Discriminação, preconceito e atitudes relativamente a lésbicas : estudo numa amostra de estudantes de enfermagem

Dissertação de mestrado integrado em Psicologia (área de especializacao em Psicologia da Saúde)As atitudes, perceções e crenças dos profissionais de saúde acerca da homossexualidade feminina têm implicações práticas no acesso desta comunidade a cuidados de saúde. No entanto, a investigação neste domínio ainda permanece limitada. Neste sentido, este estudo pretende compreender e analisar a discriminação, o preconceito e as atitudes para com lésbicas de futuros enfermeiros, com base numa amostra particular de 204 estudantes de enfermagem do sexo feminino, com idades compreendidas entre os 18 e 31 anos (M=21). Na realização deste trabalho, foram aplicados os seguintes instrumentos: a) um questionário com dados sociodemográficos; b) a Escala de Perceção de Discriminação; c) uma versão reduzida do Questionário Multidimensional do Preconceito Polimorfo, e d) a Escala de Discriminação na Saúde. Os resultados mostram que estes estudantes, em média, consideram que a religião é a dimensão mais discriminatória, ao contrário da área da saúde, que apontam como sendo aquela em que há menos discriminação. Adicionalmente, a maioria admite que a homofobia varia com o contexto e localização geográfica e acredita que a orientação sexual pode ser um fator de risco (79.2%), relativamente a episódios de mal-estar psicológico/psiquiátrico. A heteronormatividade dos participantes destacou-se como um fator relacionado com o nível de discriminação na área da saúde. As crenças e/ou atitudes mais negativas foram encontradas nos estudantes mais novos, nos que habitam em meios rurais, nos que detêm orientação política tendencialmente de direita, e nos que não conhecem nem têm amigas lésbicas. No entanto, estes dados devem ser interpretados com precaução, tendo em consideração fatores externos que poderão contribuir para as perceções dos participantes. Seria desejável que os estudantes tivessem acesso a mais informação sobre a comunidade lésbica, nomeadamente, através da inclusão de material apropriado nos programas curriculares, potenciando um maior conhecimento e atitudes mais positivas para com as pessoas lésbicas. É necessária a continuidade desta linha de estudos, no sentido de dar voz às necessidades das minorias sexuais e em particular às das lésbicas, invisíveis pela condição de mulher e orientação sexual em simultâneo.The attitudes, perceptions and beliefs of healthcare professionals about feminin homosexuality draw practical implications in the access of this community to healthcare services. Nevertheless, research in this domain is still sparse. In this direction, this study proposes to comprehend and analyse the discrimination, the prejudice and the attitudes toward lesbians of future nurses, based on a particular sample of 204 female nursing students, with ages between 18 and 31 years old (M=21). In the development of this work, the following instruments have been applied: a) a questionary containing sociodemographic data; b) the Scale of Perception of Discrimination; c) a shortened version of the Multidimensional Questionary of the Polymorphic Prejudice and d) the Scale of Discrimination in Health. The results show that these students, in average, consider that religion is the most discriminatory dimension. Additionally, the majority admits that the homophobia varies with the context and geographical location and believes that the sexual orientation can be a risk fator (79.2%), in what concerns episodes of psychological/psychiatric discomfort. The heteronormativity of the participants has revealed to be as a fator associated with the level of discrimination in the healthcare area. The more negative beliefs and/or attitudes were assumed by the younger students, by those that live in the countryside, by those that possess a tendentially right-wing political ideology, and by those that do not have lesbian friends. However, these statistics must be interpreted with the precaution, having in consideration external factors that may possibly contribute to the participants’ perceptions. It would be desirable for students to have access to more information about the lesbian community, through the inclusion of particular material in their curriculum programmes, fostering a greater knowledge and more positive attitudes toward lesbian people. It is essential to continue this line of studies, to voice the needs of the sexual minorities, in particular the lesbians that are invisible due to their simultaneous woman condition and sexual orientation.Fundação para a Ciência e a Tecnologia (FCT) - Projeto PIHM/GC/0005/2008, designado por "Cidadania sexual nas (mulheres) lésbicas em Portugal. Experiências de discriminação e possibilidades de mudanç

