Staphylococcus epidermidis is an opportunistic pathogen and, due to its ability to establish biofilms, is a leading causative agent of indwelling medical device-associated infection. The presence of high amounts of dormant bacteria is a hallmark of biofilms, making them more tolerant to antimicrobials and to the host immune response. We observed that S. epidermidis biofilms grown in excess glucose accumulated high amounts of viable but non-culturable (VBNC) bacteria, as assessed by their low ratio of culturable bacteria over the number of viable bacteria. This effect, which was a consequence of the accumulation of acidic compounds due to glucose metabolism, was counteracted by high extracellular levels of calcium and magnesium added to the culture medium allowing modulation of the proportions of VBNC bacteria within S. epidermidis biofilms. Using bacterial inocula obtained from biofilms with high and low proportions of VBNC bacteria, their stimulatory effect on murine macrophages was evaluated in vitro and in vivo. The inoculum enriched in VBNC bacteria induced in vitro a lower production of tumour necrosis factor alpha, interleukin-1 and interleukin-6 by bone-marrow-derived murine macrophages and, in vivo, a lower stimulatory effect on peritoneal macrophages, assessed by increased surface expression of Gr1 and major histocompatibility complex class II molecules. Overall, these results show that environmental conditions, such as pH and extracellular levels of calcium and magnesium, can induce dormancy in S. epidermidis biofilms. Moreover, they show that bacterial suspensions enriched in dormant cells are less inflammatory, suggesting that dormancy can contribute to the immune evasion of biofilms.

The objective of this systematic review was to identify the available qualitative data and to develop a framework to address the life experiences of homeless families in parenthood. The research was performed in the PubMed and CINAHL Complete databases, for works published in Portuguese, English, French and Spanish. Studies that included qualitative data, or both qualitative and quantitative data, were considered for this research. A total of 358 articles were obtained, of which 37 were assessed for eligibility, and 26 were rejected. In the end, 11 studies were selected. The Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research was used. These studies were conducted mostly in the United States, in temporary/transitional shelters for nuclear or single-parent families (led by women) in a homeless situation. In this context, the area which arose as the more relevant one was mental health, followed by the social studies. Two types of dimensions emerged from the results: mediating dimensions (which include the categories “Insecurity”, “Lack of Privacy”, “Isolation”, “Stigma” and “Disempowerment”) that are responsible for difficulties related to education, and behavioural changes in both the parents and the children; and supporting dimensions (which include the categories “Context as a Facilitator”, “Relationship with Others” and “Parents’ and children’s Self”) that lead to motivation, as well as the acquisition of strategies by the parents, to resolve parenting issues. This research helps expand nursing knowledge and presents a synthesis of the life experiences of homeless families in parenthood. Nursing can respond to the vulnerable population, due to its predominant role in promoting their health.

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Background: The contact with antibiotics at an early age may lead to a number of nefarious consequences. Nevertheless, the amount of literature available on the usage of antibiotics in children is scarce. Taking into account the increasing emergence of resistant bacterial strains, it is imperative to study and make society aware of the excessive exposure of children to antibiotics. The purpose of this study was to evaluate the incidence of antibiotic therapy in children under the age of six, in the metropolitan area of Oporto.

Table I : Correlation between the REQ-2T subsclaesand its external validator : the DASS-21..

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In first episode psychosis (FEP), the term psychosis is merely descriptive and doesn't allow for any assumptions regarding etiology or prognosis. Given the heterogeneity of psychopathology in FEP there is great uncertainty regarding the establishment of an accurate diagnosis.