Dynamics of Pneumococcal Carriage in Adults: A New Look at an Old Paradigm.

BACKGROUND: Limited information is available on pneumococcal colonization among adults. We studied pneumococcal carriage dynamics in healthy adults using high-sensitivity approaches. METHODS: Eighty-seven adults (25-50 years old) were followed for 6 months in Portugal. Nasopharyngeal, oropharyngeal, and saliva samples were obtained monthly; pneumococcal carriers were also sampled weekly. Carriage was investigated by quantitative polymerase chain reaction (targeting lytA and piaB) and culture. Positive samples were serotyped. RESULTS: Approximately 20% of the adults were intermittent carriers; 10% were persistent carriers (>4 months). Pneumococcal acquisition and clearance rates were 16.5 (95% confidence interval [CI], 11.2-24.2) and 95.9 (95% CI, 62.3-145.0) cases/1000 person-weeks, respectively. Living with children increased pneumococcal acquisition (hazard ratio, 9.7 [95% CI, 2.6-20.5]; P < .001). Median duration of carriage was 7 weeks and did not depend on regular contact with children. CONCLUSIONS: The pneumococcal carrier state in healthy adults is more dynamic than generally assumed: Acquisition is frequent and duration of carriage is often long. This suggests that some adults may act as reservoirs of pneumococci and hence, depending on the social structure of a community, the magnitude of herd effects potentially attainable through children vaccination may vary. These findings are important when designing strategies to prevent pneumococcal disease in adults.

Film production with flaxseed mucilage and polyvinyl alcohol mixtures and evaluation of their properties.

Flaxseed mucilage was extracted with distilled water, dried and used for film production with polyvinyl alcohol (PVA) (ratio 1:1) of different hydrolysis degrees (88.0 and 98.3%). The properties of the films were evaluated by determining the thickness, tensile measurements, moisture content, water vapor permeability, apparent opacity, scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FTIR) analysis and thermogravimetric analysis. Flaxseed mucilage, when mixed with PVA, produces less resistant, less rigid, more-flexible films, has a higher thermal stability, and does not change the water vapor barrier properties compared with pure mucilage films. SEM revealed that films with mucilage and PVA mixtures formed a compact and homogeneous structure, corroborating the FTIR spectra that indicated a chemical interaction between these two biopolymers. In general, the degree of PVA hydrolysis did not influence the properties of the films when mixed with flaxseed mucilage extract. Therefore, films obtained from mixtures of flaxseed mucilage and PVA can be an interesting and advantageous alternative for producing bio-based packaging.

Predicting volleyball serve-reception at group level.

In a group-serve-reception task, how does serve-reception become effective? We addressed "who" receives/passes the ball, what task-related variables predict action mode selection and whether the action mode selected was associated with reception efficacy. In 182 serve-receptions we tracked the ball and the receivers' heads with two video-cameras to generate 3D world-coordinates reconstructions. We defined receivers' reception-areas based on Voronoi diagrams (VD). Our analyses of the data showed that this approach was accurate in describing "who" receives the serve in 95.05% of the times. To predict action mode selection, we used variables related to: serve kinematics, receiver's movement and on-court positioning, the relation between receiver and his closest partner, and interactions between receiver-ball and receiver-target. Serve's higher initial velocities together with higher maximum height, as well as smaller longitudinal distances between receiver and target increased the chances for the use of the overhand pass. Conversely, decreasing alignment of the receiver with the ball and the target increased the chances of using the underhand-lateral pass. Finally, the use of the underhand-lateral pass was associated with lower quality receptions. Behavioural variability's relevance for serve-reception training is discussed.

Sodium lauryl ether sulfate (SLES) degradation by nitrate-reducing bacteria.

