Sexualidade da pessoa com deficiência intelectual - Atitudes de pais e profissionais

Dissertação de Mestrado em Psicologia Educacional, apresentada ao ISPA - Instituto UniversitárioTendo em conta que as atitudes dos pais e profissionais face à sexualidade das pessoas com deficiência intelectual têm um papel preponderante na disponibilização de oportunidades de vivências e experiências sexuais e na passagem de informação correcta acerca da sexualidade (Brown & Pirtle, 2008), o presente estudo pretende conhecer e analisar as atitudes e necessidades que ambos têm, bem como verificar se existem diferenças estatisticamente significativas entre elas. Tendo sido utilizada uma abordagem mista através da utilização do questionário ASQ-ID- Attitudes to Sexuality Questionnaire (Individuals with an Intellectual Disability) e de uma entrevista semi-estruturada, o presente estudo contou com uma amostra de 130 participantes (80 profissionais e 50 pais), dos quais três mães e três profissionais foram entrevistados. Os resultados obtidos confirmaram a nossa hipótese de que existem diferenças estatisticamente significativas nas atitudes dos pais e profissionais, demonstrando que os profissionais têm atitudes mais liberais. Através das entrevistas, verificámos que os profissionais têm necessidades de formação no que toca à capacidade para intervirem de forma adequada nas várias manifestações sexuais dos seus clientes, tendo sido enfatizada a necessidade do envolvimento da família neste processo, a consideração das diferenças individuais e a promoção de contextos favoráveis nas instituições para as vivências e experiências sexuais desta população. Por fim, atestou-se ainda através do discurso dos inquiridos, a falta de um consenso dentro das instituições acerca daquilo que devem fazer em situações onde os clientes necessitam de resposta.ABSTRACT: Given that the attitudes of parents and professionals towards sexuality of people with intellectual disabilities have a role in providing opportunities for experiences and sexual experiences and pass correct information about sexuality (Brown & Pirtle, 2008), this study seeks to examine and analyze the attitudes and needs that both have and see if there are statistically significant differences between them. Having used a mixed approach by using the questionnaire ASQ-ID-Attitudes to Sexuality Questionnaire (Individuals with an Intellectual Disability) and a semi-structured interview, this study involved a sample of 130 participants (80 professionals and 50 parents), of which three mothers and three professionals were interviewed. The results confirmed our hypothesis that there are significant differences in the attitudes of parents and professionals, demonstrating that professionals have more liberal attitudes. Through the interviews, we found that professionals have training needs in relation to the ability to intervene appropriately in various sexual manifestations of its customers, having emphasized the need to involve the family in this process, consideration of individual differences and promoting favorable contexts in institutions for sexual experiences and the experiences of this population. Finally, it is also attested by the discourse of the respondents, the lack of consensus within institutions about what they should do in situations where customers need to be answered

Drug Repurposing: A Systematic Approach to Evaluate Candidate Oral Neuroprotective Interventions for Secondary Progressive Multiple Sclerosis

Objective: To develop and implement an evidence based framework to select, from drugs already licenced, candidate oral neuroprotective drugs to be tested in secondary progressive multiple sclerosis. Design: Systematic review of clinical studies of oral putative neuroprotective therapies in MS and four other neurodegenerative diseases with shared pathological features, followed by systematic review and meta-analyses of the in vivo experimental data for those interventions. We presented summary data to an international multi-disciplinary committee, which assessed each drug in turn using pre-specified criteria including consideration of mechanism of action. Results: We identified a short list of fifty-two candidate interventions. After review of all clinical and pre-clinical evidence we identified ibudilast, riluzole, amiloride, pirfenidone, fluoxetine, oxcarbazepine, and the polyunsaturated fatty-acid class (Linoleic Acid, Lipoic acid; Omega-3 fatty acid, Max EPA oil) as lead candidates for clinical evaluation. Conclusions: We demonstrate a standardised and systematic approach to candidate identification for drug rescue and repurposing trials that can be applied widely to neurodegenerative disorders

Up-regulation of 5-HT2B receptor density and receptor-mediated glycogenolysis in mouse astrocytes by long-term fluoxetine administration

The effects were studied of short-term (1 week) versus long-term (2-3 weeks) fluoxetine treatment of primary cultures of mouse astrocytes, differentiated by treatment with dibutyryl cyclic AMP. From previous experiments it is known that acute treatment with fluoxetine stimulates glycogenolysis and increases free cytosolic Ca2+ concentration ([Ca2+](i)) in these cultures, whereas short-term (one week) treatment with 10 muM down-regulates the effects on glycogen and [Ca2+](i), when fluoxetine administration is renewed (or when serotonin is administered), Moreover, antagonist studies have shown that these responses are evoked by activation of a 5-HT2 receptor that is different from the 5-HT2A receptor and therefore at that time tentatively were interpreted as being exerted on 5-HT2C receptors. In the present study the cultures were found by RT-PCR to express mRNA for 5-HT2A and 5-HT2B receptors, but not for the 5-HT2C receptor, identifying the 5-HT2 receptor activated by fluoxetine as the 5-HT2B receptor, the most recently cloned 5-HT2 receptor and a 5-HT receptor known to be more abundant in human, than in rodent, brain. Both short-term and long-term treatment with fluoxetine increased the specific binding of [H-3]mesulergine, a ligand for all three 5-HT2 receptors. Long-term treatment with fluoxetine caused an agonist-induced up-regulation of the glycogenolytic response to renewed administration of fluoxetine, whereas short-term treatment abolished the fluoxetine-induced hydrolysis of glycogen. Thus, during a treatment period similar to that required for fluoxetine's clinical response to occur, 5-HT2B-mediated effects are initially down-regulated and subsequently up-regulated