PE(38:6). Higher expression of phosphatidylserine PS(36:1) and sphingomyelin SM(34:0) along with a decrease in PS(38:6) levels were observed. However, in cells cultured in a synthetic medium, TNF-α and IFN-γ only enhanced the levels of PS(36:1). These results indicate that lipid metabolism and signaling is modulated during mesenchymal stromal cells action.

Effect of photodynamic therapy on the virulence factors of Staphylococcus aureus

Staphylococcus aureus are Gram-positive bacteria who integrate the human microbiota. Nevertheless, these bacteria can be pathogenic to the humans. Due to the increasing occurrence of antibiotic-resistant S. aureus new approaches to control this pathogen are necessary. The antimicrobial photodynamic inactivation process (PDI) is based in the combined use of a light source, an oxidizing agent like oxygen and an intermediary agent (a photosensitizer). These three components interact to form cytotoxic reactive oxygen species that irreversibly damage vital constituents of the microbial cells and ultimately lead to cell death. In fact, PDI is being shown to be a promising alternative to the antibiotic approach in the inactivation of pathogenic microorganisms. However, information on effects of photosensitization on particular virulence factors is strikingly scarce. The objective of this work was to evaluate the effect of PDI on virulence factors of S. aureus. For this, as photosensitizer the 5,10,15,20-tetrakis(1-methylpyridinium-4-yl)porphyrin tetra-iodide (Tetra-Py+-Me) and six strains of S. aureus (one reference strain, one strain with 1 enterotoxin, two strains with 3 enterotoxins and two strains resistant to methicillin, MRSA – one with 5 enterotoxins and the other without enterotoxins) were used. The effect of photosensitization on catalase activity, beta hemolysis, lipases, thermonuclease, enterotoxins, coagulase production and resistance to methicillin was assessed. The results indicate that the expression of some virulence factors in the cells subjected to this therapy is affected. Additionally the susceptibility of the strains to PDI did not decrease upon successive treatments.

‘To me, it's like a little box of tricks’: Breaking the depressive interlock as a programme participant in mindfulness-based cognitive therapy

Objectives. Mindfulness meditation practices have become increasingly popular in clinical therapies, changing patterns of depressogenic thinking for individuals who experience consecutive episodes of depression. We were interested in finding out how Mindfulness Based Cognitive Therapy (MBCT) worked for programme participants by focussing on how meditative practices changed their relationships to their thoughts. Design. Data for the study came from six semi-structured research interviews carried out with individuals who had taken part in an 8 week MBCT programme Methods. We used Interpretative Phenomenological Analysis (IPA) to analyse the experiential accounts. Results. We report on two superordinate themes – Engaging the Neutral Mind (with subordinate themes ‘breaking the paralysis of worry’ and ‘choosing to think differently’) and Experiencing the Neutral Mind (with subordinate themes of ‘reflection on previous thinking styles’ and ‘becoming psychologically self-reliant’). Conclusions. Themes from the present study offer support to the assertion that mindfulness meditation helps facilitate a different mode of meta-cognitive processing with which to handle depression-related cognitions. Practitioner Points Participants reported that they experienced an enhanced capacity to differentiate between their thought processes, experiencing an ability to tolerate some more uncomfortable thoughts and experiencing a/more choice in how to respond to thoughts Participants recognised that ruminating over negative thoughts was related to depressive states and experienced a shift in meta-cognitive processes that actively challenged depressogenic cognitions Participants became more psychologically self-reliant and therapeutically independent following MBCT Integrating mindfulness based practices in therapy may be a mediating factor in sustaining psychological wellbeing and may help clients develop self-compassion Future research looks to examining exit cases to understand elements of MBCT which are experienced as less successful by clients

Elaboração de um manual de gestão ambiental para autarquias: uma ferramenta para a sustentabilidade