The use of bacteriophages against P. aeruginosa biofilms

P. aeruginosa is a relevant opportunistic pathogen involved in nosocomial infections and, worryingly, it frequently shows a low antibiotic susceptibility. One of its virulence factors is associated with the ability to adhere to surfaces and form virulent biofilms. This work describes the use of newly isolated broad host lytic phages (T7-like), capable to infect antibiotic resistant P. aeruginosa strains, to control planktonic and biofilm cells. Furthermore, it characterizes phage-resistant mutants phenotypes which arose after biofilm treatment with phages. Two of the phages used (phages phiIBB-PAA2 and phiIBB-PAP21) caused a great biomass reduction of planktonic cells, and when tested against 24 hours old biofilms, using a MOI of 1, reduced already after 2 hours of infection the amounts of viable cells by approximately 1 - 2 log and, this reduction was further enhanced after 6 hours of biofilm infection. However, P. aeruginosa PAO1, after 24 hours in contact with phiIBB-PAP21, acquired resistance to the phage which led to an increase in the amount of biofilm cells. Conversely, after 24 hours, phage phiIB-PAA2 for P. aeruginosa ATCC10145 continued to destroy cells. Based on morphological analysis of the colonies, five different P. aeruginosa phenotypes were isolated, after 72 hours of P. aeruginosa ATCC 10145 biofilm infection with phage phiIBB-PAA2, and only one remained susceptible to the phage. Furthermore, all phage-resistant phenotypes revealed a reduced ability to form biofilms resulting in lower amounts of biomass and viable cells in 24 hours old biofilms and, after 48 hours of biofilm formation, 3 out of these 5 strains continued to form less biofilm compared to the parental strain suggesting that these strains have an attenuated virulence. Overall, the phages used in this work showed a great capacity in infecting a wide number of antibiotic resistant strains and also control biofilms. Nevertheless, we found that phage-resistant phenotypes can arise quickly after exposure of biofilms to phages

The use of bacteriophages for P. aeruginosa biofilm control

Pseudomonas aeruginosa is a relevant opportunistic pathogen frequently associated with several nosocomial infections and, worryingly, this bacterium shows a low antibiotic susceptibility. One of its virulence factors is related with the ability to adhere to surfaces and also human epithelium and form virulent biofllms. This work describes the isolation and characterization of lytic phages capable to infect antibiotic resistant P. aeruginosa strains. It is also described herein the potential of the new isolated phages for planktonic cells and biofilm control. According to the results of this work, the isolated phages showed different spectra of activity and most of them were efficient even against P. aeruginosa multidrug resistant strains. Furthermore, the biofilm infection assays revealed that phages can be a good strategy to combat virulent biofilms achieving significant reductions in the number of biofilm cells.(undefined

Isolation of lytic phages for clinical antibiotic resistant Pseudomonas aeruginosa

Pseudomonas aeruginosa is a relevant opportunist pathogen involved in noso-comial infections. P. aeruginosa uses an arsenal of virulence factors to cause serious infections and one of the most worrying characteristics of this bacte-rium is its low antibiotic susceptibility. The low susceptibility to antibiotics can be attributed to a concerted action of multidrug efflux pumps with chromo-somally-encoded antibiotic resistance genes and the low permeability of the bacterial cellular envelopes. Furthermore, P. aeruginosa can develop acquired resistance either by mutation in chromosomally-encoded genes or by the horizontal gene transfer of antibiotic resistance determinants. Today, prevention and control of bacterial resistance requires new antimicrobial agents, the prudent use of existing ones, new vaccines and enhanced public health efforts to reduce transmission of bacterial resistance. Bacteriophages and their lytic enzymes can be an alternative to antibiotherapy towards the reduction of P. aeruginosa, without causing elimination of beneficial microorganisms. In this work, 4 P. aeruginosa strains, namely ATCC, CECT 111, PAO1 were used to screen for phages present in hospital effluents. Overall, 17 different bacteriophages were isolated. These newly isolated phages were tested against 35 antibiotic multi-resistant clinical strains provided by the São Marcos hospital (Braga) and their lytic spectra studied. Most phages were well capable of infecting different isolates, however some phages had quite a narrow spectrum of activity. The best four phages were selected and characterized according to their structural proteins and one-step growth

