Eating habits: what foods do children between 12 and 36 months consume?

OBJECTIVE: to identify toddlers' eating habits. METHOD: a cross-sectional study of quantitative analysis, with a sample of 808 toddlers who attended day care centers in the district of Viseu, Portugal, between November 2018 and September 2019. Data were collected using a questionnaire directed at parents. RESULTS: the prevalence of children who ate six meals a day was 42.8%, and 42.5%, those who ate five meals. It was found that 2.0% of children consumed chocolates, 1.0%, desserts, and 0.4%, carbonated beverages, daily. On average, dairy product (M=5.61; SD=2.62) and meat/fish/egg (M=4.80; SD=3.57) consumption was higher than recommended, while fat (M=0.48; SD=0.40), legume (M=0.49; SD=0.45), vegetable (M=1.18; SD=0.87) and water (M=0 .51; SD=0.29) consumption was lower. CONCLUSIONS: there was a higher or lower consumption than recommended for some foods, highlighting the need to implement nursing intervention programs aimed at promoting healthy eating habits in toddlers and families.

Eating habits: what foods do children between 12 and 36 months consume? / Hábitos alimentarios: ¿qué alimentos consumen los niños de 12 a 36 meses? / Hábitos alimentares: que alimentos consomem as crianças dos 12 aos 36 meses?

ABSTRACT Objective: to identify toddlers' eating habits. Method: a cross-sectional study of quantitative analysis, with a sample of 808 toddlers who attended day care centers in the district of Viseu, Portugal, between November 2018 and September 2019. Data were collected using a questionnaire directed at parents. Results: the prevalence of children who ate six meals a day was 42.8%, and 42.5%, those who ate five meals. It was found that 2.0% of children consumed chocolates, 1.0%, desserts, and 0.4%, carbonated beverages, daily. On average, dairy product (M=5.61; SD=2.62) and meat/fish/egg (M=4.80; SD=3.57) consumption was higher than recommended, while fat (M=0.48; SD=0.40), legume (M=0.49; SD=0.45), vegetable (M=1.18; SD=0.87) and water (M=0 .51; SD=0.29) consumption was lower. Conclusions: there was a higher or lower consumption than recommended for some foods, highlighting the need to implement nursing intervention programs aimed at promoting healthy eating habits in toddlers and families.

RESUMEN Objetivo: identificar los hábitos alimentarios de los niños pequeños. Método: estudio transversal con análisis cuantitativo, con una muestra de 808 niños pequeños que asistieron a guarderías en el distrito de Viseu, Portugal, entre noviembre de 2018 y septiembre de 2019. La recopilación de datos utilizó un cuestionario dirigido a los padres. Resultados: la prevalencia de niños que hacían seis comidas al día fue de 42,8%, y de 42,5%, los que hacían cinco comidas. Se encontró que el 2,0% de los niños consumía chocolates, el 1,0% postres dulces y el 0,4% bebidas carbonatadas diariamente. En promedio, el consumo de productos lácteos (M=5,61; DE=2,62) y carne/pescado/huevos (M=4,80; DE=3,57) fue superior al recomendado, mientras que el consumo de grasas (M=0,48; DE=0,40), legumbres (M=0,49; DE=0,45), hortalizas (M=1,18; DE=0,87) y agua (M=0,51; DE=0,29) fue menor. Conclusiones: hubo un consumo superior o inferior al recomendado para algunos alimentos, destacando la necesidad de implementar programas de intervención de enfermería dirigidos a promover hábitos alimentarios saludables en los toddles y las familias.