O aumento da degradação ambiental, que se tem vindo a verificar ao longo dos anos tem conduzido a um despertar para as questões ambientais. Surge assim a necessidade, ao nível das organizações em geral, de integrar a gestão dos seus aspectos ambientais na sua gestão comum, pelo que a implementação de sistemas de gestão ambiental como mecanismo de auto-regulação, tem vindo a ser encarada pelas organizações como uma visão pró-activa, que além de evitar soluções dispendiosas de tratamento e eventuais multas por incumprimento legal, promove a eficácia económica das empresas e melhora continuamente o seu desempenho ambiental. Esta filosofia é já bastante comum nas empresas, sendo que a administração pública, e em particular o governo local, começou recentemente a dar os primeiros passos nesta matéria. Com este trabalho pretende-se criar um documento orientador para o Governo Local, no âmbito da implementação de um sistema de gestão ambiental. O presente documento constitui o relatório base onde é feito um enquadramento da temática ao nível do governo local, num contexto nacional e internacional, são enunciados os objectivos e explicada a metodologia inerente ao desenvolvimento do estudo; O segundo documento que constitui o estudo, é o Manual de Gestão Ambiental que contem uma abordagem da metodologia de implementação faseada de um sistema de gestão ambiental e possibilita a adopção de boas práticas ambientais, ao nível das actividades desenvolvidas nestas organizações. O manual pretende constituir uma base de orientação para as Autarquias locais, de forma que estas possam, através da metodologia proposta, reduzir os impactes ambientais associados às suas actividades e melhorar continuamente o seu desempenho ambiental.

In vitro blood-brain barrier models to predict the permeation of gene therapy vectors into the brain

A terapia génica tem-se revelado uma alternativa relevante no tratamento de doenças neurodegenerativas (DN). Contudo, a entrega de vetores para transferência génica no cérebro representa ainda um enorme desafio devido à presença da barreira hemato-encefálica (BHE). A BHE é uma interface dinâmica e seletiva entre o sangue e o cérebro, constituída pelas células endoteliais cerebrais, astrócitos e pericitos, desempenhando um importante papel na regulação da homeostasia cerebral. A BHE representa um dos maiores obstáculos no tratamento de DN, uma vez que esta barreira impede o transporte para o cérebro da maioria das moléculas terapêuticas, incluindo os vetores para terapia génica. Embora tenham sido desenvolvidos diferentes modelos in vitro da BHE de forma a avaliar o transporte de fármacos através da BHE, muito poucos foram criados com o intuito de testar a permeabilidade desta barreira a vetores de terapia génica. O presente trabalho teve como objetivo principal o desenvolvimento e a avaliação de modelos in vitro de BHE que permitam a investigação da capacidade dos vetores de terapia génica de penetrarem no cérebro. No nosso estudo, foram testados diferentes modelos in vitro de BHE em monocultura, constituídos por células endoteliais de rato ou murganho (RBE4 e bEnd3, respetivamente), e modelos de co-cultura, que combinam células endoteliais com células neuronais (Neuro2a) ou astrócitos primários, cultivados num sistema transwell. Para caraterizar estes modelos foram realizados testes de permeabilidade e de resistência elétrica transendotelial, bem como estudos baseados na técnica de PCR quantitativo e na imunocitoquímica das proteínas das junções intercelulares. Verificámos que os modelos baseados na cultura de células bEnd3 e células neuronais ou astrócitos apresentavam as melhores propriedades de barreira. Posteriormente foi avaliada nos modelos selecionados a penetração de um vetor não-viral que reconhecidamente tem a capacidade de atravessar in vivo a BHE: o peptídeo da glicoproteína do vírus da raiva (RGV-9r). Os siRNAs marcados com um fluoróforo e acoplados ao peptídeo RVG-9r foram capazes de penetrar eficientemente as células bEnd3, localizadas no lado luminal do insert, via endocitose mediada por recetores, e ainda de penetrar os astrócitos ou células neuronais, previamente cultivadas no lado abluminal. Estes resultados correlacionam-se, de forma clara, com os resultados previamente descritos em estudos in vivo. Em conclusão, os modelos in vitro de BHE baseados na co-cultura de células bEnd3 com células Neuro2a ou astrócitos, têm grande potencial na seleção de candidatos a vetores de terapia génica para o cérebro, uma vez que apresentam importantes características da BHE e se baseiam num método fácil e reprodutível. Tal facto representa uma promessa significativa para a identificação de novas estratégias de terapia génica não invasiva para o tratamento de doenças neurológicas.