A genotypic analysis of five P. aeruginosa strains after biofilm infection by phages targeting different cell surface receptors

Book of Abstracts of CEB Annual Meeting 2017[Excerpt] Antibiotic resistance constitutes currently one of the most serious threats to the global public health and it urgently requires new and effective solutions. Bacteriophages are bacterial viruses increasingly recognized as being good alternatives to the traditional antibiotic therapies [1]. In the present study, the efficacy of phages against Pseudomonas aeruginosa PAO1 biofilm and planktonic cell cultures was evaluated over the course of 48 hours. Although significant reductions in the number of viable cells were achieved for both cases, the high level of adaptability of the bacteria in response to the selective pressure caused by phage treatment resulted in the emergence of phage-resistant variants. However, very few studies have explored this phenomenon. [...]info:eu-repo/semantics/publishedVersio

Comportamentos e auto-perceção em saúde oral de uma população geriátrica da região do Porto, Portugal

ResumoO envelhecimento é uma etapa da vida que se acompanha de numerosas transformações fisiopatológicas. As doenças orais não apresentando, de um modo geral, risco de vida podem ter repercussões ao nível da mastigação, da fonética, da estética e do bem-estar geral.ObjetivosCaracterizar a auto-perceção e comportamentos em saúde oral dos idosos institucionalizados, da região do Porto, e avaliar a sua associação com variáveis sociodemográficas.MétodosEstudo transversal baseado numa amostra de conveniência que incluiu indivíduos com idade superior a 65 anos de idade, institucionalizados em 5 lares e 2 centros de dia do distrito do Porto.ResultadosA amostra foi constituída por 129 indivíduos, com idades compreendidas entre 65 e 98 anos, sendo 77,5%, do sexo feminino. Relativamente à escolaridade, 34,9% não possuía qualquer grau e 51,9% possuía 1 a 4 anos de escolaridade. Cerca de 42% dos participantes afirmou necessitar de tratamento dentário. Relativamente à autoperceção da saúde oral, 17,1% dos participantes classificaram como má, 45% classificou como razoável e 38% referiu ser boa. Quanto aos hábitos de higiene oral, 46,5% referiu escovar os dentes menos de 2 vezes por dia. A necessidade de reabilitação protética foi reconhecida por 33,3% dos participantes. Relativamente aos cuidados médico- dentários, 55,8% referiu não consultar o médico dentista há mais de 3 anos. Foi verificada associação estatisticamente significativa entre a menor frequência de escovagem, menor frequência de visitas ao médico dentista e a baixa escolaridade.ConclusãoNeste estudo foi percetível a falta de informação sobre os determinantes de saúde oral, nomeadamente em relação com a higiene oral.AbstractAging is a life stage that is accompanied by numerous pathophysiologic changes affecting oral and general health. Oral diseases don’t show, in general, risk of life but can impact the level of mastication, phonetics, aesthetics and general welfare.ObjectivesCharacterize the self-perception and behaviors in oral health of institutionalized elderly of Porto region and assess its association with sociodemographic variables.MethodsCross-sectional study based on a convenience sample that included individuals aged over 65 years institutionalized in nursing homes and day centers of the district of Porto.ResultsThe sample consisted of 129 individuals, aged 65 to 98 years, most were female (77.5%), reported having between 1-4 years of schooling and 34.9% reported never attended school. 41.9% of respondents claimed the need of dental treatment and of these, 61.1% had consulted a dentist for more than one year. The self-perception of oral health was rated as “poor” by 17%, 45% as fair and 38% as “good”. Regarding oral hygiene habits, 46.5% reported brushing their teeth less than 2 times a day and only 18.6% use additional means of daily hygiene. Regarding dental care visits, 55.8% reported a dental consultation for more than three years. A significant association between lower frequency of brushing and low education was observed. The lower frequency of visits to the dentist was associated with low educational level of participants.ConclusionThere was a noticeable lack of information about oral health determinants, mainly in relation to oral hygiene among this elderly population

