Vacina universal para a gripe

Monografia realizada no âmbito da unidade de Estágio Curricular do Mestrado Integrado em Ciências Farmacêuticas, apresentada à Faculdade de Farmácia da Universidade de CoimbraO vírus responsável pela gripe possui atualmente um grande impacto na saúde pública, a nível mundial. A maneira mais simples de proteger a população contra este vírus é através da sua prevenção e, para isso, recorre-se à vacinação. É de salientar no entanto que, devido às recorrentes alterações a nível dos antigénios virais circulantes e ao aparecimento de novas estirpes do vírus, torna-se necessário proceder a uma reformulação anual da vacina. Para além desta situação, estas vacinas serão ainda inefetivas em possíveis pandemias que poderão surgir. Assim, denota-se a importância da formulação de uma vacina universal que promova uma proteção duradoura contra as diferentes estirpes, ultrapassando assim as limitações que atualmente se verificam – proteção limitada e pouco duradoura e a dificuldade da formulação de uma vacina eficaz, num período de tempo adequado, após o aparecimento de uma pandemia. Ao longo deste trabalho serão apresentadas diferentes abordagens/estratégias que atualmente estão sob investigação, nomeadamente a utilização de proteínas altamente conservadas como a M2 e a nucleoproteína (NP), a utilização da neuraminidase (NA), a utilização de partes conservadas da hemaglutinina (HA) e ainda a utilização de misturas de partículas tipo vírus (VLPs) que expressam diferentes subtipos de HA e de outras proteínas.Currently, the responsible virus for the flu has a major impact on public health worldwide. Immunization campaigns are the simplest way to protect the population against this virus. It should be noted however that, due to recurrent changes in circulating viral antigens and to the emergence of new strains of the virus, it becomes necessary to carry out an annual reformulation of the vaccine. In addition, these vaccines will still be ineffective in possible pandemics that may arise. Thereby denotes the importance of the formulation of a universal vaccine that promotes long-lasting protection against different strains, thus overcoming the limitations that currently occur - limited and short-lived protection and the difficulty of formulating an effective vaccine in a period of suitable time after the occurrence of a pandemic. Throughout this work are shown different approaches/strategies are currently under investigation, namely the use of proteins highly conserved as the M2 and the nucleoprotein (NP), the use of neuraminidase (NA), the use of parts conserved of hemagglutinin (HA ) and also the use of mixtures of virus-like particles (VLPs) expressing the different subtypes of HA and other proteins

Relatório de estágio em farmácia comunitária

Relatório de estágio realizado no âmbito do Mestrado Integrado em Ciências Farmacêuticas, apresentado à Faculdade de Farmácia da Universidade de Coimbr

O envolvimento de estudantes e graduados em Medicina em investigação científica e liderança: o papel das características individuais

