Cultural competence in mental health nursing: validity and internal consistency of the Portuguese version of the multicultural mental health awareness scale-MMHAS.

BACKGROUND: Cultural competence is an essential component in rendering effective and culturally responsive services to culturally and ethnically diverse clients. Still, great difficulty exists in assessing the cultural competence of mental health nurses. There are no Portuguese validated measurement instruments to assess cultural competence in mental health nurses. This paper reports a study testing the reliability and validity of the Portuguese version of the Multicultural Mental Health Awareness Scale-MMHAS in a sample of Portuguese nurses. METHODS: Following a standard forward/backward translation into Portuguese, the adapted version of MMHAS, along with a sociodemographic questionnaire, were applied to a sample of 306 Portuguese nurses (299 males, 77 females; ages 21-68 years, M = 35.43, SD = 9.85 years). A psychometric research design was used with content and construct validity and reliability. Reliability was assessed using internal consistency and item-total correlations. Construct validity was determined using factor analysis. RESULTS: The factor analysis confirmed that the Portuguese version of MMHAS has a three-factor structure of multicultural competencies (Awareness, Knowledge, and Skills) explaining 59.51% of the total variance. Strong content validity and reliability correlations were demonstrated. The Portuguese version of MMHAS has a strong internal consistency, with a Cronbach's alpha of 0.958 for the total scale. CONCLUSIONS: The results supported the construct validity and reliability of the Portuguese version of MMHAS, proving that is a reliable and valid measure of multicultural counselling competencies in mental health nursing. The MMHAS Portuguese version can be used to evaluate the effectiveness of multicultural competency training programs in Portuguese-speaking mental health nurses. The scale can also be a useful in future studies of multicultural competencies in Portuguese-speaking nurses.

Cyborgs, biotechnologies, and informatics in health care - new paradigms in nursing sciences.

Nursing Sciences are at a moment of paradigmatic transition. The aim of this paper is to reflect on the new epistemological paradigms of nursing science from a critical approach. In this paper, we identified and analysed some new research lines and trends which anticipate the reorganization of nursing sciences and the paradigms emerging from nursing care: biotechnology-centred knowledge; the interface between nursing knowledge and new information technologies; body care centred knowledge; the human body as a cyborg body; and the rediscovery of an aesthetic knowledge in nursing care.

The influence of 5-lipoxygenase on cigarette smoke-induced emphysema in mice.

BACKGROUND: Pulmonary emphysema is characterized by the loss of lung architecture. Our hypothesis is that the inhibition of 5-lipoxygenase (5-LO) production may be an important strategy to reduce inflammation, oxidative stress, and metalloproteinases in lung tissue resulting from cigarette smoke (CS)-induced emphysema. METHODS: 5-LO knockout (129S2-Alox5(tm1Fun)/J) and wild-type (WT) mice (129S2/SvPas) were exposed to CS for 60days. Mice exposed to ambient air were used as Controls. Oxidative, inflammatory, and proteolytic markers were analyzed. RESULTS: The alveolar diameter was decreased in CS 5-LO(-/-) mice when compared with the WT CS group. The CS exposure resulted in less pronounced pulmonary inflammation in the CS 5-LO(-/-) group. The CS 5-LO(-/-) group showed leukotriene B4 values comparable to those of the Control group. The expression of MMP-9 was decreased in the CS 5-LO(-/-) group when compared with the CS WT group. The expression of superoxide dismutase, catalase, and glutathione peroxidase were decreased in the CS 5-LO(-/-) group when compared with the Control group. The protein expression of nuclear factor (erythroid-derived 2)-like 2 was reduced in the CS 5-LO(-/-) group when compared to the CS WT group. CONCLUSION: In conclusion, we show for the first time that 5-LO deficiency protects 129S2 mice against emphysema caused by CS. We suggest that the main mechanism of pathogenesis in this model involves the imbalance between proteases and antiproteases, particularly the association between MMP-9 and TIMP-1. General significance This study demonstrates the influence of 5-LO mediated oxidative stress, inflammation, and proteolytic markers in CS exposed mice.

DJ-1 binds to Rubicon to Impair LC-3 Associated Phagocytosis.