RESUMO Objetivo: identificar os hábitos alimentares dos toddlers. Método: estudo transversal de análise quantitativa, com amostra de 808 toddlers que frequentavam creches do distrito de Viseu, Portugal, entre novembro de 2018 e setembro de 2019. Realizou-se coleta de dados com um questionário direcionado aos pais. Resultados: a prevalência de crianças que diariamente realizavam seis refeições era de 42,8%, e 42,5%, as que realizavam cinco refeições. Constatou-se que 2,0% das crianças consumia chocolates, 1,0%, sobremesas doces, e 0,4%, bebidas gaseificadas, diariamente. Em média, o consumo de laticínios (M=5,61; DP=2,62) e de carnes/peixes/ovos (M=4,80; DP=3,57) era superior ao recomendado, enquanto o consumo de gorduras (M=0,48; DP=0,40), leguminosas (M=0,49; DP=0,45), vegetais (M=1,18; DP=0,87) e de água (M=0,51; DP=0,29) era inferior. Conclusões: verificou-se um consumo superior ou inferior ao recomendado para alguns alimentos, salientando a necessidade de implementação de programas de intervenção de enfermagem que visam promover hábitos alimentares saudáveis nos toddlers e famílias.

Padrão de sono em crianças de 12 a 36 meses de idade / Patrón del sueño de niños de 12 a 36 meses de edad / Sleep pattern in children aged 12 to 36 months age

Resumo Objetivo Avaliar o padrão de sono de crianças de 12 a 36 meses. Método Estudo transversal, realizado em uma amostra de 808 crianças com 12-36 meses de idade, que frequentavam creches no distrito de Viseu, Portugal. Coleta de dados realizada por meio de questionário aplicado aos pais, entre novembro de 2018 e setembro de 2019. Estudo aprovado pela comissão de ética do Instituto de Ciências Biomédicas Abel Salazar, Portugal. Resultados Verificou-se que durante a semana as crianças dormiam, por dia, entre 9h 30m e 18h (M=12h 25m ±1h 02m) e no fim de semana, entre 9h e 19h (M=12h 49m ±1h 15m). No fim de semana, as crianças deitavam-se e acordavam mais tarde que à semana (M=21h 42m ±40m, M=8h 15m ±50m, respetivamente). A maioria não dormia a sesta da manhã, somente a da tarde. Conclusão Os resultados indicam que a maioria das crianças (91,5% semana; 85,6% fim de semana) dorme o número de horas recomendado. As mais novas são as que dormem mais. Implicações para a prática É importante que, nas consultas de vigilância de saúde, os enfermeiros realizem educação para a saúde direcionada aos pais sobre a relevância de manter um padrão de sono adequado à criança.

Resumen Objetivo Evaluar el patrón de sueño de niños de 12 a 36 meses. Método Estudio transversal, realizado en una muestra de 808 niños de 12 a 36 meses que asistían a guarderías en el distrito de Viseu, Portugal. La recolección de datos se realizó mediante cuestionario aplicado a padres entre noviembre de 2018 y septiembre de 2019. El estudio fue aprobado por el Comité de Ética del Instituto de Ciências Biomédicas Abel Salazar, Portugal. Resultados Se encontró que en los días laborables los niños dormían, por día, entre 9h 30m y 18h (M=12h 25m ±1h 02m) y los fines de semana entre 9h y 19h (M=12h 49m ±1h 15m). Los fines de semana los niños se acostaban y se despertaban más tarde que en la semana (M=21h 42m ±40m, M=8h 15m ±50m, respectivamente). La mayoría no dormía la siesta por la mañana, pero sí por la tarde. Conclusión Los resultados indican que la mayoría de los niños (91,5% en días laborables, 85,6% en fines de semana) duermen el número de horas recomendado. Los más pequeños son los que más duermen. Implicaciones para la práctica Es importante que, en las consultas de vigilancia de la salud infantil, las enfermeras brinden educación sanitaria a los padres sobre la importancia de mantener un patrón de sueño adecuado a la edad del niño.