Isolation of novel bacteriophages for the control of P. aeruginosa biofilms

Pseudomonas aeruginosa is one of the most common gram-negative bacterium involve in nosocomial infections and, worryingly, it frequently shows a low antibiotic susceptibility. Additionally, P. aeruginosa has an inapt ability to adhere to surfaces and form virulent biofilms which are particularly difficult to eradicate. In this way, there is a need to develop new antimicrobial agents as an alternative to antibiotherapy and bacteriophages (phages) appear as one attractive solution for this problem. This work describes the isolation and characterization of novel phages and their application for planktonic and biofilm cell control. 17 different phages were isolated from hospital effluents and were tested against 35 antibiotic multi-resistant clinical strains provided by the São Marcos Hospital (Braga). Four of these phages, showing broad lytic spectra, were selected and their efficacy against planktonic cells was studied. Despite the superior lytic spectra exhibited by the selected phages, two of them were not efficient against their hosts and therefore were not chosen for biofilm control experiments. Meanwhile, the other 2 phages (phages phiIBB-PAA2 and phiIBB-PAP21), well capable of causing a great biomass reduction of planktonic cells, were tested against 24 hours old biofilms using different multiplicities of infection (MOI). Both phages caused an approximately 2 log reduction of biofilm-cells, already after 2 hours and the reduction was further enhanced after 6 hours of biofilm treatment, independently of the MOI. The main dissimilarity between the two phage-host systems concerns the biofilm-cell resistance to the phages. In brief, biofilm-cells of P. aeruginosa PAO1, the host of phage phiIBB-PAP21, acquired resistance to the phage and consequently an increase on the amount of cells after 24 hours of infection was observed. On the other hand, phage phiIBB-PAA2 continued to destroy the biofilms of P. aeruginosa ATCC 10145 and there were no evidences of cells becoming resistant, even after 24 hours of infection. This work shows that the two selected phages are well capable of controlling biofilms; however short treatment prevents the emergence of phage resistant hosts

Relatório de Estágio

O relatório de estágio que aqui se apresenta integra-se na unidade curricular Integração Curricular: Prática Educativa e Relatório de Estágio integrante do ciclo de estudos do Mestrado em Ensino do 1º e 2º Ciclo do Ensino Básico. Pretendeu-se com ele, analisar reflexivamente o percurso de desenvolvimento profissional da professora estagiária, concretizado no 2ºCiclo do Ensino Básico da Escola Pêro Vaz de Caminha e no 1º Ciclo do Ensino Básico da Escola EB1/JI dos Miosótis pertencentes ao Agrupamento de Escolas Pêro Vaz de Caminha. A prática pedagógica supervisionada em complemento com os saberes aprofundados, partilhados e desenvolvidos nas várias unidades curriculares que compõem o ciclo de estudos do mestrado, contribuíram para o desenvolvimento de competências profissionais, tais como, a construção de uma atitude profissional investigativa e reflexiva; a articulação entre saberes teóricos e a prática pedagógica; o saber pensar e agir nos contextos; a co construção de saberes profissionais junto da comunidade educativa; e a planificação de atividades promotoras de aprendizagens significativas e diversificadas. Destacam-se as caraterísticas da metodologia de Investigação- Ação como orientadoras do desenvolvimento da prática pedagógica supervisionada, sendo promotoras de um processo que permitiu a professora estagiária analisar as suas práticas de uma forma sistemática e aprofundada. Como tal, a prática pedagógica foi baseada em ciclos que alternaram entre a observação, planificação, ação e reflexão crítica basilares para a construção de uma identidade profissional docente.The internship report presented here is part of the Course Curriculum Integration: Educational Practice and internship Report cycle integrated in the Masters in Education from the 1st and 2nd Cycle of Basic Education. The aim for this report was to; reflexively analyze the route of the professional trainee teacher development, implemented in 2nd Cycle of Basic Education School Pêro Vaz de Caminha and the 1st Cycle of Basic Education in EB1 / JI Miosótis belonging to the Group of Schools Pêro Vaz de Caminha. The Supervised Teaching Practice in addition to the deep knowledge, shared and developed in several courses that is part of the master's studies cycle knowledge, contributed to the development of professional skills, such as building a professional investigative and reflective attitude; the relationship between theoretical knowledge and pedagogical practice; learn to think and act in contexts; co build professional knowledge within the educational community; planning activities in order to promote meaningful and diversified learning. We highlight the features of the methodology of action research as guiding the development of supervised teaching practice, and facilitating a process that allowed the intern to analyze her practices in a systematic and thorough manner. As such, the pedagogical practice was based on cycles that alternated between observation, planning, action and critical reflection essential to the construction of a professional identity