The surfactant sodium lauryl ether sulfate (SLES) is widely used in the composition of detergents and frequently ends up in wastewater treatment plants (WWTPs). While aerobic SLES degradation is well studied, little is known about the fate of this compound in anoxic environments, such as denitrification tanks of WWTPs, nor about the bacteria involved in the anoxic biodegradation. Here, we used SLES as sole carbon and energy source, at concentrations ranging from 50 to 1000 mg L-1, to enrich and isolate nitrate-reducing bacteria from activated sludge of a WWTP with the anaerobic-anoxic-oxic (A2/O) concept. In the 50 mg L-1 enrichment, Comamonas (50%), Pseudomonas (24%), and Alicycliphilus (12%) were present at higher relative abundance, while Pseudomonas (53%) became dominant in the 1000 mg L-1 enrichment. Aeromonas hydrophila strain S7, Pseudomonas stutzeri strain S8, and Pseudomonas nitroreducens strain S11 were isolated from the enriched cultures. Under denitrifying conditions, strains S8 and S11 degraded 500 mg L-1 SLES in less than 1 day, while strain S7 required more than 6 days. Strains S8 and S11 also showed a remarkable resistance to SLES, being able to grow and reduce nitrate with SLES concentrations up to 40 g L-1. Strain S11 turned out to be the best anoxic SLES degrader, degrading up to 41% of 500 mg L-1. The comparison between SLES anoxic and oxic degradation by strain S11 revealed differences in SLES cleavage, degradation, and sulfate accumulation; both ester and ether cleavage were probably employed in SLES anoxic degradation by strain S11.

The Potential of Bioaugmentation-Assisted Phytoremediation Derived Maize Biomass for the Production of Biomethane via Anaerobic Digestion.

Anthropogenic behaviors are causing the severe build-up of heavy metal (HM) pollutants in the environment, particularly in soils. Amongst a diversity of remediation technologies, phytoremediation is an environmentally friendly technology that, when coupling tolerant plants to selected rhizospheric microorganisms, can greatly stimulate HM decontamination of soils. Maize (Zea mays) is a plant with the reported capacity for HM exclusion from contaminated soil but also has energetic importance. In this study, Zea mays was coupled with Rhizophagus irregularis, an arbuscular mycorrhizal fungus (AMF), and Cupriavidus sp. strain 1C2, a plant growth-promoting rhizobacteria (PGPR), as a remediation approach to remove Cd and Zn from an industrial contaminated soil (1.2 mg Cd kg-1 and 599 mg Zn kg-1) and generate plant biomass, by contrast to the conservative development of the plant in an agricultural (with no metal pollution) soil. Biomass production and metal accumulation by Z. mays were monitored, and an increase in plant yield of ca. 9% was observed after development in the contaminated soil compared to the soil without metal contamination, while the plants removed ca. 0.77% and 0.13% of the Cd and Zn initially present in the soil. The resulting biomass (roots, stems, and cobs) was used for biogas generation in several biomethane (BMP) assays to evaluate the potential end purpose of the phytoremediation-resulting biomass. It was perceptible that the HMs existent in the industrial soil did not hinder the anaerobic biodegradation of the biomass, being registered biomethane production yields of ca. 183 and 178 mL of CH4 g-1 VS of the complete plant grown in non-contaminated and contaminated soils, respectively. The generation of biomethane from HM-polluted soils' phytoremediation-derived maize biomass represents thus a promising possibility to be a counterpart to biogas production in an increasingly challenging status of renewable energy necessities.

Evaluation of Methicillin-Resistant Staphylococcus aureus Carriage in the Elderly in Portugal Using Selective Enrichment Followed by Quantitative Real-Time PCR.

The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in hospitals in Portugal is worrisome and among the highest in Europe. Surprisingly, MRSA prevalence in the community was described as very low (<2%) based on studies that used classical culture-based methods (CCBM). We investigated whether the apparent limited spread of MRSA in the community in Portugal might result from low sensitivity of CCBM. Nasopharyngeal- and oropharyngeal-paired samples obtained from senior adults living in nursing (n = 299) or family homes (n = 300) previously characterized by CCBM were reanalyzed. Samples were inoculated in a semi-selective enrichment medium, and those showing visible growth were evaluated by qPCR targeting nuc, mecA, and mecC genes (SSE+qPCR). By SSE+qPCR, 34 of the 1,198 (2.8%) samples were MRSA positive compared with 21 (1.8%) by CCBM. SSE+qPCR improved non-significantly detection of MRSA carriers from 5.4% to 8.0% (p = 0.12) in the nursing home collection, and from 0.3% to 1.7% (p = 0.13) in the family home collection. MRSA isolates belonged to three HA-MRSA clones widely disseminated in Portuguese hospitals. In conclusion, use of semi-selective medium combined with qPCR did not change the overall scenario previously described. In Portugal, MRSA circulation in the community among senior adults is low.