Abstract Objective To evaluate the sleep pattern in children aged 12 to 36 months. Method Cross-sectional study, carried out in a sample of 808 children aged 12-36 months who attended day care centers in the district of Viseu, Portugal. The data was collected through a questionnaire applied to parents between November 2018 and September 2019. The study was approved by the Ethics Committee of Instituto de Ciências Biomédicas Abel Salazar, Portugal. Results The children were found to sleep between 9 h 30 min and 18 h (M=12 h 25 min ±1 h 02 min) per day during the week and between 9 h and 19 h (M=12 h 49 min ±1 h 15 min) on weekends. The children went to bed and woke up later on weekends than during the week (M=21 h 42 min ±40 min, M=8 h 15 min ±50 min, respectively). Most did not take morning naps, but only afternoon naps. Conclusion The results indicate that most children (91.5% on weekdays; 85.6% on the weekend) sleep the recommended number of hours. The youngest are the ones who sleep the most. Implications for practice It is important that, during child health surveillance consultations, nurses provide health education to parents about the importance of maintaining a sleep pattern that is adequate for their child's age.

Investigation of the roles of AgrA and σB regulators in Listeria monocytogenes adaptation to roots and soil.

Little is known about the regulatory mechanisms that ensure the survival of the food-borne bacterial pathogen Listeria monocytogenes in the telluric environment and on roots. Earlier studies have suggested a regulatory overlap between the Agr cell-cell communication system and the general stress response regulator σB. Here, we investigated the contribution of these two systems to root colonisation and survival in sterilised and biotic soil. The ability to colonise the roots of the grass Festuca arundinacea was significantly compromised in the double mutant (∆agrA∆sigB). In sterile soil at 25°C, a significant defect was observed in the double mutant, suggesting some synergy between these systems. However, growth was observed and similar population dynamics were shown in the parental strain, ΔagrA and ΔsigB mutants. In biotic soil at 25°C, viability of the parental strain declined steadily over a two-week period highlighting the challenging nature of live soil environments. Inactivation of the two systems further decreased survival. The synergistic effect of Agr and σB was stronger in biotic soil. Transcriptional analysis confirmed the expected effects of the mutations on known Agr- and σB-dependent genes. Data highlight the important role that these global regulatory systems play in the natural ecology of this pathogen.

Mild Stress Conditions during Laboratory Culture Promote the Proliferation of Mutations That Negatively Affect Sigma B Activity in Listeria monocytogenes.

In Listeria monocytogenes, the full details of how stress signals are integrated into the σB regulatory pathway are not yet available. To help shed light on this question, we investigated a collection of transposon mutants that were predicted to have compromised activity of the alternative sigma factor B (σB). These mutants were tested for acid tolerance, a trait that is known to be under σB regulation, and they were found to display increased acid sensitivity, similar to a mutant lacking σB (ΔsigB). The transposon insertions were confirmed by whole-genome sequencing, but in each case, the strains were also found to carry a frameshift mutation in the sigB operon. The changes were predicted to result in premature stop codons, with negative consequences for σB activation, independently of the transposon location. Reduced σB activation in these mutants was confirmed. Growth measurements under conditions similar to those used during the construction of the transposon library revealed that the frameshifted sigB operon alleles conferred a growth advantage at higher temperatures, during late exponential phase. Mixed-culture experiments at 42°C demonstrated that the loss of σB activity allowed mutants to take over a population of parental bacteria. Together, our results suggest that mutations affecting σB activity can arise during laboratory culture because of the growth advantage conferred by these mutations under mild stress conditions. The data highlight the significant cost of stress protection in this foodborne pathogen and emphasize the need for whole-genome sequence analysis of newly constructed strains to confirm the expected genotype.IMPORTANCE In the present study, we investigated a collection of Listeria monocytogenes strains that all carried sigB operon mutations. The mutants all had reduced σB activity and were found to have a growth advantage under conditions of mild heat stress (42°C). In mixed cultures, these mutants outcompeted the wild type when mild heat stress was present but not at an optimal growth temperature. An analysis of 22,340 published L. monocytogenes genome sequences found a high rate of premature stop codons present in genes positively regulating σB activity. Together, these findings suggest that the occurrence of mutations that attenuate σB activity can be favored under conditions of mild stress, probably highlighting the burden on cellular resources that stems from deploying the general stress response.

The σB-dependent regulatory sRNA Rli47 represses isoleucine biosynthesis in Listeria monocytogenes through a direct interaction with the ilvA transcript.

