Health literacy strengths and needs among migrant communities from Portuguese-speaking African countries in Portugal: a cross-sectional study.

Introduction: Health literacy among migrants is a matter of public health and social justice. Migrants from diverse backgrounds encounter challenges such as linguistic barriers, cultural disparities, restricted access to health services, and heterogeneous migration statuses. Addressing these challenges requires careful consideration of their unique experiences and needs to promote equitable health outcomes. This can hinder their ability to navigate the healthcare system, understand health information, and engage in health-promoting behaviours. However, there is still a significant gap in our understanding of health literacy within migrant communities. This study has a dual aim: to identify health literacy strengths and needs among migrants from Portuguese-speaking African Countries (PALOP) countries in the Lisbon Metropolitan Area and to examine associations between demographic, socioeconomic, migration and health condition characteristics and the health literacy domains. Methods: A cross-sectional survey was conducted. Data were collected from 506 PALOP migrants using the Health Literacy Questionnaire (HLQ). We also collected demographic, socioeconomic, migration, and health condition data. We employed multiple linear regression to understand the relationship between the HLQ nine domains and these characteristics. Results: The HLQ scores revealed distinct patterns of health literacy between the groups. Health literacy needs were particularly evident in the domains related to feeling understood and supported by healthcare providers and navigating the healthcare system. Conversely, higher scores and potential strengths were observed in actively managing one's health and understanding enough health information to make informed decisions. However, in these, the average scores suggest that a high proportion of people recognised difficulties. 'The results also indicated that a higher educational level was associated with increased health literacy. In contrast, low self-perceived health status, living alone, shorter duration of residence in Portugal, and being either undocumented or in the process of obtaining legal status were associated with lower health literacy. Conclusion: Our study highlights the importance of migration-related variables and self-reported health status in understanding health literacy among migrant communities. Factors such as length of stay and low self-perceived health status are associated with potentially disadvantageous levels of health literacy, which could exacerbate health inequalities. Assessing these variables is critical to identify gaps in health literacy and develop tailored interventions to reduce health inequalities.

Childbirth Experience Questionnaire: Cross-cultural validation and psychometric evaluation for European Portuguese.

BACKGROUND: Self-reported measures are relevant both for the clinic and for health evaluation because they provide an interpretation of quality parameters. Women who experience labour can express themselves through these measures, identifying indicators that need improvement. OBJECTIVE: The objective of this study is to adapt the Childbirth Experience Questionnaire to the Portuguese context and to determine its psychometric properties. METHOD: A methodological study carried out with a convenience sample where the participants were 161 female users of a hospital in southern Portugal. They were aged between 20 and 43 years (M = 31.05, SD = 4.87) and answered a questionnaire approximately 48 h postpartum, preserving the ethical principles. The original instrument, with 22 items, underwent the linguistic and cultural adequacy process. RESULTS: Factor analysis with Varimax rotation was performed, revealing a set of 19 items with factor weights above .400. The set of items remained four-dimensional as the original, explaining 62.517% of the variance. In the retest, the reliability results showed that similar characteristics to the original study are maintained in the two subscales that express 'Participation' (three items) and 'Professional Support' (four items), with internal consistency values of .807 and .782. The 'Own Performance' and 'Own Threshold' subscales were elaborated from the results of the Varimax rotation, presenting Cronbach's alpha coefficients of .840 and 714, respectively. The total scale showed alpha values of .873 and .823 in the test and retest, respectively. Time stability showed a positive association, with r = .659 (p < .001). Accuracy through the split-half method reached an alpha value of .880 with Spearman-Brown correction. The floor effect was high in the 'Participation' subscale, both in the test and in the retest. Convergent validity between the instrument and the 'Index of Strategies for Pain Relief in Labour' discrete variable showed a Spearman's rho value of .209 (p = .011) in the total scale. In discriminating validity, the Mann-Whitney test reveals that the women who recognize interactions with the midwife have more favourable scores in Childbirth Experience Questionnaire (U = 2748.000; Z = 2.905; p = .004). CONCLUSION: The current version in European Portuguese suggests that it is a valid and reliable measure. This study may facilitate other validation processes in Lusophony countries.