Tese de Doutoramento em Ciências da SaúdeHistorically, physicians have played important roles in the advancement of medicine and in the improvement of medical care, disseminating research findings and assuming leadership and health advocacy responsibilities. In recent years, there has been an increasing recognition of such roles within competency frameworks in medical education. Medical schools have the responsibility to promote these competencies. Exploring the underlying factors associated with student’s engagement in scientific research and leadership is important to inform policies and strategies. Student’s engagement might result from the interplay between context and individual variables. However, little is known about medical students engagement in activities that go beyond the core curriculum of medical schools. Also, it is important to understand the relationship between pre and post graduation engagement in scientific research and leadership, since one of the objectives of undergraduate medical training is to succeed in promoting engagement behaviors in future physicians. The main research questions addressed in this thesis were: (1) To what extent individual characteristics of medical students and doctors influence their engagement in scientific research and leadership? and (2) Does engagement in those activities as a medical student predict future engagement after graduation? The three studies in this Thesis were conducted in the School of Health Sciences of the University of Minho (Portugal) and explored the role of individual characteristics (personality, socio-demographic and academic performance) on the engagement in scientific research and leadership activities of medical students. Furthermore, this Thesis addressed the relationship between engagement in scientific research after graduation and graduates’ individual characteristics (personality, socio-demographic and performance) and also prior engagement in scientific research during medical school. Finally, the link between prior engagement in leadership during medical school and engagement in leadership after graduation was investigated. Two types of data sources were used: self-reported measures and official data. All studies used a quantitative approach. Different statistical procedures (regression models, classification tree, Chisquare test) were performed to test our research hypothesis. The results show that individual characteristics have a significant contribution for the explanation of medical students engagement in scientific research and leadership activities. In addition, prior engagement in scientific research during medical school significantly predicts later engagement in PhD programs and research papers publication. Finally, prior engagement in leadership during medical school is associated to engagement in leadership after graduation. In conclusion, this work reveals that it is important to consider personality traits, socio-demographic variables, academic performance and previous engagement to predict the engagement of medical students and doctors in scientific research and leadership.Historicamente, os médicos têm desempenhado um papel importante no avanço da medicina e na melhoria dos cuidados de saúde, disseminando os resultados da investigação médica e assumindo responsabilidades de liderança e de defesa da saúde das populações. Nos últimos anos, estes papéis têm merecido um reconhecimento crescente nos referenciais internacionais que enquadram as competências a desenvolver durante a formação dos futuros médicos. Cabe às escolas médicas promover essas competências. Para informar as políticas e estratégias necessárias, torna-se importante explorar os fatores subjacentes ao envolvimento dos alunos de medicina na investigação científica e na liderança. O envolvimento dos alunos nestas atividades resulta da interação entre o contexto e as variáveis individuais. No entanto, o conhecimento disponível sobre o envolvimento de estudantes de medicina em atividades que vão para além do curriculum de medicina é ainda escasso. Além disso, a compreensão da relação entre o envolvimento pré e pós-graduado em investigação científica e liderança é importante, pois um dos objetivos principais da formação médica prégraduada é a promoção do envolvimento dos futuros médicos nestas atividades. As principais questões de investigação abordadas nesta Tese foram: (1) Em que medida as características individuais dos estudantes de medicina e dos médicos influenciam o seu envolvimento na investigação científica e liderança? e (2) O envolvimento durante a escola médica está associado ao envolvimento futuro nessas atividades após a o término do curso? Os três estudos nesta tese foram realizados na Escola de Ciências da Saúde da Universidade do Minho (Portugal) e exploraram o papel das características individuais (personalidade, características sociodemográficas e desempenho académico) no envolvimento de estudantes de Medicina em atividades de investigação científica e liderança. Além disso, esta Tese abordou a relação entre as características individuais, o envolvimento em investigação científica durante o curso de medicina e o futuro envolvimento dos médicos em investigação científica após a graduação. Finalmente, foi investigada a relação entre o envolvimento em atividades de liderança durante a escola médica e o envolvimento em atividades de liderança após a graduação. Os dados foram provenientes de duas fontes distintas: autorrelato e dados oficiais sobre a participação. Todos os estudos usaram uma abordagem de natureza quantitativa. Foram utilizados procedimentos estatísticos diferentes (modelos de regressão, árvore de classificação, teste do quiquadrado) para testar as hipóteses de investigação. Os resultados revelam que as características individuais têm uma contribuição significativa para a explicação do envolvimento de estudantes de medicina em atividades de investigação científica e de liderança, no contexto do estudo. Além disso, demonstram que o envolvimento em investigação científica durante o curso prevê significativamente o envolvimento futuro em programas de doutoramento e a publicação de trabalhos de investigação. Finalmente, estabelece uma associação entre o envolvimento em atividades de liderança durante o curso e o envolvimento em atividades de liderança após a graduação. Em conclusão, este estudo revelou a importância de considerar os traços de personalidade, as variáveis sociodemográficas, o desempenho académico e o envolvimento anterior na predição do envolvimento de estudantes de medicina e graduados em atividades de investigação científica e de liderança.The longitudinal study was sponsored by a grant from the Portuguese Foundation for Science and Technology - project PTDC/ESC/65116/2006

Relatório de estágio em farmácia hospitalar

Relatório de estágio realizado no âmbito do Mestrado Integrado em Ciências Farmacêuticas, apresentado à Faculdade de Farmácia da Universidade de Coimbr

NEO-FFI : propriedades psicométricas de um inventário reduzido de personalidade no contexto português

The aim of this study was to assess the psychometric properties (validity and reliability) of the Portuguese adaptation of the NEO Five-Factor Inventory (NEO-FFI) and to compare the obtained structure to the original North American version. The methods of analysis used for cross-validation of the factorial structure were the Principal Axis Factoring (PAF) and the Confi rmatory Factor Analysis (CFA). PAF reproduced the original structure of NEO-FFI and CFA revealed a satisfactory fi t of single-factor models for the fi ve dimensions. The reliability analysis showed high values of internal consistency which are congruent with previous international adaptations of the NEO-FFI. Multidimensional analysis showed signifi cant main effects of gender and academic qualifi cations on personality using age as covariant. The fi ndings suggest that the Portuguese version of the NEO-FFI is a reliable instrument to measure the fi ve dimensions of personality.O objetivo deste estudo foi avaliar as propriedades psicométricas (validade e fidelidade) da adaptação portuguesa do NEO-FFI e comparar a estrutura obtida com a versão original americana. Como métodos para a validação cruzada da estrutura fatorial foram usados a Análise Fatorial de Eixos Principais (PAF) e uma Análise Fatorial Confirmatória (CFA). A PAF reproduziu a estrutura original do NEO-FFI e a CFA revelou modelos uni-factoriais de ajustamento satisfatório para cada uma das cinco dimensões. A análise de fidelidade revelou elevados valores de consistência interna, congruentes com as adaptações prévias internacionais do NEO-FFI. A análise multidimensional revelou efeitos principais significativos do género e das qualificações académicas na personalidade, usando a idade como co-variante. Os resultados sugerem que a versão portuguesa do NEO-FFI é um instrumento fiável para medir as cinco dimensões da personalidade