Quantitative image analysis as a robust tool to assess effluent quality from an aerobic granular sludge system treating industrial wastewater.

Quantitative image analysis (QIA) is a simple and automated method for process monitoring, complementary to chemical analysis, that when coupled to mathematical modelling allows associating changes in the biomass to several operational parameters. The majority of the research regarding the use of QIA has been carried out using synthetic wastewater and applied to activated sludge systems, while there is still a lack of knowledge regarding the application of QIA in the monitoring of aerobic granular sludge (AGS) systems. In this work, chemical oxygen demand (COD), ammonium (N-NH4+), nitrite (N-NO2-), nitrate (N-NO3-), salinity (Cl-), and total suspended solids (TSS) levels present in the effluent of an AGS system treating fish canning wastewater were successfully associated to QIA data, from both suspended and granular biomass fractions by partial least squares models. The correlation between physical-chemical parameters and QIA data allowed obtaining good assessment results for COD (R2 of 0.94), N-NH4+ (R2 of 0.98), N-NO2- (R2 of 0.96), N-NO3- (R2 of 0.95), Cl- (R2 of 0.98), and TSS (R2 of 0.94). While the COD and N-NO2- assessment models were mostly correlated to the granular fraction QIA data, the suspended fraction was highly relevant for N-NH4+ assessment. The N-NO3-, Cl- and TSS assessment benefited from the use of both biomass fractions (suspended and granular) QIA data, indicating the importance of the balance between the suspended and granular fractions in AGS systems and its analysis. This study provides a complementary approach to assess effluent quality parameters which can improve wastewater treatment plants monitoring and control, with a more cost-effective and environmentally friendly procedure, while avoiding daily physical-chemical analysis.

Edible coatings and films with incorporation of prebiotics -A review.

Prebiotics are compounds naturally present in some foods or can be synthesized by microorganisms and enzymes. Among the benefits associated with prebiotic consumption are the modulation of the intestinal microbiota that increase the production of short chain fatty acids and prevent the development of some disorders such as colon cancer, irritable bowel syndrome, diabetes, obesity, among others. Traditionally, prebiotics have been used in diverse food formulations to enhance their healthy potential or to improve their technological and sensory properties. However, different alternatives for the production of prebiotic products are being explored, such as edible coatings and films. Therefore, this review aims to highlight recent research on edible coatings and films incorporated with different prebiotics, the concept of prebiotics, the general characteristics of these materials, and the main production methods, as well as presenting the perspectives of uses in the food industry. Current works describe that polyols and oligosaccharides are the most employed prebiotics, and depending on their structure and concentration, they can also act as film plasticizer or reinforcement agent. The use of prebiotic in the coating can also improve probiotic bacteria survival making it possible to obtain fruits and vegetables with synbiotic properties. The most common method of production is casting, suggesting that other technologies such as extrusion can be explored aiming industrial scale. The use of film and coating carried of prebiotic is an emerging technology and there are still several possibilities for study to enable its use in the food industry. This review will be useful to detect the current situation, identify problems, verify new features, future trends and support new investigations and investments.

Long-term stability of a non-adapted aerobic granular sludge process treating fish canning wastewater associated to EPS producers in the core microbiome.

The tolerance of aerobic granular sludge (AGS) to variable wastewater composition is perceived as one of its greatest advantages compared to other aerobic processes. However, research studies select optimal operational conditions for evaluating AGS performance, such as the use of pre-adapted biomass and the control of wastewater composition. In this study, non-adapted granular sludge was used to treat fish canning wastewater presenting highly variable organic, nutrient and salt levels over a period of ca. 8 months. Despite salt levels up to 14 g NaCl L-1, the organic loading rate (OLR) was found to be the main factor driving AGS performance. Throughout the first months of operation, the OLR was generally lower than 1.2 kg COD m-3 day-1, resulting in stable nitrification and low COD and phosphorous levels at the outlet. An increase in OLR up to 2.3 kg COD m-3 day-1 disturbed nitrification and COD and phosphate removal, but a decrease to average values between 1 and 1.6 kg COD m-3 day-1 led to resuming of those processes. Most of the bacteria present in the AGS core microbiome were associated to extracellular polymeric substances (EPS) production, such as Thauera and Paracoccus, which increased during the higher OLR period. Ammonium-oxidizing bacteria (AOB) and nitrite-oxidizing bacteria (NOB) species were detected in AGS biomass; while AOB were identified throughout the operation, NOB were no further identified after the period of increased OLR. Different polyphosphate-accumulating organisms (PAOs) were detected along the process: CandidatusAccumulibacter, Tetrasphaera and Gemmatimonas. A non-adapted granular sludge was able to treat the fish canning wastewater and to tolerate salinity fluctuations up to 14 g L-1. Overall, a high microbial diversity associated to EPS producers allowed to preserve bacterial groups responsible for nutrients removal, contributing to the adaptation and long-term stability of the AGS system.

