Nurses’ job satisfaction in long term care: the role of socio-demographic and professional variables

Background: This study examined job satisfaction among nurses in long-term care units in order to analyze the role of sociodemographic and professional variables in this process. Methods: A cross sectional study of 48 nurses, working in long-term care units in Portugal, was conducted using a sociodemographic and professional questionnaire, and the Portuguese version of the Nurses Job Satisfaction Rating Scale (Ferreira & Loureiro, 2012). Data analysis was performed by using descriptive and inferential statistics. Results: The study included 48 participants with a mean age of 28.0±3.90. Most participants were female (81.2%), not married (62.5%), had the graduate level (62.5%), and less than 5 years of professional experience (81.3%). Nurses showed a positive overall satisfaction with work (M = 83.35), but a negative satisfaction with benefits/rewards (M = 14.52) and with promotion (M= 18.38). Satisfaction with promotion was influenced by educational attainment level and, satisfaction with benefits/rewards was influenced by nurses’ work schedule. Female nurses and those with a higher income, reported more satisfaction with communication, and nurses with more age exhibited greater satisfaction with the chief/boss. Conclusion: Work benefits, rewards and promotion constitute crucial factors that determine job satisfaction among nurses in long-term care. Nurses’ sociodemographic and professional characteristics must be considered by organizations in the promotion of positive work environments.info:eu-repo/semantics/publishedVersio

Maturity-onset diabetes of the young secondary to HNF1B variants (HNF1B-MODY): a series of 10 patients from a single diabetes center

Background: Maturity-Onset Diabetes of the Young (MODY) is an autosomal dominant condition and represents 1-5% of all cases of diabetes mellitus. MODY is often misdiagnosed as type 1 or type 2 diabetes. The rare subtype 5 (HNF1B-MODY) is due to hepatocyte nuclear factor 1β (HNF1B) molecular alteration and is remarkable for its multisystemic phenotypes characterized by a broad spectrum of pancreatic and extra-pancreatic clinical manifestations. Methods: Retrospective study of patients with HNF1B-MODY diagnosis followed in the Centro Hospitalar Universitário Lisboa Central (Lisbon, Portugal). Demographic data, medical history, clinical and laboratory data, follow-up, and treatment procedures were obtained from electronic medical records. Results: We found 10 patients with HNF1B variants (7 index cases). The median age at diabetes diagnosis was 28 (IQR 24) years and the median age at HNF1B-MODY diagnosis was 40.5 (IQR 23) years. Six patients were initially misclassified as type 1 and 4 as type 2 diabetes. The average time between diabetes diagnosis and the diagnosis of HNF1B-MODY was 16.5 years. Diabetes was the first manifestation in half of the cases. The other half presented with kidney malformations and chronic kidney disease at pediatric age as the first manifestation. All these patients were submitted for kidney transplantation. Long-term diabetes complications included retinopathy (4/10), peripheral neuropathy (2/10), and ischemic cardiomyopathy (1/10). Other extra-pancreatic manifestations included liver test alterations (4/10) and congenital malformation of the female reproductive tract (1/6). History of a first-degree relative with diabetes and/or nephropathy diagnosed at a young age was present in 5 of the 7 index cases. Conclusions: Despite being a rare disease, HNF1B-MODY is underdiagnosed and often misclassified. It should be suspected in patients with diabetes and CKD, especially when diabetes appears at a young age, family history is present, and nephropathy appears before/shortly after the diagnosis of diabetes. The presence of unexplained liver disease increases the degree of suspicion for HNF1B-MODY. Early diagnosis is important to minimize complications and to allow familial screening and pre-conception genetic counseling. Trial registration is not applicable due to the retrospective nature of the study, non-interventional.info:eu-repo/semantics/publishedVersio

Development and psychometric properties of a new questionnaire for assessing Mental Health Literacy in young people

Objectives: Several instruments assess constructs related to mental health literacy and to the stigma associated with mental health problems. However, most of them have conceptualisations that may limit the assessment of the mental health literacy concept in a more up-to-date and comprehensive perspective. Furthermore, some of the instruments’ structure may limit their use in large scale samples, in a short period of time and with repeated measures. This article presents the development of the Mental Health Literacy questionnaire (MHLq) and the studies to assess its psychometric properties. Methods: After item-pool generation, content validity was assessed by experts and a think aloud procedure. The MHLq was tested in two samples of students (study 1 n=239; aged between 12 and 15 years old; study 2 n=737; aged between 11 and 17 years old) to determine its psychometric properties. Results: Factor analysis procedures favoured a three-factor solution (with 33 items) of the MHLq. The questionnaire showed good internal consistency (total score α=0.84; Factor 1 first aid skills and help seeking - α=0.79; Factor 2 knowledge/stereotypes - α=0.78; Factor 3 self-help strategies - α=0.72); and excellent test-retest reliability, the ICC for the total score of MHLq was 0.88 and for the three dimensions of MHLq was 0.80 (Factor 1), 0.90 (Factor 2) and 0.86 (Factor 3). Conclusions: The MHLq is a practical, valid and reliable tool for identifying gaps in knowledge, beliefs and behavioural intentions, in large samples, allowing the development and evaluation of interventions aimed at promoting mental health in young people.info:eu-repo/semantics/publishedVersio

Unbiased stereological method to assess proliferation throughout the subependymal zone

The subependymal zone (SEZ), frequently named as adult subventricular zone (SVZ), is a niche of adult neural stem and progenitor cells that lines a large extension of the lateral ventricles of the brain. The majority of the studies do not analyze the SEZ throughout its entire extension. Instead, studies of cell populations within the SEZ typically focus their analysis on a narrow space between specific bregma coordinates that provides a perspective of only a small portion of the SEZ. We have previously proposed a standard division for the SEZ at the anterior-posterior and dorsal-ventral axes based on external brain anatomical hallmarks (Falcao et al., PLoS One 7:e38647, 2012). Herein, we describe in detail the procedure and a stereological approach that can be used to obtain an unbiased estimation of the SEZ cell proliferation under physiological and pathological conditions. This approach takes into consideration clear SEZ anatomical divisions, both on the anterior-posterior and dorsal-ventral axes, which will standardize future studies on the SEZ

Interleukin-10: A Key Cytokine in Depression?