The facultative intracellular pathogen Listeria monocytogenes can persist and grow in a diverse range of environmental conditions, both outside and within its mammalian host. The alternative sigma factor Sigma B (σB) plays an important role in this adaptability and is critical for the transition into the host. While some of the functions of the σB regulon in facilitating this transition are understood the role of σB-dependent small regulatory RNAs (sRNAs) remain poorly characterized. In this study, we focused on elucidating the function of Rli47, a σB-dependent sRNA that is highly induced in the intestine and in macrophages. Using a combination of in silico and in vivo approaches, a binding interaction was predicted with the Shine-Dalgarno region of the ilvA mRNA, which encodes threonine deaminase, an enzyme required for branched-chain amino acid biosynthesis. Both ilvA transcript levels and threonine deaminase activity were increased in a deletion mutant lacking the rli47 gene. The Δrli47 mutant displayed a shorter growth lag in isoleucine-depleted growth media relative to the wild-type, and a similar phenotype was also observed in a mutant lacking σB. The impact of the Δrli47 on the global transcription profile of the cell was investigated using RNA-seq, and a significant role for Rli47 in modulating amino acid metabolism was uncovered. Taken together, the data point to a model where Rli47 is responsible for specifically repressing isoleucine biosynthesis as a way to restrict growth under harsh conditions, potentially contributing to the survival of L. monocytogenes in niches both outside and within the mammalian host.

Role and regulation of the stress activated sigma factor sigma B (σB) in the saprophytic and host-associated life stages of Listeria monocytogenes.

The stress activated sigma factor sigma B (σB) plays a pivotal role in allowing the food-borne bacterial pathogen Listeria monocytogenes to modulate its transcriptional landscape in order to survive in a variety of harsh environments both outside and within the host. While we have a comparatively good understanding of the systems under the control of this sigma factor much less is known about how the activity of σB is controlled. In this review, we present a current model describing how this sigma factor is thought to be controlled including an overview of what is known about stress sensing and the early signal transduction events that trigger its activation. We discuss the known regulatory overlaps between σB and other protein and RNA regulators in the cell. Finally, we describe the role of σB in surviving both saprophytic and host-associated stresses. The complexity of the regulation of this sigma factor reflects the significant role that it plays in the persistence of this important pathogen in the natural environment, the food chain as well as within the host during the early stages of an infection. Understanding its regulation will be a critical step in helping to develop rational strategies to prevent its growth and survival in the food destined for human consumption and in the prevention of listeriosis.

Microbial stress meeting: From systems to molecules and back.

The 4th Microbial Stress Meeting: from Systems to Moleculesand Back was held in April 2018 in Kinsale, Ireland. The meeting covered five main topics: 1. Stress at the systems and structural level; 2. Responses to osmotic and acid stress; 3. Stress responses in single cells; 4. Stress in host-pathogen interactions; and 5. Biotechnological optimisation of microorganisms through engineering and evolution, over three days. Almost 130 delegates, from 24 countries and both the industrial and academic sectors, attended the meeting, presenting 9 lectures, 28 short talks and 52 posters. The meeting showcased the diverse and rapid advancements in microbial stress research, from the single cell level to mixed populations. In this report, a summary of the highlights from the meeting is presented.

Parental perception of toddlers body image

Currently, weight disorders, have reached a large part of the world population.Obesity in children, including toddlers, is a serious public health problem. There are many parents who do not recognize their children's overweight/obesity and toddlers parents of are less likely to recognize this problem. It is known that identifying overweight/obesity is critical to implementing pre-vention strategies and interventions as early as possible. We carried out a descriptive study of quantitative approach. It was applied: "Toddler Silhouette Scale" to parents of toddlers who attend day care centers in located the district of Viseu, Portugal. Data processed using IBM-SPSS24. It was concluded that 83.3% of the parents reported that their child had normal weight, 13.3% underweight and 3.3% overweight. Regarding the silhouette that they consider ideal, the totality of the parents, select silhouettes referring to the normal weight. In the evaluation of the current silhouette of the child, 6.7% opts for the image 1 (low Weight) and 3.3% for the image 6 (overweight), all the others select images of normal weight. According to the weight records of the individual health report, 3.3% of the children were underweight, 10% overweight and 6.7% obese. Our results corroborate those of the author of the scale who concluded that most parents correctly identify the silhouette that matches their child's actual weight. A study carried out in Portugal, revealed an absence of parental perception about the excess weight of the children

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Antimicrobial-resistant Escherichia coli and Enterococcus spp. isolated from Miranda donkey (Equus asinus): an old problem from a new source with a different approach.

