A Saúde Numa Perspectiva de Segurança e Defesa

A consciencialização de que o potencial estratégico de uma Nação é fortemente dependente do seu potencial humano, da sua capacidade de mobilização e desenvolvimento, e, consequentemente, da forma como resiste e responde aos desafios do Ambiente em que se insere. A análise de que neste final de século, de entre a imprevisibilidade das ameaças resultantes da evolução do Mundo no sentido da concretização da «Aldeia Global», desde já se perfilam as resultantes do desequilíbrio demográfico entre as regiões, do envelhecimento das populações em áreas em que a projecção do poder está intrinsecamente associada a uma economia altamente competitiva, e, ainda, as que resultam das novas ameaças biológicas cujo impacto no perfil demográfico das populações se começa a conhecer. A abordagem estratégica perante estas ameaças implica «Pensar» Saúde numa visão abrangente, integrada e intersectorial dadas as implicações evidentes nas Areas da Defesa e da Segurança. A expectativa de conseguir através da análise do impacto previsível de uma destas ameaças suscitar uma reflexão sobre a necessidade de enquadrar a política global da Saúde no Conceito Estratégico de Defesa Nacional

Catching up lives in the trash: the case of a recycling cooperative in Santa Maria-DF, Brazil

Tomando como objeto de estudo o caso de uma cooperativa de trabalho de reciclagem em Santa Maria-DF, foram trabalhadas algumas dimensões profissionais e pessoais da vida de catadores e catadoras, tendo como objetivo conhecer as suas perspetivas sobre as condições profissionais, pessoais e sociais enquanto profissionais da catação de resíduos sólidos organizados em cooperativa de trabalho de reciclagem, identificando quais as suas principais dificuldades, constrangimentos e necessidades e procurando conhecer de que forma o movimento cooperativista de trabalho de reciclagem contribui para o possível desenvolvimento dos seus processos de inclusão social. Do ponto de vista metodológico e técnico optou-se por uma abordagem qualitativa, com a realização de entrevistas e o desenvolvimento de observação. Foi possível perceber que os catadores/as não estão socialmente inseridos, carecem de educação, saúde, renda, laboram em precárias condições de trabalho, correspondem a um grupo altamente vulnerável, em que pese o cooperativismo de trabalho, via cooperativa de reciclagem proporcionar o emprego na catação tal pode considerar-se como a face perversa da inclusão.cooperative of work of recycling in Santa Maria-DF. Based on the analysis of some professional and personal dimensions of the life of waste pickers, it aims to know their perspectives on the professional, personal and social conditions as solid waste disposal workers organized in a recycling work cooperative, identifying their main difficulties, constraints and needs and seeking to know how the cooperative movement of recycling work contributes to the possible development of social inclusion processes. From the methodological and technical point of view, a qualitative approach was chosen, with the accomplishment of interviews and the development of observation. It was observed that the collectors are not socially inserted; they lack education, health, income; working conditions are precarious. They are a highly vulnerable group. Although included in cooperative work, this can be considered as the perverse face of inclusion.info:eu-repo/semantics/publishedVersio

A eficácia dos territórios educativos de Intervenção Prioritária (TEIP) na redução da indisciplina em contexto escolar: intervir na prevenção ou na remediação? um estudo de metodologias mistas