The ability to effectively clear infection is fundamental to host survival. Sepsis, defined as dysregulated host response to infection, is a heterogenous clinical syndrome that does not uniformly clear intact bacterial or sterile infection (i.e., lipopolysaccharide). These findings were further associated with increased survival in DJ-1 deficient animals exposed to intact bacteria relative to DJ-1 deficient challenged with lipopolysaccharide. We analyzed bacterial and lipopolysaccharide clearance in bone marrow macrophages (BMM) cultured ex vivo from wild-type and DJ-1 deficient mice. Importantly, we demonstrated that DJ-1 deficiency in BMM promotes Rubicon-dependent increase in L3C-associated phagocytosis, non-canonical autophagy pathway used for xenophagy, during bacterial but not lipopolysaccharide infection. In contrast to DJ-1 deficient BMM challenged with lipopolysaccharide, DJ-1 deficient BMM exposed to intact bacteria showed enhanced Rubicon complexing with Beclin-1 and UVRAG and consistently facilitated the assembly of complete autophagolysosomes that were decorated with LC3 molecules. Our data shows DJ-1 impairs or/and delays bacterial clearance and late autophagolysosome formation by binding to Rubicon resulting in Rubicon degradation, decreased L3C-associated phagocytosis, and decreased bacterial clearance in vitro and in vivo - implicating Rubicon and DJ-1 as critical regulators of bacterial clearance in experimental sepsis.

Assessment of the factor structure and reliability of the Portuguese version of the General Health Questionnaire-28 among adults.

BACKGROUND: The General Health Questionnaire (GHQ, Goldberg & Hillier, 1979 , Psychological Medicine, 9, 139-145) is a self-administered questionnaire used to measure non-psychotic psychiatric disorders. There is a study using a Portuguese version of this questionnaire (n = 60) including a group of inpatients with infectious diseases (Ribeiro & Antunes, 2003 , Revista Portuguesa de Psicossomática, 5(1), 37-45), but there are no larger studies in non-clinical Portuguese population. AIMS: The primary aim of the study was to confirm the psychometric properties of the Portuguese version of the GHQ-28 among 171 Portuguese adults in non-clinical settings. METHODS: The Portuguese version of the GHQ-28 was administered to 171 adult subjects of Portuguese general population. RESULTS: The Portuguese version of the GHQ-28 has an internally consistent measure Cronbach's α 0.922 for the GHQ-28 total scale. For the subscale somatic symptoms Cronbach's α was 0.825; for the subscale Anxiety/ Insomnia, Cronbach's α was 0.873; for the subscale Social dysfunction Cronbach's α was 0.873 and for the subscale Severe Depression was 0.838. Four factors were extracted using factor analysis: somatic symptoms (items 1-7); anxiety/insomnia (items 8-14); psychosocial dysfunction (items 15-21); and severe depression (items 22-28). CONCLUSIONS: The findings suggest that the GHQ-28 is a suitable screening instrument for adult Portuguese population in non-clinical settings.

Psychometric properties of a Russian version of the Social Support Questionnaire (SSQ6) in eastern European immigrants.

BACKGROUND: The concept of social support and its relationship to physical health and psychological well-being has been well documented. The Social Support Questionnaire [Sarason, Sarason, Shearin, & Pierce (1987) A brief measure of social support: Practical and theoretical implications. Journal of Social and Personal Relationships, 4, 497-510] is a self-administered questionnaire used to measure the availability and satisfaction with perceived social support an individual has. AIM: The purpose of this study was to assess the psychometric properties of a Russian version of the SSQ6 in a sample of Russian-speaking immigrants residing in Portugal. METHODS: The SSQ6 was administered to 555 subjects - Russian-speaking immigrants residing in several regions of Portugal. The questionnaire was administered on a group basis along with a number of other self-report tests as part of a larger mental health status immigrants' study. RESULTS: The Russian version of the SSQ6 has an internally consistent measure Cronbach's α 0.885 for the total scale. For the subscale SSQ6N (number of supporters) Cronbach's α was 0.907; for the subscale SSQ6S (satisfaction of support) Cronbach's α was 0.921. Two factors were extracted using factor analysis - Number of supporters and Satisfaction with social support.