PURPOSE: The Miranda donkey (Equus asinus) is an endangeredasinine from Miranda do Douro region, located in the north east of Portugal. We studied the antimicrobial resistance and virulence genes in Escherichia coli and Enterococcus spp. isolates from these animals. METHODOLOGY: In March 2014, a total of 66 faecal samples were recovered from independent animals. Antibiotic resistance was determined by the disc diffusion method. Carriage of genes coding for antibiotic-resistant and virulent factors was analysed by PCR. RESULTS: A total of 66 E. coli and 41 enterococcal isolates were detected, with Enterococcus faecium (61 %) and Enterococcus hirae (24 %) being the most prevalent species. For enterococcal isolates, high percentages of resistance rates to tetracycline (68.3 %), quinupristin/dalfopristin (51.2 %) and ciprofloxacin (48.8 %) were observed. The genes erm(A) and/or erm(B), tet(M) and/or tet(L), vat(D) and/or vat(E) and aph(3')-IIIa were also found. The most frequent virulence gene detected was gel(E), followed by ace, cpd and hyl. Escherichia coli isolates were highly resistant to streptomycin (78 %), whereas 39 % of them exhibited resistance to aminoglycosides and tetracycline. Genes sul1 and/or sul2 were detected in 66.7 % of trimethoprim/sulfamethoxazole-resistant isolates. The virulence genes detected were fim(A) (46 %) and cnf1 (27 %). CONCLUSION: To the best of our knowledge, this is the first report showing antibiotic resistance among Escherichiacoli and Enterococcus spp. isolates from the Miranda donkey in Portugal, indicating possible antibiotic-resistant bacterial reservoirs. However, the detection of these resistances presents a low risk for other animals and human beings in that rural area.

New Synthesis of Gold- and Silver-Based Nano-Tetracycline Composites.

A new synthetic methodology of water-soluble gold and silver nanoparticles (AuNPs@TC and AgNPs@TC), using the antibiotic tetracycline (TC) as co-reducing and stabilizing agent, is reported. Both colloids exhibit high water stability. The average sizes obtained were 25±10 and 15±5 nm, respectively. Both composites were tested against TC-resistant bacteria, presenting an increasing antibacterial effect in the case of AgNPs@TC. The sensing towards metal ions was also explored. An interesting and reversible affinity of AuNPs@TC towards AlIII cations in an aqueous system was also observed.

New Synthesis of Gold- and Silver-Based Nano-Tetracycline Composites.

Invited for this month's cover are collaborators from the University NOVA of Lisbon/FCT, The University of Trás-os-Montes e Alto Douro (both in Portugal), and the University of La Rioja (Spain). The cover picture is devoted to the nano-tetracycline composites based on gold and silver nanoparticles that are able to detect aluminium (III) in water and can be used as antibacterial delivery tools. For more details, read the full text of the article at 10.1002/open.201600016.

A Decade-Long Commitment to Antimicrobial Resistance Surveillance in Portugal.