PsycINFO Clasification Categories and Codes from the American Psychological Association :3312 Behavior Therapy & Behavior Modification 3560 Classroom Dynamics & Student Adjustment & AttitudesEste estudo recorre a métodos de investigação mistos para contribuir para a reflexão acerca do impacto das estratégias empregues pelas escolas integradas na política Territórios Educativos de Intervenção Prioritária (TEIP) na redução da indisciplina em contexto escolar. A concetualização teórica assenta no modelo de Bronfenbrenner como estrutura de compreensão dos factores de risco e consequências associadas. Os resultados do estudo qualitativo indicam uma diversidade de estratégias para a indisciplina nas TEIP desta amostra, particularmente no nível de intervenção primário, com caráter universal e preventivo. No estudo quantitativo, verificámos uma fraca associação entre as estratégias TEIP e a incidência da indisciplina. Por vezes, as associações verificadas foram no sentido contrário ao esperado, ou seja, quanto mais repetida foi a implementação de estratégias de tipo preventivo ou corretivo, mais expressiva foi a indisciplina após dois anos de programa TEIP. O estudo quantitativo demonstrou ainda associações complexas, por vezes positivas e por vezes negativa entre o insucesso escolar e a indisciplina. A discussão examina os resultados quantitativos e as estratégias da política pública TEIP à luz da evidência internacional e nacional do impacto das estratégias de intervenção e prevenção para a indisciplina.This study uses mixed research methods to contribute to the reflection on the impact of the strategies employed by schools integrated in the policy Territórios Educativos de Intervenção Prioritária (TEIP) in reducing indiscipline in schools. The theoretical conceptualization is based on Bronfenbrenner’s model as a framework for understanding risk factors and associated consequences. The results of the qualitative study show a diversity of strategies for indiscipline in this sample of TEIP schools, particularly at the level of primary intervention with universal and preventive goals. In the quantitative study, we found a weak association between the TEIP strategies and the incidence of indiscipline. Sometimes associations were verified against the direction expected, that is, the more repeated was the implementation of preventive or corrective type of strategies, the more significant was the indiscipline after two years of TEIP program. The quantitative study also demonstrated a complex association (sometimes positive and other negative) between school failure and indiscipline. The discussion examines the quantitative results and strategies of the TEIP policy in light of international and national evidence on the impact of intervention and prevention strategies for indiscipline

Practice-driven restructuring of the pharmacy curricula: focus on advanced services

Poster presented at the 5th PCNE Working Symposium 2016: “Work in Progress – Progress in Work”, 19-20 February 2016, Hillerød, Denmark

Genotypic resistance profiles of HIV-2 infected patients from Cape Verde failing first-line antiretroviral therapy

The pol gene from HIV-2 infected patients from Cape Verde experiencing virologic failure was sequenced and drug resistance mutations were determined. Most patients were taking a first line regimen of AZT, 3TC and LPV/r. Resistance mutations were found in most patients (11/17, 64.7%) especially I82F (4/7, 57.1%) and M184 V (10/17, 58.8%). Resistance to all reverse transcriptase and protease inhibitors was found in 58.8% (10/17) of the patients. Integrase inhibitors are warranted to treat these patients.info:eu-repo/semantics/acceptedVersio

Development of a platform to align education and practice: bridging academia and the profession in Portugal

Limited fitness for practice may result from a mismatch between education and practice. Aiming to meet the common interests of academics and practitioners, the Portuguese Pharmaceutical Society (PPS) developed the Education and Practice Platform (EPP). The EPP includes one representative from each pharmacy faculty, and all Councils of Speciality Boards of Practice. Brainstorming with involved parties enabled sharing of interests, concerns and identifying a common path. Aims, mission, vision and values were set. The EPP's mission is to: act as an enabler to foster the quality and adequacy of education through sharing best practices, ultimately leading to facilitate professional integration, and to foster quality development in teaching practices with recognition for autonomy in freedom to teach and to learn. Its vision is an alignment of education and practice with the PPS' statutes to ensure validation of the competences defined for each practice area, and compliance with international guidance. Key performance indicators (KPIs) were set. Activities developed include the creation of a national forum to discuss education and practice, development of workshops on teaching methods and pharmacy internships, enhanced representation in international events and response to global and national requests. Ongoing work focuses on the creation of a common training framework in hospital and community pharmacy practice adapted to Portugal. The EPP is a worldwide case study, encouraging the development of discussion contributing to an open climate of sharing best practices, indirectly leading to foster a better alignment between education and practice. Many of these results are so far intangible in scientific terms but worth describing.info:eu-repo/semantics/publishedVersio

Development of nevirapine resistance in children exposed to the prevention of mother-to-child HIV-1 transmission programme in Maputo, Mozambique