Measuring Medical Students' Empathy: Exploring the Underlying Constructs of and Associations Between Two Widely Used Self-Report Instruments in Five Countries.

PURPOSE: Understanding medical student empathy is important to future patient care; however, the definition and development of clinical empathy remain unclear. The authors sought to examine the underlying constructs of two of the most widely used self-report instruments-Davis's Interpersonal Reactivity Index (IRI) and the Jefferson Scale of Empathy version for medical students (JSE-S)-plus, the distinctions and associations between these instruments. METHOD: Between 2007 and 2014, the authors administered the IRI and JSE-S in three separate studies in five countries, (Brazil, Ireland, New Zealand, Portugal, and the United Kingdom). They collected data from 3,069 undergraduate medical students and performed exploratory factor analyses, correlation analyses, and multiple linear regression analyses. RESULTS: Exploratory factor analysis yielded identical results in each country, confirming the subscale structures of each instrument. Results of correlation analyses indicated significant but weak correlations (r = 0.313) between the total IRI and JSE-S scores. All intercorrelations of IRI and JSE-S subscale scores were statistically significant but weak (range r = -0.040 to 0.306). Multiple linear regression models revealed that the IRI subscales were weak predictors of all JSE-S subscale and total scores. The IRI subscales explained between 9.0% and 15.3% of variance for JSE-S subscales and 19.5% for JSE-S total score. CONCLUSIONS: The IRI and JSE-S are only weakly related, suggesting that they may measure different constructs. To better understand this distinction, more studies using both instruments and involving students at different stages in their medical education, as well as more longitudinal and qualitative studies, are needed

Empathy in senior year and first year medical students: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>The importance of fostering the development of empathy in undergraduate students is continuously emphasized in international recommendations for medical education. Paradoxically, some studies in the North-American context using self-reported measures have found that empathy declines during undergraduate medical training. Empathy is also known to be gender dependent- (highest for female medical students) and related to specialty preference - (higher in patient-oriented than technology-oriented specialties). This factor has not been studied in Portuguese medical schools.</p> <p>Methods</p> <p>This is a cross-sectional study of undergraduate medical students on self-rated measures of empathy collected at entrance and at the conclusion of the medical degree, and on the association of empathy measures with gender and specialty preferences in one medical school in Portugal. Empathy was assessed using the Portuguese adaptation of the Jefferson Scale of Physician Empathy-students version (JSPE-spv) among three cohorts of undergraduate medical students in the first (N = 356) and last (N = 120) year. The construct validity of JSPE-spv was cross-validated with Principal Component Analysis and Confirmatory Factor Analysis. Reliability was assessed using Cronbach' Alpha. Global JSPE-spv score differences were examined by year of medical school, gender and specialty preferences (people-oriented vs technology-oriented specialties).</p> <p>Results</p> <p>The empathy scores of students in the final year were higher as compared to first year students (F (1,387) = 19.33, p < .001, ɳ²_p= 0.48; π = 0.99). Female students had higher empathy scores than male students (F (1,387) = 8.82, p < .01, ɳ ²_p= 0.23; π = 0.84). Significant differences in empathy were not found between the students who prefer people-oriented specialties compared to those who favor the technology-oriented specialties (F (1,387) = 2.44, p = .12, ɳ ²_p= 0.06; π = 0.06).</p> <p>Conclusions</p> <p>This cross-sectional study in one medical school in Portugal showed that the empathy measures of senior year students were higher than the scores of freshmen. A longitudinal cohort study is needed to test variations in students' empathy measures throughout medical school.</p

Individual characteristics and student's engagement in scientific research : a cross-sectional study