Antimicrobial resistance (AMR) is a worldwide problem with serious health and economic repercussions. Since the 1940s, underuse, overuse, and misuse of antibiotics have had a significant environmental downside. Large amounts of antibiotics not fully metabolized after use in human and veterinary medicine, and other applications, are annually released into the environment. The result has been the development and dissemination of antibiotic-resistant bacteria due to many years of selective pressure. Surveillance of AMR provides important information that helps in monitoring and understanding how resistance mechanisms develop and disseminate within different environments. Surveillance data is needed to inform clinical therapy decisions, to guide policy proposals, and to assess the impact of action plans to fight AMR. The Functional Genomics and Proteomics Unit, based at the University of Trás-os-Montes and Alto Douro in Vila Real, Portugal, has recently completed 10 years of research surveying AMR in bacteria, mainly commensal indicator bacteria such as enterococci and Escherichia coli from the microbiota of different animals. Samples from more than 75 different sources have been accessed, from humans to food-producing animals, pets, and wild animals. The typical microbiological workflow involved phenotypic studies followed by molecular approaches. Throughout the decade, 4,017 samples were collected and over 5,000 bacterial isolates obtained. High levels of AMR to several antimicrobial classes have been reported, including to ß-lactams, glycopeptides, tetracyclines, aminoglycosides, sulphonamides, and quinolones. Multi-resistant strains, some relevant to human and veterinary medicine like extended-spectrum ß-lactamase-producing E. coli and vancomycin-resistant enterococci, have been repeatedly isolated even in non-synanthropic animal species. Of particular relevance are reports of AMR bacteria in wildlife from natural reserves and endangered species. Future work awaits as this threatening yet unsolved problem persists. GRAPHICAL ABSTRACTSummary diagram of the antimicrobial resistance surveillance work developed by the UTAD Functional Genomics and Proteomics Unit.

Use of MALDI-TOF mass spectrometry fingerprinting to characterize Enterococcus spp. and Escherichia coli isolates.

Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) is a faster and more accurate method to identify intact bacteria than conventional microbiology and/or molecular biology methods. The MALDI-TOF MS method is potentially applicable in diagnostic laboratories to characterize commensal bacterial species, some of which are major pathogens, from human or animal gastrointestinal tracts. The aim of this study was to analyze at the cluster and statistical level the capacity of MALDI-TOF MS to distinguish between previously characterized enterococci and Escherichia coli isolated from wild birds of the Azores archipelago. Soluble proteins were extracted from intact cell cultures of 60 isolates of Enterococcus spp. and 60 isolates of E. coli by an expedient method. MALDI-TOF MS was used to obtain 1200 mass spectra that were statistically analyzed and compared. A total of 215 distinct mass-to-charge (m/z) peaks were obtained, including a peak at m/z 4428±3, which is exclusively found in spectra from Enterococcus isolates, and peaks at m/z 5379±3 and m/z 6253±3, which are only detected in spectra from E. coli isolates. By processing mass spectra and analyzing them statistically with MassUp software, including principal component analysis (PCA) and clustering, it was possible to correctly distinguish between isolates of Enterococcus and Escherichia genera. The results of the proteomic analysis confirm that these tools could be used to characterize whole bacterial cells. In the future, with an optimized protocol for obtaining plasmid-associated proteins and the further development of bioinformatics methods, it is likely that mass peak characteristic of antimicrobial resistance will be detected, increasing the potential usefulness of MALDI-TOF in routine clinical assays. BIOLOGICAL SIGNIFICANCE: This study highlights the importance of MALDI-TOF MS in the rapid and reliable identification of bacteria by whole-cell analysis. The mass spectrometry approach performed in this study further contributes for the microbial biomarker discovery culminating in a preferable bacteria identification and antimicrobial resistance tool for the future of clinical microbiology. This article is part of a Special Issue entitled: HUPO 2014.

Azorean wild rabbits as reservoirs of antimicrobial resistant Escherichia coli.