Background: Single-dose nevirapine (sd-NVP) has been the main option for prevention of mother-to-child transmission (PMTCT) of HIV-1 in low-resource settings. However, sd-NVP can induce the selection of HIV-1 resistant mutations in mothers and infants. In Mozambique, there are limited data regarding the profile of NVP resistance associated mutations (RAM) in the context of PMTCT. Objectives: To assess the prevalence and the factors associated with NVP RAM among children born to HIV-1 infected mothers enrolled in the PMTCT programme adopted in Mozambique. Methods: One hundred and fifty seven children aged 6 to 48 weeks were sequentially included (July 2011 to March 2012) at four centres in Maputo. Genotyping of RAM was performed in samples with HIV-1 RNA≥ 100 copies/μL (Viroseq). Sequencing was performed with ABI 3100 (Applied Biosystems). Logistic regression modelling was undertaken to identify the factors associated with NVP RAM. Results: Seventy-nine children had their samples genotyped. Their median age was 7.0 (3–12) months and 92.4% received prophylaxis with sd-NVP at birth plus daily NVP. 35.4% of mothers received antiretrovirals (ARVs) for PMTCT. ARV RAM were detected in 43 (54.4%) of the children. 45.6% of these children had at least one NVP RAM. The most common mutations associated with NVP resistance were K103N (n = 16) and Y181C (n = 15). NVP RAM was significantly associated with mother exposure to PMTCT (crude odds ratio [OR] 30.3, 95% CI 4.93–186.34) and with mother’s CD4 count < 350 cells/mm3 (crude OR 3.08, 95% CI 1.02–9.32). In the multivariable analysis the mother’s exposure to PMTCT was the only variable significantly associated with NVP RAM (adjusted OR 48.65, 95% CI 9.33–253.66). Conclusions: We found a high prevalence of NVP RAM among children who were exposed to the drug regimen for PMTCT in Mozambique. The mothers’ exposure to PMTCT significantly increased the risk of NVP RAM.This study was funded by the Associação para a Investigação e Desenvolvimento da Faculdade de Medicina (AIDFM). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.info:eu-repo/semantics/publishedVersio

The role of the humoral immune response in the molecular evolution of the envelope C2, V3 and C3 regions in chronically HIV-2 infected patients

<p>Abstract</p> <p>Background</p> <p>This study was designed to investigate, for the first time, the short-term molecular evolution of the HIV-2 C2, V3 and C3 envelope regions and its association with the immune response. Clonal sequences of the <it>env </it>C2V3C3 region were obtained from a cohort of eighteen HIV-2 chronically infected patients followed prospectively during 2–4 years. Genetic diversity, divergence, positive selection and glycosylation in the C2V3C3 region were analysed as a function of the number of CD4+ T cells and the anti-C2V3C3 IgG and IgA antibody reactivity</p> <p>Results</p> <p>The mean intra-host nucleotide diversity was 2.1% (SD, 1.1%), increasing along the course of infection in most patients. Diversity at the amino acid level was significantly lower for the V3 region and higher for the C2 region. The average divergence rate was 0.014 substitutions/site/year, which is similar to that reported in chronic HIV-1 infection. The number and position of positively selected sites was highly variable, except for codons 267 and 270 in C2 that were under strong and persistent positive selection in most patients. N-glycosylation sites located in C2 and V3 were conserved in all patients along the course of infection. Intra-host variation of C2V3C3-specific IgG response over time was inversely associated with the variation in nucleotide and amino acid diversity of the C2V3C3 region. Variation of the C2V3C3-specific IgA response was inversely associated with variation in the number of N-glycosylation sites.</p> <p>Conclusion</p> <p>The evolutionary dynamics of HIV-2 envelope during chronic aviremic infection is similar to HIV-1 implying that the virus should be actively replicating in cellular compartments. Convergent evolution of N-glycosylation in C2 and V3, and the limited diversification of V3, indicates that there are important functional constraints to the potential diversity of the HIV-2 envelope. C2V3C3-specific IgG antibodies are effective at reducing viral population size limiting the number of virus escape mutants. The C3 region seems to be a target for IgA antibodies and increasing N-linked glycosylation may prevent HIV-2 envelope recognition by these antibodies. Our results provide new insights into the biology of HIV-2 and its relation with the human host and may have important implications for vaccine design.</p

Formar os farmacêuticos do futuro: uma experiência adaptada ao exercício da profissão

Poster apresentado no 12º Congresso das Farmácias – A Inovar Consigo, 14-16 Abril de 2016 Centro de Congressos de Lisboa, Portugal