Literacia em saúde mental da puérpera / Postpartum mental health literacy

Introdução: A necessidade de desenvolver o conhecimento sobre a problemática da literacia em saúde mental da puérpera, quer na compreensão dos fenómenos que a afetam, quer nas estratégias que promovem a sua saúde mental, assume-se como relevante. A mulher deve ser dotada dos conhecimentos que lhe permitam promover a sua saúde, prevenir e efetuar a gestão de eventuais doenças. Ser literada em saúde mental e em tudo o que o conceito envolve. Objetivos: Determinar que variáveis sociodemográficas interferem na literacia em saúde mental das puérperas; identificar que variáveis de caracterização obstétrica interferem na literacia em saúde mental das puérperas. Metodologia: Estudo quantitativo, descritivo e correlacional, com enfoque transversal. A amostra deste estudo é constituída por 128 puérperas que se encontravam nas primeiras duas semanas após o puerpério, recrutadas segundo uma amostragem não probabilística por bola de neve, com uma média de idade de 30,95 anos (±5,07 anos). Recorreu-se à aplicação de um questionário ad hoc constituído por um grupo de questões de caracterização sociodemográfica, caracterização obstétrica, a Escala de Apgar Familiar (Smilkstein, 1978) Versão Portuguesa de Agostinho & Rebelo (1988) e o Questionário de Literacia em Saúde Mental (LSMq) de Campos, Palha, Dias, Veiga & Duarte (2014). Resultados: A idade, o estado civil, as habilitações literárias e a situação profissional são variáveis sociodemográficas que interferiram na literacia em saúde mental das puérperas estudadas, resultando na aceitação da H1. A gravidez planeada, número de filhos, idade gestacional do bebé ao nascimento, frequência de um curso de preparação para o parto e parentalidade, tipo de gravidez, quem esclareceu dúvidas antes da alta hospitalar e apoio no aleitamento materno antes da alta hospitalar assumiram-se como variáveis de caracterização obstétrica com relevância estatisticamente significativas, resultando na aceitação da H2. Conclusão: Os resultados obtidos assumem-se como uma mais-valia para os Enfermeiros Especialistas em Saúde Materna e Obstetrícia, para que possam dotar as puérperas de literacia em saúde mental, um elemento determinante para o seu bem-estar holístico, bem como da família.

Cuidadoras informais de Portugal: vivências do cuidar de idosos / Informal caregivers in Portugal: experiences of caring for elderly

O cuidador informal surge da necessidade de se cuidar dos doentes e idosos no domicílio, com a função de auxiliar nas medicações, higiene e alimentação sem remuneração. Esse tipo de auxílio suscita sobrecarga física, psicológica e financeira. No âmbito da qualidade do cuidar, salienta-se a necessidade de se olhar e ajudar os cuidadores informais no árduo apoio aos seus doentes, que, na maioria, são idosos. O objetivo deste artigo é apresentar as percepções vivenciadas pelas cuidadoras informais, bem como o reconhecimento, por elas próprias, das sobrecargas que as afetam holisticamente - emocionais, físicas, financeiras -, e a importância de desenvolver estratégias de coping na formação sobre como melhor cuidar. As entrevistadas residem nas regiões Norte e Centro de Portugal e responderam ao inquérito adaptado do The Zarit Burden Interview. As entrevistas foram analisadas com o apoio do software NVivo 8. Os dados obtidos indicam que as cuidadoras informais enfrentam mais sobrecargas físicas e emocionais do que financeiras. No entanto, salientaram que, apesar das dificuldades, gostam de cuidar dos seus familiares. Quanto a serem convidadas para participarem de formações sobre como melhor cuidar, algumas confirmaram o interesse. Verificase que as cuidadoras informais são carentes de uma formação que as capacite a melhor cuidar prevenindo consequências danosas.

The informal caregiver arises from the need to care for sick and elderly in their homes with the task of assisting with medications, hygiene and food without payment. This kind of aid raises overhead in physical, psychological and financial. From the quality of care emphasizes the need to look at and assist caregivers in helping hard their patients, which most are elderly. The aim is to present the perceptions experienced by informal caregivers, as well as recognition of the same burdens that affect them holistically: emotional, physical, financial and the importance of developing coping strategies through training on how to better care. The interviewed in the research belong to the North and Central Portugal, answer to the survey adapted from The Zarit Burden Interview. The interviews were analyzed with the support of NVivo 8 software. The data indicate that informal caregivers face more types of physical and emotional than financial burden. However, they stressed that despite the difficulties like taking care of their families. About being invited to participate in training on how to best care, some have confirmed their interest. We found that informal caregivers are lacking of an education that enables them to better care for preventing unsafe consequences.

Modulation of rat cerebellum oxidative status by prolonged red wine consumption.