Antibiotic resistance in bacteria is an increasing problem that is not only constrained to the clinical setting but also to other environments that can lodge antibiotic resistant bacteria and therefore they may serve as reservoirs of genetic determinants of antibiotic resistance. One hundred and thirty-six faecal samples from European wild rabbits (Oryctolagus cuniculus algirus) were collected on São Jorge Island in Azores Archipelago, and analysed for Escherichia coli isolates. Seventy-seven isolates (56.6%) were recovered and studied for antimicrobial resistance, one isolate per positive sample. Thirteen (16.9%), 19 (24.7%), 25 (32.4%) and 20 (26%) isolates were ascribed to A, B1, B2 and D phylogenetic groups, respectively, by specific primer polymerase chain reaction. Different E. coli isolates were found to be resistant to ampicillin (16.9%), tetracycline (1.3%), streptomycin (42.9%), sulfamethoxazole-trimethoprim (1.3%), amikacin (1.3%), tobramycin (2.6%) and nalidixic acid (1.3%). Additionally, the blaTEM, tetA, strA/strB, aadA, sul1, intI, intI2 and qacEΔ+sul1 genes were found in most resistant isolates. This study showed that E. coli from the intestinal tract of wild rabbits from Azores Archipelago are resistant to widely prescribed antibiotics in medicine and they constitute a reservoir of antimicrobial resistant genes, which may play a significant role in the spread of antimicrobial resistance. Therefore, antibiotic resistant E. coli from Azorean wild rabbits may represent an ecological and public health problem.

Dissemination of antibiotic resistant Enterococcus spp. and Escherichia coli from wild birds of Azores Archipelago.

Antibiotic-resistant is profoundly important to human and animal health, but the environmental reservoirs of resistance determinants are poorly understood, in particular in wild environments in remote Archipelagos. Moreover, the prevalence of antibiotic-resistant bacteria in wild bird populations is rather unknown. In the present study, we used the Azores Islands as a model study for antimicrobial resistance in a remote Archipelago, and examined the antibiotic resistance profile in enterococci and Escherichia coli recovered from faecal samples of wild birds collected in this Archipelago. A total of 138 enterococci and 115 E. coli isolates were analyzed for resistance to antimicrobial agents. Of the enterococcal isolates, Enterococcus faecalis was the most prevalent detected species (59 isolates), followed by Enterococcus faecium (40 isolates), Enterococcus durans (27 isolates) and Enterococcus hirae (12 isolates). The enterococci strains showed high percentages of resistance to tetracycline (32.6%), to ciprofloxacin (19.6%) and to erythromycin (11.6%). Lower level of resistance (<10%) was detected for ampicillin, chloramphenicol and teicoplanin. One vancomycin-resistant E. faecalis isolate was detected and harbored the vanA resistant gene. Resistance genes detected included tet(M) and/or tet(L), ermB in all tetracycline and erythromycin-resistant isolates. Resistance in E. coli isolates was detected for ampicillin, tetracycline, sulfamethoxazole/trimethoprim, streptomycin, and tobramycin. The blaTEM, aadA, aadA5, strA, strB, tet(A) and/or tet(B), and the intI genes were found in all ampicillin, streptomycin, tetracycline, and sulfamethoxazole/trimethoprim-resistant isolates respectively. The data shown in this study are essential to improve knowledge about the dissemination of resistant strains through wild birds from remote archipelagos such as the Azores Archipelago and the possible implications involved in transferring these resistances either to other animals or to humans.

Echinoderms from Azores islands: an unexpected source of antibiotic resistant Enterococcus spp. and Escherichia coli isolates.

The prevalence of antibiotic resistance and the implicated mechanisms of resistance were evaluated in Enterococcus spp. and Escherichia coli, isolated from a total of 250 faecal samples of echinoderms collected from Azorean waters (Portugal). A total of 144 enterococci (120 Enterococcus faecium, 14 E. hirae, 8 E. faecalis, 2 E. gallinarum) and 10 E. coli were recovered. High percentages of resistance in enterococci were found for erythromycin, ampicillin, tetracyclin and ciprofloxacin. The erm(A) or erm(B), tet(M) and/or tet(L), vat(D), aac(6')-aph(2″) and aph(3')-IIIa genes were found in isolates resistant to erythromycin, tetracycline, quinupristin/dalfopristin, high-level gentamicin and high-level kanamycin, respectively. Resistance in E. coli isolates was detected for streptomycin, amikacin, tetracycline and tobramycin. The aadA gene was found in streptomycin-resistant isolates and tet(A)+tet(B) genes in tetracycline-resistant isolates. The data recovered are essential to improve knowledge about the dissemination of resistant strains through marine ecosystems and the possible implications involved in transferring these resistances either to other animals or to humans.