Impact of private use of the 13-valent pneumococcal conjugate vaccine (PCV13) on pneumococcal carriage among Portuguese children living in urban and rural regions.

In Portugal, the 13-valent pneumococcal conjugate vaccine (PCV13) was commercially available between 2010 and 2015, following a decade of private use of PCV7. We evaluated changes on serotype distribution and antimicrobial susceptibility of pneumococci carried by children living in two regions of Portugal (one urban and one rural). Three epidemiological periods were defined: pre-PCV13 (2009-2010), early-PCV13 (2011-2012), and late-PCV13 (2015-2016). Nasopharyngeal samples (n = 4,232) were obtained from children 0-6 years old attending day-care centers. Private use of PCVs was very high in both regions (>75%). Pneumococcal carriage remained stable and high over time (62.1%, 62.4% and 61.6% (p = 0.909) in the urban region; and 59.8%, 62.8%, 59.5% (p = 0.543) in the rural region). Carriage of PCV7 serotypes remained low (5.3%, 7.8% and 4.3% in the urban region; and 2.5%, 3.7% and 4.8% in the rural region). Carriage of PCV13 serotypes not targeted by PCV7 decreased in both the urban (16.4%, 7.3%, and 1.6%; p < 0.001) and rural regions (13.2%, 7.8%, and 1.9%; p < 0.001). This decline was mostly attributable to serotype 19A (14.1%, 4.4% and 1.3% in the urban region; and 11.1%, 3.6% and 0.8% in the rural region, both p < 0.001). Serotype 3 declined over time in the urban region (10.1%, 4.4%, 0.8%; p < 0.001) and had no obvious trend in the rural region (4.2%, 6.7%, 2.4%; p = 0.505). Serotype 6C decreased in both regions while serotypes 11D, 15A/B/C, 16F, 21, 22F, 23A/B, 24F, 35F, and NT were the most prevalent in the late-PCV13 period. Intermediate resistance to penicillin and non-susceptibility to erythromycin decreased significantly in both regions (19.5%, 13.3%, and 9.3%; and 25.4%, 25.9%, and 13.4%; both p < 0.001, respectively in the urban region; and 12.4%, 11.1%, and 2.8% (p < 0.001); and 15.3%, 14.7%, and 9.2% (p = 0.037), respectively, in the rural region). In conclusion, private use of PCV13 led to significant changes on the pneumococcal population carried by children in Portugal.

Linking Tensegrity to Sports Team Collective Behaviors: Towards the Group-Tensegrity Hypothesis.

Collective behaviors in sports teams emerge from the coordination between players formed from their perception of shared affordances. Recent studies based on the theoretical framework of ecological dynamics reported new analytical tools to capture collective behavior variables that describe team synergies. Here, we introduce a novel hypothesis based on the principles of tensegrity to describe collective behavior. Tensegrity principles operate in the human body at different size scales, from molecular to organism levels, in structures connected physically (biotensegrity). Thus, we propose that a group of individuals connected by information can exhibit synergies based on the same principles (group-tensegrity), and we provide an empirical example based on the dynamics of a volleyball team sub-phase of defense.

Quantitative monitoring of an activated sludge reactor using on-line UV-visible and near-infrared spectroscopy.