Genetically Modified Mesenchymal Stromal/Stem Cells: Application in Critical Illness.

Critical illnesses including sepsis, acute respiratory distress syndromes, ischemic cardiovascular disorders and acute organ injuries are associated with high mortality, morbidity as well as significant health care system expenses. While these diverse conditions require different specific therapeutic approaches, mesenchymal stem/stromal cell (MSCs) are multipotent cells capable of self-renewal, tri-lineage differentiation with a broad range regenerative and immunomodulatory activities, making them attractive for the treatment of critical illness. The therapeutic effects of MSCs have been extensively investigated in several pre-clinical models of critical illness as well as in phase I and II clinical cell therapy trials with mixed results. Whilst these studies have demonstrated the therapeutic potential for MSC therapy in critical illness, optimization for clinical use is an ongoing challenge. MSCs can be readily genetically modified by application of different techniques and tools leading to overexpress or inhibit genes related to their immunomodulatory or regenerative functions. Here we will review recent approaches designed to enhance the therapeutic potential of MSCs with an emphasis on the technology used to generate genetically modified cells, target genes, target diseases and the implication of genetically modified MSCs in cell therapy for critical illness.

Emergence of the East-Central-South-African genotype of Chikungunya virus in Brazil and the city of Rio de Janeiro may have occurred years before surveillance detection.

Brazil, which is hyperendemic for dengue virus (DENV), has had recent Zika (ZIKV) and (CHIKV) Chikungunya virus outbreaks. Since March 2016, CHIKV is the arbovirus infection most frequently diagnosed in Rio de Janeiro. In the analysis of 1835 syndromic patients, screened by real time RT-PCR, 56.4% of the cases were attributed to CHIKV, 29.6% to ZIKV, and 14.1% to DENV-4. Sequence analyses of CHIKV from sixteen samples revealed that the East-Central-South-African (ECSA) genotype of CHIKV has been circulating in Brazil since 2013 [95% bayesian credible interval (BCI): 03/2012-10/2013], almost a year before it was detected by arbovirus surveillance program. Brazilian cases are related to Central African Republic sequences from 1980's. To the best of our knowledge, given the available sequence published here and elsewhere, the ECSA genotype was likely introduced to Rio de Janeiro early on 2014 (02/2014; BCI: 07/2013-08/2014) through a single event, after primary circulation in the Bahia state at the Northestern Brazil in the previous year. The observation that the ECSA genotype of CHIKV was circulating undetected underscores the need for improvements in molecular methods for viral surveillance.

Vulnerability to stress in migratory contexts: a study with Eastern European immigrants residing in Portugal.

The assessment of individual vulnerability to stress emerges as a predictive factor of a higher risk of developing stress-related disorders. In the last decade, the geography of immigration in Portugal experienced intense transformations in terms of recruitment and patterns of geographic settlement, with an increasing and exponential inflow of new and diversified migratory groups. The immigrant populations coming from Eastern European countries are a recent migratory flow, with linguistic, cultural and socio-demographic specificities which are very different from the general Portuguese population. This makes them a paradigmatic group in potential transcultural studies on mental health issues. The primary aim of the study was to describe the characteristics of vulnerability to stress and determine their impact on the mental health status of Russian-speaking immigrants residing in Portugal. The relationship between vulnerability to stress, sociodemographic variables, mental health status and social support were analyzed, using the SSQ6, GHQ28, 23QVS and a socio-demographic questionnaire. A comparative analysis was carried out, using a control group of 110 Portuguese subjects without previous migratory experiences, matched by sex, age group and academic qualifications. The eastern European immigrants reported high levels of vulnerability to stress assessed by the cut-off point of the 23QVS. Immigrants also reported higher percentage of vulnerability to stress and lower social support levels of social support versus the control group. Several factors inherent to the dynamics of the migratory process were related to the presence of vulnerability to stress. The findings suggest that vulnerability to stress is positively correlated with worse mental health outcomes and negatively correlated with the social support perceived as available--number of supporters and satisfaction with social support.