Challenging mono and dual-species biofilms with phages and antibiotics

Pseudomonas aeruginosa is a relevant opportunistic pathogen, and worryingly it frequently shows a low antibiotic susceptibility. This bacterium is responsible for 65% of mortality in hospitals all over the world. One of its virulence factors is associated with the ability to adhere to surfaces and form virulent biofilms. This work describes the results from several years of investigation using P. aeruginosa phages alone and combined with antibiotics or other phages against single and mixedspecies biofilms. The mixed species biofilms of P. aeruginosa reported herein were formed with fungi (Candida albicans) since these two microorganisms co-inhabit a wide variety of environments and the interactions between them can result in huge medical and economic impacts; and with Acinetobacter baumannii also an opportunistic pathogen associated with nosocomial infections. In both mixed species biofilms there was observed an inhibitory effect of P. aeruginosa since the levels of C. albicans and A. baumannii were highly reduced in the presence of P. aeruginosa. In P. aeruginosa - C. albicans biofilms, the Pseudomonas phages were able to attack their host population; however, as soon as the phages had killed P. aeruginosa, the numbers of viable C. albicans cells increased rapidly. Furthermore, C. albicans’ morphology and virulence were significantly affected in the presence of P. aeruginosa. In P. aeruginosa – A. baumannii biofilms, phages applied only to one of the hosts decreased, as expected, that specific population already after 6 h. Nevertheless, while after treatment of the mixed species biofilms with P. aeruginosa phages we observed a growth of A. baumannii, the same did not occur when the biofilms were only treated with the A. baumannii phage. The use of both phages was effective and reduced significantly the numbers of viable cells of the mixed population biofilm. Despite the potential of the phages used in this work as antimicrobial agents, it is well known that bacteria can quickly adapt and create new survival strategies and the emergence of phage-resistant phenotypes is inevitable. Indeed, we observed the rapid appearance of Pseudomonas aeruginosa resistant phenotypes following 24h of biofilm contact with phages and those phenotypes exhibited altered LPS structures. Thus, the combination therapy of phages and 4 commonly used antibiotics in the treatment of P. aeruginosa infections was also evaluated. The results obtained proved that certain antibiotics and phages have potentially more benefits and even act synergistically compared to just phages or antibiotics alone

Fast emergence of phage-resistant Pseudomonas aeruginosa biofilm cells in response to the pressure exerted by bacteriophage treatment

Antibiotic resistance constitutes currently one of the most serious threats to the global public health and it urgently requires new and effective solutions. Bacteriophages are bacterial viruses increasingly recognized as an attractive alternative to the conventional antibiotic therapies. In the present study, the efficacy of phages against Pseudomonas aeruginosa PAO1 biofilm and planktonic cell cultures was evaluated over the course of 48 hours. Although significant reductions in the number of viable cells were achieved for both cases, the high adaptation capability of bacteria in response to the selective pressure caused by phage treatment, resulted in the inevitable arising of phage-resistant variants. In most cases, those variants appeared later in planktonic cultures than in biofilms. Given the interest in further understanding their genetic makeup and possible mutations accumulated, some were selected for further phenotypic and genotypic characterization. The complete genomes of five P. aeruginosa PAO1 phage-resistant variants were sequenced and all revealed to carry mutations in the galU gene, which is involved in lipopolysaccharide core biosynthesis, as well as in one pil gene, which is involved in type IV pilus synthesis. Three of the P. aeruginosa PAO1 variants further revealed large deletions (> 200 kbp) in their genomes. Overall the results of this study reveal that the selective pressure caused by phages while targeting biofilms results in a faster emergence of resistance compared to planktonic cultures, probably due to the high genetic diversity of cells within biofilms. Furthermore phage-resistant variants seem to be quite adapted to the biofilm phenotype