The performance of an activated sludge reactor can be significantly enhanced through use of continuous and real-time process-state monitoring, which avoids the need to sample for off-line analysis and to use chemicals. Despite the complexity associated with wastewater treatment systems, spectroscopic methods coupled with chemometric tools have been shown to be powerful tools for bioprocess monitoring and control. Once implemented and optimized, these methods are fast, nondestructive, user friendly, and most importantly, they can be implemented in situ, permitting rapid inference of the process state at any moment. In this work, UV-visible and NIR spectroscopy were used to monitor an activated sludge reactor using in situ immersion probes connected to the respective analyzers by optical fibers. During the monitoring period, disturbances to the biological system were induced to test the ability of each spectroscopic method to detect the changes in the system. Calibration models based on partial least squares (PLS) regression were developed for three key process parameters, namely chemical oxygen demand (COD), nitrate concentration (N-NO(3)(-)), and total suspended solids (TSS). For NIR, the best results were achieved for TSS, with a relative error of 14.1% and a correlation coefficient of 0.91. The UV-visible technique gave similar results for the three parameters: an error of approximately 25% and correlation coefficients of approximately 0.82 for COD and TSS and 0.87 for N-NO(3)(-) . The results obtained demonstrate that both techniques are suitable for consideration as alternative methods for monitoring and controlling wastewater treatment processes, presenting clear advantages when compared with the reference methods for wastewater treatment process qualification.

Periodic cycles of pneumococcal serotypes carried by children before and after 7-valent pneumococcal conjugate vaccine.

BACKGROUND: Periodic cycles in the serotype-specific incidence of invasive pneumococcal disease have been described but less is known in carriage. METHODS: We analyzed serotype carriage prevalence among children 0-6 years old over a 15-year period that included pre-PCV7 data and a decade of PCV7 use. Mixed generalized additive models were used to study periodic cycles and how PCV7 impacted on them. RESULTS: Pneumococcal carriage data of 7,463 children were analyzed. Periodic cycles ranging from 3 to 6 years were observed for PCV7-serotypes (VT) 14, 19F and 23F and for non-PCV7 types (NVT) 3, 6A, 6C, 11A, and NT. An indirect impact of PCV7 on periodic cycles of NVT was observed and could be translated in three ways: (i) a higher amplitude in the PCV7 period (serotypes 3 and 11A), (ii) sustained increase in the prevalence of carriage (serotypes 6C, 19A and NT) and (iii) an increase in the inter-epidemic period (serotypes 3, 6A and NT). An increase in the child's mean age of carriage of VTs 6B, 19F and 23F was observed. Serotypes 3, 6C, 11A and 15A became more frequent in ages previously associated with carriage of VTs. CONCLUSIONS: Periodic cycles among serotypes frequently carried exist and can be modeled. These cycles can be perturbed upon introduction of PCVs and can lead to shifts in the mean age of carriage. Cyclic re-emergence of VTs can occur in settings with non-universal vaccine use. These results should be taken into account when interpreting surveillance data on pneumococcal carriage.

Predicting Volleyball Serve-Reception.

Serve and serve-reception performance have predicted success in volleyball. Given the impact of serve-reception on the game, we aimed at understanding what it is in the serve and receiver's actions that determines the selection of the type of pass used in serve-reception and its efficacy. Four high-level volleyball players received jump-float serves from four servers in two reception zones-zone 1 and 5. The ball and the receiver's head were tracked with two video cameras, allowing 3D world-coordinates reconstruction. Logistic-regression models were used to predict the type of pass used (overhand or underhand) and serve-reception efficacy (error, out, or effective) from variables related with the serve kinematics and related with the receiver's on-court positioning and movement. Receivers' initial position was different when in zone 1 and 5. This influenced the serve-related variables as well as the type of pass used. Strong predictors of using an underhand rather than overhand pass were higher ball contact of the server, reception in zone 1, receiver's initial position more to the back of the court and backward receiver movement. Receiver's larger longitudinal displacements and an initial position more to the back of the court had a strong relationship with the decreasing of the serve-reception efficacy. Receivers' positioning and movement were the factors with the largest impact on the type of pass used and the efficacy of the reception. Reception zone affected the variance in the ball's kinematics (with the exception of the ball's lateral displacement), as well as in the receivers' positioning (distances from the net and from the target). Also the reception zone was associated with the type of pass used by the receiver but not with reception efficacy. Given volleyball's rotation rule, the receiver needs to master receiving in the different reception zones; he/she needs to adapt to the diverse constraints of each zone to maintain performance efficacy. Thus, being able to flexibly vary positioning and passing, given local (zone) constraints, can yield an advantage in high-level volleyball serve-reception. Further, research needs to consider other serve modes (e.g., power-jump serve) and a full-court context of performance to support the present study's findings.