A number of studies support the view that wine polyphenols can reinforce the endogenous antioxidant system by reducing ethanol (EtOH)-induced neuronal oxidative damage. Herein, we have investigated the effects of prolonged red wine (RW) consumption on several biomarkers of redox status in the cerebellum, a brain region highly vulnerable to the noxious effects of EtOH. Adult male Wistar rats were given RW with an EtOH concentration adjusted to 20% for 6 months, and the results were compared with those obtained in EtOH-treated (20%) and pair-fed control (PFC) animals. Malondialdehyde (MDA) and glutathione levels, and the activities of antioxidant enzymes such as superoxide dismutase (SOD), catalase (CAT), glutathione reductase (GR), glutathione-S-transferase (GST) and selenium-dependent glutathione peroxidase (Se-GPX) were estimated in cerebellum homogenates. Chronic RW ingestion resulted in diminished MDA and reduced glutathione levels in cerebellar tissue. Moreover, RW-treated rats had a significant decrease in SOD, GR and GST activities but presented an increase in the activity of Se-GPX compared with animals from EtOH and PFC groups. In contrast, CAT activity was not altered by RW and EtOH intakes. Taken together, these findings show that prolonged consumption of RW markedly modifies cerebellum redox status probably due to its high content of polyphenols.

Effect of chronic ethanol exposure on the hepatotoxicity of ecstasy in mice: an ex vivo study.

3,4-Methylenedioxymethamphetamine (MDMA) is frequently consumed at "rave" parties by polydrug users that usually take this drug in association with ethanol. In addition, many young people are repeatedly exposed to ethanol, which likely leads to tolerance phenomena. Both compounds are metabolized in the liver, with formation of hepatotoxic metabolites, which gives high relevance to the evaluation of their putative toxicological interaction. Therefore, the aim of this study was to evaluate the toxicity induced by 0.8 and 1.6 mM MDMA to freshly isolated hepatocytes obtained from ethanol-treated mice whose tap drinking water was replaced by a 5% ethanol solution for 1 week and, afterwards, by a 12% ethanol solution for 8 weeks (ethanol group) comparatively to non-treated animals (non-ethanol group). The hepatocytes were incubated under normothermic and hyperthermic conditions in order to simulate in vitro the hyperthermic response induced in vivo by MDMA, a condition that has been recognized as a life-threatening effect associated with MDMA exposure and implicated in its hepatotoxicity. Six mice treated under the same protocol as the ethanol group were used for histological analysis, and compared to non-ethanol-treated animals. The pre-treatment of mice with ethanol caused a significant decrease in the hepatocytes yield in the isolation procedure comparatively to the non-ethanol group, which can be explained by an increase in collagen deposition along the hepatic parenchyma as observed in the histological analysis. The initial cell viability of hepatocytes suspensions was similar between ethanol and non-ethanol groups. However, the ethanol group showed a higher GSH oxidation rate, which was enhanced under hyperthermia. Additionally, a concentration-dependent MDMA-induced loss of cell viability and ATP depletion was observed for both groups, at 41 degrees C. In conclusion, the repeated treatment with ethanol seems to increase the vulnerability of freshly isolated mice hepatocytes towards pro-oxidant conditions, as ascertained by the increase in collagen deposition, lower hepatocyte yield and decreased glutathione levels. However, MDMA toxicity to the isolated hepatocytes was independent of ethanol pre-treatment, while significantly dependent on incubation temperature.

Cytotoxicity and cell signalling induced by continuous mild hyperthermia in freshly isolated mouse hepatocytes.

An increasing body of data has been demonstrating that mammalian cells have elaborate networks of molecular signalling in counteracting heat shock and in developing adaptation to oxidative stress to avoid cell death. However, the precise mechanisms linking heat shock, oxidative stress and cell survival/cell death mechanisms are not yet clearly understood. The purpose of this study was thus to study the time course of hyperthermia-induced oxidative stress and cellular signalling through the activation of heat shock factor 1 (HSF1) and heat shock protein 70 (HSP70), using freshly isolated mouse hepatocytes. The results accomplished in this work demonstrated that mild continuous hyperthermia (41 degrees ) leads to oxidative stress and loss of cellular viability in a time-dependent manner, with significant effects already observed at the first hour of incubation. These toxic effects developed concomitantly with activation of HSF1 and emerged before the formation of HSP70 levels. Thus, although cell signalling was triggered through the transcriptional activation of HSP70 via HSF1, this putative protective process did not modify the trend of hepatotoxic effects mediated by this type of hyperthermic challenging.