Impact of an evidence-based online module on best practice in physical therapy for children with developmental coordination disorder: a mixed methods study

Aims : This study evaluates the impact of a Developmental Coordination Disorder (DCD) evidence-based online module including synthesized resources, practical strategies, and interactive component on self-reported physical therapist (PT) knowledge, skills, and practice. Methods : PTs from across Canada completed questionnaires before, immediately after, and 2 months following completion of the module. Questionnaires used 7-point Likert scale items and short open-ended questions; analyzes used paired t-tests and a thematic approach. Results : Fifty PTs completed both pre- and post-questionnaires; 41 of these completed the follow-up questionnaire. Most items (79%) evaluating self-reported knowledge and skills increased significantly following module completion and this increase was maintained two months later. Most participants (92%) reported an increase in their confidence to provide DCD evidence-based services. Participants plan to modify their evaluative practices (e.g., involving children in goal setting) and their management of DCD (e.g., using best practice principles, providing resources to families and physicians). At the 2- month follow-up, 46% of participants had returned to the module to review information (e.g., video, resources) or to download handouts. Conclusion : An online module developed collaboratively with PTs has the potential not only to increase PTs’ knowledge, but also to support them in implementing evidence-based services for children with DCD.

Development of non-viral vectors for gene therapy for pathologies of the retina

Tese de doutoramento, Ciências Biomédicas, Departamento de Ciências Biomédicas e Medicina, Universidade do Algarve, 2015

S.C. Recycling Professionals Certification Training Manual 2015

The certification program is centered on a three-day workshop that includes detailed instruction and a 16-chapter manual/reference guide. The manual/reference guide offers a comprehensive overview of both old and new recycling issues faced by programs including composting, electronics and funding. It also provides detailed information on the requirements of county programs as outlined in the S.C. Solid Waste Policy and Management Act of 1991.

Pharmacist intervention on adherence to therapy in the elderly

Background: Non-adherence to therapy contributes to the increase in hospitalizations, admissions to nursing homes, decreased quality of life and consequent increased morbimortality in the elderly. Aim: To assess whether pharmacist intervention contributes to the adherence to medical prescription by elderly patients.

Topical bacteriophage therapy of the infected diabetic foot

Tese de doutoramento, Medicina (Medicina Interna), Universidade de Lisboa, Faculdade de Medicina, 2014

Detecting Adverse Events in Clinical Trial Free Text

Thesis (Master's)--University of Washington, 2013

Expert Insight into the Assessment of Competence in Cognitive–behavioural Therapy: a Qualitative Exploration of Experts' Experiences, Opinions and Recommendations

To offer insight into how cognitive–behavioural therapy (CBT) competence is defined, measured and evaluated and to highlight ways in which the assessment of CBT competence could be further improved, the current study utilizes a qualitative methodology to examine CBT experts’ (N = 19) experiences of conceptualizing and assessing the competence of CBT therapists. Semi-structured interviews were used to explore participants’ experiences of assessing the competence of CBT therapists. Interview transcripts were then analysed using interpretative phenomenological analysis in order to identify commonalities and differences in the way CBT competence is evaluated. Four superordinate themes were identified: (i) what to assess, the complex and fuzzy concept of CBT competence; (ii) how to assess CBT competence, selecting from the toolbox of assessment methods; (iii) who is best placed to assess CBT competence, expertise and independence; and (iv) pitfalls, identifying and overcoming assessment biases. Priorities for future research and ways in which the assessment of CBT competence could be further improved are discussed in light of these findings.

The First Year Experience of Occupational Therapy Students at an Australian Regional University: Promoting Student Retention and Developing a Regional and Remote Workforce

Abstract Objective: Student retention at regional universities is important in addressing regional and remote workforce shortages. Students attending regional universities are more likely to work in regional areas. First year experience at university plays a key role in student retention. This study aimed to explore factors influencing the first year experience of occupational therapy students at a regional Australian university. Design: Surveys were administered to 58 second year occupational therapy students in the first week of second year. Data were analysed using descriptive statistics, inferential statistics (Pearson χ2; Spearman rho) and summarising descriptive responses. Setting: An Australian regional university. Participants: Second year undergraduate occupational therapy students. Main outcome measures: Factors influencing students’ decisions to study and continue studying occupational therapy; factors enhancing first year experience of university. Results: Fifty-four students completed the survey (93.1%). A quarter (25.9%) of students considered leaving the course during the first year. The primary influence for continuing was the teaching and learning experience. Most valued supports were orientation week (36.7%) and the first year coordinator (36.7%). Conclusion: The importance of the first year experience in retaining occupational therapy students is highlighted. Engagement with other students and staff and academic support are important factors in facilitating student retention. It is important to understand the unique factors influencing students’ decisions, particularly those from regional and remote areas, to enter and continue in tertiary education to assist in implementing supports and strategies to improve student retention.