The impact of private use of PCV7 in 2009 and 2010 on serotypes and antimicrobial resistance of Streptococcus pneumoniae carried by young children in Portugal: Comparison with data obtained since 1996 generating a 15-year study prior to PCV13 introduction.

In Portugal, the 7-valent pneumococcal conjugate vaccine (PCV7) was not introduced in the national immunization plan but was commercially available between 2001 and 2010. We studied serotype distribution and antibiotic susceptibility of Streptococcus pneumoniae carried by children in 2009 and 2010. Vaccination with PCV7 was extracted from children's immunization bulletins and information on recent antimicrobial consumption was obtained through a questionnaire. For comparison, we included data from previous studies conducted since 1996: 1996-1999, 2001-2003, 2006-2007. Pneumococci were isolated from nasopharyngeal samples of 1092 children up to six years old attending day-care in an urban area. Among these, 76% (819/1070) were vaccinated and 62% (677/1092) carried pneumococci. In 2009-2010, serotype replacement was extensive. Carriage of PCV7 serotypes was 4.9% and 5.8%, in 2009 and 2010, respectively, with the majority being of serotype 19F (carried by 4.3% and 4.6% of all participants, respectively). Colonization by serotype 19F was associated with vaccine status (7.7% (19/248) of non-vaccinees vs. 3.5% (29/818) of PCV7-vaccinees, p=0.010). Carriage of serotype 19A was high in 2009 and 2010 (8.6% of all participants) consistent with values already observed in 2007; carriage of serotype 6A was <1% (10/1092), indicating a major decline after 2007 (5.8% or 31/538, p<0.001). Non-vaccine serotypes increased and serotype 6C became the most frequently carried serotype in 2010 (11.2% (54/481)). High-level resistance to penicillin (MIC ≥2mg/L) showed a decreasing trend (p<0.001), whereas resistance to both penicillin and erythromycin increased (p<0.001) and was detected in 15-20% of all isolates in 2009-2010, most of which were non-vaccine serotypes. Antimicrobial use decreased over time (p<0.001). In conclusion, widespread private use of PCV7 has impacted on colonization leading to near elimination of all PCV7 serotypes except for serotype 19F. Antimicrobial consumption declined but it may be too soon to observe generalized changes in antimicrobial resistance rates.

Insights into alpha-hemolysin (Hla) evolution and expression among Staphylococcus aureus clones with hospital and community origin.

BACKGROUND: Alpha-hemolysin (Hla) is a major virulence factor in the pathogenesis of Staphylococcus aureus infection, being active against a wide range of host cells. Although hla is ubiquitous in S. aureus, its genetic diversity and variation in expression in different genetic backgrounds is not known. We evaluated nucleotide sequence variation and gene expression profiles of hla among representatives of hospital (HA) and community-associated (CA) S. aureus clones. METHODS: 51 methicillin-resistant S. aureus and 22 methicillin-susceptible S. aureus were characterized by PFGE, spa typing, MLST and SCCmec typing. The internal regions of hla and the hla promoter were sequenced and gene expression was assessed by RT-PCR. RESULTS: Alpha-hemolysin encoding- and promoter sequences were diverse, with 12 and 23 different alleles, respectively. Based on phylogenetic analysis, we suggest that hla may have evolved together with the S. aureus genetic background, except for ST22, ST121, ST59 and ST93. Conversely, the promoter region showed lack of co-evolution with the genetic backgrounds. Four non-synonymous amino acid changes were identified close to important regions of hla activity. Amino acid changes in the RNAIII binding site were not associated to hla expression. Although expression rates of hla were in general strain-specific, we observed CA clones showed significantly higher hla expression (p = 0.003) when compared with HA clones. CONCLUSION: We propose that the hla gene has evolved together with the genetic background. Overall, CA genetic backgrounds showed higher levels of hla expression than HA, and a high strain-to-strain variation of gene expression was detected in closely related strains.