Background: In light of the increasing recognition of the importance of physician scientists, and given the association between undergraduate research experiences with future scientific activity, it is important to identify and understand variables related to undergraduate student’s decision to engage in scientific research activities. The present study assessed the influence of individual characteristics, including personality traits and socio-demographic characteristics, on voluntary engagement in scientific research of undergraduate medical students. Methods: For this study, all undergraduate students and alumni of the School of Health Sciences in Minho, Portugal were invited to participate in a survey about voluntary engagement in scientific research activities. Data were available on socio-demographic, personality and university admission variables, as part of an ongoing longitudinal study. A regression model was used to compare (1) engaged with (2) not engaged students. A classification and regression tree model was used to compare students engaged in (3) elective curricular research (4) and extra-curricular research. Results: A total of 466 students (88%) answered the survey. A complete set of data was available for 435 students (83%).Higher scores in admission grade point average and the personality dimensions of “openness to experience” and “conscientiousness” increased chances of engagement. Higher “extraversion” scores had the opposite effect. Male undergraduate students were two times more likely than females to engage in curricular elective scientific research and were also more likely to engage in extra-curricular research activities. Conclusions: This study demonstrated that student’s grade point average and individual characteristics, like gender, openness and consciousness have a unique and statistically significant contribution to student’s involvement in undergraduate scientific research activities.Fundação para a Ciência e a Tecnologia (FCT) - PTDC/ESC/65116/200

Depression in medical students: insights from a longitudinal study

Background: Factors associated with depression of medical students are poorly understood. The purpose of this study is to determine the prevalence of depression in medical students, its change during the course, if depression persists for affected students, what are the factors associated with depression and how these factors change over time. Methods: A prospective, longitudinal observational study was conducted at the Medical School of the University of Minho, Portugal, between academic years 2009-2010 to 2012-2013. We included students who maintained their participation by annually completing a questionnaire including Beck Depression Inventory (BDI). Anxiety and burnout were assessed using the State Trait Anxiety Inventory and Maslach Burnout Inventory. Surveys on socio-demographic variables were applied to evaluate potential predictors, personal and academic characteristics and perceived difficulties. ANOVA with multiple comparisons were used to compare means of BDI score. The medical students were organized into subgroups by K-means cluster analyses. ANOVA mixed-design repeated measurement was performed to assess a possible interaction between variables associated with depression. Results: The response rate was 84, 92, 88 and 81% for academic years 2009-2010, 2010-2011,2011-2012 and 2012/2013, respectively. Two hundred thirty-eight medical students were evaluated longitudinally. For depression the prevalence ranged from 21.5 to 12.7% (academic years 2009/2010 and 2012/2013). BDI scores decreased during medical school. 19.7% of students recorded sustained high BDI over time. These students had high levels of trait-anxiety and choose medicine for anticipated income and prestige, reported more relationship issues, cynicism, and decreased satisfaction with social activities. Students with high BDI scores at initial evaluation with low levels of trait-anxiety and a primary interest in medicine as a career tended to improve their mood and reported reduced burnout, low perceived learning problems and increased satisfaction with social activities at last evaluation. No difference was detected between men and women in the median BDI score over time. Conclusions: Our findings suggest that personal factors (anxiety traits, medicine choice factors, relationship patterns and academic burnout) are relevant for persistence of high levels of BDI during medical training. Medical schools need to identity students who experience depression and support then, as early as possible, particularly when depression has been present over time.info:eu-repo/semantics/publishedVersio

Consensus document for lipid profile determination and reporting in Spanish clinical laboratories

Las enfermedades cardiovasculares (ECV) siguen siendo la principal causa de muerte en nuestro país. El control adecuado de las alteraciones del metabolismo lipídico es un reto clave en prevención cardiovascular que está lejos de alcanzarse en la práctica clínica real. Existe una gran heterogeneidad en los informes del metabolismo lipídico de los laboratorios clínicos españoles, lo que puede contribuir al mal control del mismo. Por ello, un grupo de trabajo de las principales sociedades científicas implicadas en la atención de los pacientes de riesgo vascular hemos elaborado este documento con una propuesta básica de consenso sobre la determinación del perfil lipídico básico en prevención cardiovascular, recomendaciones para su realización y unificación de criterios para incorporar los objetivos de control lipídico adecuados al riesgo vascular de los pacientes en los informes de laboratorio.Cardiovascular diseases (CVD) continue to be the main cause of death in our country. Adequate control of lipid metabolism disorders is a key challenge in cardiovascular prevention that is far from being achieved in real clinical practice. There is a great heterogeneity in the reports of lipid metabolism from Spanish clinical laboratories, which may contribute to its poor control. For this reason, a working group of the main scientific societies involved in the care of patients at vascular risk, has prepared this document with a consensus proposal on the determination of the basic lipid profile in cardiovascular prevention, recommendations for its realization and unification of criteria to incorporate the lipid control goals appropriate to the vascular risk of the patients in the laboratory reports