Qualidade de vida do diabético e cuidados de enfermagem: perspectiva dos adolescentes / Quality of life of diabetics and nursing care: adolescents' perspective

Enquadramento: A vida de um adolescente pode ser alteradaapós o diagnóstico de diabetes.Tratando-se de uma doençaincurável é preciso investir no seu tratamento de modo a obteruma melhor qualidade de vida para o adolescente e família. Superar o sentimento de viver com uma doença crónica de modo a alcançar uma boa qualidade de vidarequer atenção primordial da equipa de enfermagem que presta cuidados ao adolescente. Objectivos: Avaliar a qualidade de vida em adolescentes com diabetes que frequentam a consulta externa do Hospital; analisar a sua opinião acerca dos cuidados de enfermagem; relacionar a opinião de adolescentes diabéticos sobre os cuidados de enfermagem com a sua qualidade de vida e identificar variáveis sociodemográficas e clinicas que influenciem a Qualidade de Vida dos adolescentes e a sua opinião sobre os cuidados de enfermagem. Métodos:O nosso estudo desenvolveu-secom uma amostra de 47 adolescentes que frequentam a consulta externa de diabetologia pediátrica do Centro Hospitalar Tondela- Viseu. Para o cumprimento dos objectivos delineamos uma investigação de natureza quantitativa, descritiva, correlacional. O questionário aplicado comporta a caracterização sócio demográfica da amostra e os dados clínicos, a escala de Qualidade de Vida em jovens Diabéticos que comporta três dimensões (Impacto, Preocupação e Satisfação) e ainda a Escala Newcastle (opiniões acerca dos cuidados de enfermagem).Recorremos à análise descritiva e inferencial dos dados através do programa informático SPSS versão 20.0. Resultados:São os adolescentes que consideram ter uma boa saúde que apresentam melhor QV. A autopercepção da saúde, a idade do adolescente e o número de internamentos são as variáveis que se relacionam estatisticamente com a QV.São os adolescentes que adquirem a doença mais cedo que apresentam pior QV. Conclusão:A maioria dos adolescentes tem uma opinião positiva acerca dos cuidados de enfermagem e considera ter boa QV. Este estudo serviu para salientar a importância do papel do enfermeiro na QV do adolescente diabético.

Background:The life of ateenager canbe changedafter the diagnosis ofdiabetes.Since this isan incurable diseaseyou need to investin their treatmentin order to obtaina better quality oflifefor the adolescentandfamily. Overcomingthe feeling of livingwith a chronic illnessto achievea goodquality of liferequiresprimaryattentionof the nursing teamthatprovides careto adolescents. Objectives: To evaluate quality of life in adolescents with diabetes attending outpatient Hospital; analyze your opinion about nursing care; relate the opinion of diabetic adolescents on nursing care with their quality of life (QOL) and to identify socio demographic and clinics that influence the quality of life of adolescents and their views of nursing care. Methods: Our study was carried out with a sample of 47 adolescents attending outpatient pediatric diabetology in Hospital Center Tondela-Viseu. To achieve the objectives outlined an investigation of a quantitative, descriptive, correlational. The questionnaire includes a sample socio demographic and clinical data, the scale of Quality of Life in Young Diabetics involving three dimensions (Impact, Concern and Satisfaction) and also the Newcastle Scale (opinions about the nursing care).Resort todescriptive and inferential analysisof the datathrough the softwareSPSSversion20.0 Results:They areteenagers whobelieve they havegood healththat have betterQOL. Selfperceivedhealth, age of the adolescentand the admissions number are thevariablesthatarestatisticallyrelatedtoQOL. They areteenagers whoacquire the diseasesooner thanhave a worseQOL. Conclusion: Most teenagershave a positive opinionabout thenursing careandhaving goodQOL. This studyserved tohighlight the importanceof the roleof the nurse inthe adolescentdiabeticQOL.