Low prevalence of pneumococcal carriage and high serotype and genotype diversity among adults over 60 years of age living in Portugal.

Pneumococcal disease is frequent at the extremes of age. While several studies have looked at colonization among young children, much less is known among the elderly. We aimed to evaluate pneumococcal carriage among elderly adults living in Portugal. Between April 2010 and December 2012, nasopharyngeal and oropharyngeal swabs of adults over 60 years of age, living in an urban area (n = 1,945) or in a rural area (n = 1,416), were obtained. Pneumococci were isolated by culture-based standard procedures, identified by optochin susceptibility, bile solubility and PCR screening for lytA and cpsA, and characterized by antibiotype, serotype, and MLST. Associations between pneumococcal carriage, socio-demographic and clinical characteristics were evaluated by univariate analysis and multiple logistic regression. The global prevalence of carriage was 2.3% (95% CI: 1.8-2.8). In the multiple logistic regression analysis, smoking, being at a retirement home, and living in a rural area increased the odds of being a pneumococcal carrier by 4.4-fold (95% CI: 1.9-9.2), 2.0-fold (95% CI: 1.1-3.6) and 2.0-fold (95% CI: 1.2-3.5), respectively. Among the 77 pneumococcal isolates, 26 serotypes and 40 STs were identified. The most prevalent serotypes were (in decreasing order) 19A, 6C, 22F, 23A, 35F, 11A, and 23B, which accounted, in total, for 60.0% of the isolates. Most isolates (93.5%) had STs previously described in the MLST database. Resistance to macrolides, non-susceptibility to penicillin and multidrug resistance were found in 19.5%, 11.7%, and 15.6% of the isolates, respectively. We conclude that the prevalence of pneumococcal carriage in the elderly, in Portugal, as determined by culture-based methods, is low. Serotype and genotype diversity is high. Living in a rural area, in a retirement home, and being a smoker increased the risk of pneumococcal carriage. This study contributes to the establishment of a baseline that may be used to monitor how novel pneumococcal vaccines impact on colonization among the elderly.

Sentimentos vivenciados por primigestas / Feelings experienced by the first-time pregnant women

Objetivo: desvelar os principais problemas relacionados aos sentimentos vivenciados e enfrentados pelas primigestas. Método: estudo quantitativo, exploratório-descritivo. A amostra foi composta por 17 primigestas. O instrumento de coleta de dados foi um questionário previamente estruturado. Os dados foram submetidos à análise estatística simples e disponibilizados através de tabelas com auxílio do programa Excel Office 2013. Resultados: identificou-se que o maior número das primigestas entrevistas está gerando o filho com idade inferior aos 30 anos, sendo a maioria mãe solteira, e que apesar da gravidez por muitas vezes nao ter sido planejada referenciam sentir amor pelo filho, apresentando também um índice significativo de ansiedade pelo estado que se encontram e por falta de informação ou orientação de enfermagem. Conclusão: diversos sentimentos são relatados em relação à primeira gestação, a ansiedade é um dos sentimentos mais visíveis. Tal fator pode tornar algumas condutas dificultadas, sendo possível perceber que o profissional de enfermagem fornece orientações adequadas e que a participação do enfermeiro no tocante ao planejamento familiar e acompanhameto de primigestas é relevante. Ressalta-se a importância da continuade de estudos voltados a esta temática.(AU)

Patterns of cognitive performance in healthy ageing in Northern Portugal: a cross-sectional analysis.

BACKGROUND: The Minho Integrative Neuroscience Database (MIND)-Ageing project aims to identify predictors of healthy cognitive ageing, including socio-demographic factors. In this exploratory analysis we sought to establish baseline cohorts for longitudinal assessment of age-related changes in cognition. METHODS: The population sample (472 individuals) was strictly a convenient one, but similar to the Portuguese population in the age profile. Participants older than 55 years of age were included if they did not present defined disabling pathologies or dementia. A standardized clinical interview was conducted to assess medical history and a battery of neuropsychological tests was administered to characterize global cognition (Mini Mental State Examination), memory and executive functions (Selective Reminding Test; Stroop Color and Word Test; and Block Design subtest of the Wechsler Adult Intelligence Scale). Cross-sectional analysis of the neuropsychological performance with individual characteristics such as age, gender, educational level and setting (retirement home, senior university, day care center or community), allowed the establishment of baseline clusters for subsequent longitudinal studies. RESULTS: Based on different socio-demographic characteristics, four main clusters that group distinctive patterns of cognitive performance were identified. The type of institution where the elders were sampled from, together with the level of formal education, were the major hierarchal factors for individual distribution in the four clusters. Of notice, education seems to delay the cognitive decline that is associated with age in all clusters. CONCLUSIONS: Social-inclusion/engagement and education seem to have a protective effect on mental ageing, although this effect may not be effective in the eldest elders.

Operacionalização Psicodinâmica de Diagnóstico (OPD-2) numa psicanálise / Operacionalized Psychodynsmic Diagnosis (OPD-2) in a psychoanalysis / Diagnóstico Psicodinámico Operacionalizado (OPD-2) en un psicoanálisis

A investigação em psicoterapia psicanalítica é apontada como tendo um elevado nível de abstração, falta de clareza e de consenso entre os clínicos na operacionalização de constructos e na análise de resultados fiáveis. Um diagnóstico psicodinâmico rigoroso e fiável que permita uma homogeneização de critérios de avaliação aumenta a comunicação dentro da comunidade científica e aproxima a investigação à prática. O OPD2 - Operationalized Psychodynamic Diagnosis - objetiva operacionalizar os constructos psicanalíticos, através de entrevistas semiestruturadas, e formular um diagnóstico psicodinâmico multiaxial baseado em 5 eixos: experiência da doença e pré-requisitos para o tratamento (Eixo I); relações interpessoais (Eixo II); conflito (Eixo III); estrutura (Eixo IV); perturbações mentais e psicossomáticas (Eixo V). O OPD-2 foi aplicado neste estudo com o objetivo de testar a avaliação diagnóstica através de notas de sessões numa paciente seguida em psicanálise. A realização do diagnóstico multiaxial foi, de uma forma geral, bem-sucedida e registraram-se mudanças nos focos formulados no diagnóstico.(AU)

Research on psychoanalytic psychotherapy is identified as having a high level of abstraction, lack of clarity and consensus among clinicians in the constructs operationalization and analysis of reliable results. A rigorous and reliable psychodynamic diagnosis that allows a homogenization of evaluation criteria, increases communication within the scientific community and approaches research to practice. The OPD2's - Operationalized Psychodynamic Diagnosis - objective is to operationalize psychoanalytic constructs, through semi-structured interviews, to formulate a psychodynamic multi-axial diagnosis based on 5 axes: experience of the illness and prerequisites for the treatment (Axis I); interpersonal relationships (Axis II); conflict (Axis III); structure (Axis IV); mental and psychosomatic disorders (Axis V). The OPD-2 was applied in this study with the objective to test the diagnosis evaluation using sessions notes of one patient submitted to psychoanalysis. The realization of the multiaxial diagnosis was generally successful and changes in the focus formulated in the diagnosis were registered.(AU)

La investigación en psicoterapia se identifica por tener un alto nivel de abstracción, una falta de claridad y de consenso entre los médicos en la operacionalización de los constructos y análisis de resultados fiables. Un diagnóstico psicodinámico preciso y confiable que permite la homogeneización de los criterios de evaluación aumenta la comunicación entre la comunidad científica y los enfoques de la investigación a la práctica. El OPD2 - Diagnóstico psicodinámico operacionalizado - pretende operacionalizar constructos psicoanalíticos, a través de entrevistas semi-estructuradas, y formular un diagnóstico psicodinámico multiaxial basado en 5 ejes: la experiencia de la enfermedad y los requisitos previos para el tratamiento (Eje I), las relaciones interpersonales (Eje II), los conflictos (Eje III), la estructura (Eje IV), los trastornos mentales y psicosomáticos (Eje V). La OPD-2 se aplicó en este estudio con el fin de probar la evaluación de diagnóstico a través de notas de sesiones de un paciente en psicoanálisis. Hacer el diagnóstico multiaxial fue en general exitoso y cambios se registraron en los objectivos formulados en el diagnóstico.(AU)