An increasing body of evidence implicates proinflammatory cytokines in psychiatric disorders, namely, in depression. Of notice, recent studies showed that anti-inflammatory cytokines, such as IL-10, also modulate depressive-like behavior. In this article, we propose that the anti-inflammatory cytokine IL-10 is a putative link between two of the most widely reported phenomenon observed in depressed patients: the disruption of the hypothalamic-pituitary-adrenal axis and the imbalanced production of cytokines. If so, IL-10 might represent a novel target for antidepressant therapy

The path from the choroid plexus to the subventricular zone: go with the flow!

In adult mammals, under physiological conditions, neurogenesis, the process of generating new functional neurons from precursor cells, occurs mainly in two brain areas: the subgranular zone in the dentate gyrus of the hippocampus, and the subventricular zone (SVZ) lining the walls of the brain lateral ventricles. Taking into account the location of the SVZ and the cytoarchitecture of this periventricular neural progenitor cell niche, namely the fact that the slow dividing primary progenitor cells (type B cells) of the SVZ extend an apical primary cilium toward the brain ventricular space which is filled with cerebrospinal fluid (CSF), it becomes likely that the composition of the CSF can modulate both self-renewal, proliferation and differentiation of SVZ neural stem cells. The major site of CSF synthesis is the choroid plexus (CP); quite surprisingly, however, it is still largely unknown the contribution of molecules specifically secreted by the adult CP as modulators of the SVZ adult neurogenesis. This is even more relevant in light of recent evidence showing the ability of the CP to adapt its transcriptome and secretome to various physiologic and pathologic stimuli. By giving particular emphasizes to growth factors and axonal guidance molecules we will illustrate how CP-born molecules might play an important role in the SVZ niche cell population dynamics.Ana M. Falcão and Ashley Novais are recipients of Ph.D.Fellowships from the Fundação para a Ciência e Tecnologia (FCT,Portugal).Fernanda Marques is a recipiente of post docToral fellowship from the Fundação para a Ciência e Tecnologia (FCT,Portugal).This work is supported by a grant from FCT (PTDC/SAU-OSM/104475/2008

Is it possible to “find space for mental health” in young people? effectiveness of a school-based mental health literacy promotion program

Lack of knowledge regarding, and the stigma associated with, mental disorders have been identified as major obstacles for the promotion of mental health and early intervention. The present study aimed to evaluate the effectiveness of a school-based intervention program focused on the promotion of mental health literacy (MHL) in young people (“Finding Space for Mental Health”). A sample of 543 students (22 classes), aged between 12 and 14 years old, participated in the study. Each class of students was randomly assigned to the control group (CG; n = 284; 11 classes) or the experimental group (EG; n = 259; 11 classes). MHL was assessed using the Mental Health Literacy questionnaire (MHLq), which is comprised of three dimensions—Knowledge/Stereotypes, First Aid Skills and Help Seeking, and Self-Help Strategies. The scores on these dimensions can also be combined to give an overall or total score. Participants from the EG attended the MHL promotion program (two sessions, 90 min each) delivered at one-week intervals. Sessions followed an interactive methodology, using group dynamics, music, and videos adapted to the target group. All participants responded to the MHLq at three points in time: pre-intervention assessment (one week prior to the intervention), post-intervention assessment (one week after the intervention) and follow-up assessment (six months after the intervention). The intervention effectiveness and the differential impact of sociodemographic variables on the effectiveness of the program were studied using a Generalized Estimation Equation (GEE). Results revealed that participants from the EG demonstrated, on average, significantly higher improvement in MHL from pre-intervention to follow-up when compared to participants from the CG. Different sociodemographic variables affected the effectiveness of the program on distinct dimensions of the MHLq. Overall, “Finding Space for Mental Health” showed efficacy as a short-term promotion program for improving MHL in schools.info:eu-repo/semantics/publishedVersio

Adult Hippocampal Neurogenesis Modulation by the Membrane-Associated Progesterone Receptor Family Member Neudesin

Neudesin (Neuron-derived neurotrophic factor, NENF), a membrane-associated progesterone receptor family (MAPR) member, is a neuron secreted protein with neurotrophic properties during embryonic stages. However, its role in the adult brain is still poorly addressed. In this study we have used neudesin-null (Nenf-/-) mice and performed a characterization of the proliferation state of the adult neurogenic niches, the adult subventricular zone (SVZ) and the hippocampus subgranular zone (SGZ). Nenf-/- males did not presented any deficits in proliferation in the SVZ neither in vivo nor in vitro. On the other hand a decrease in cell proliferation in the SGZ was observed, as well as a decrease in the number of newborn neurons in the dentate gyrus (DG) that was accompanied by impaired context discrimination in a contextual fear conditioning (CFC) task. Since NENF neurotrophic action is suggested to occur via the formation of a progesterone stability complex for the activation of non-genomic cascade, we further evaluated progesterone metabolism in the absence of NENF. Interestingly, expression of progesterone catabolic rate-determining enzyme, 5-α-reductase was upregulated in the DG of Nenf-/-, together with a significant increase in the expression of the δGABAA receptor gene, involved in DG tonic inhibition. Taken together, these findings add in vivo evidence on the neurotrophic properties of NENF in the adult brain. Furthermore, the mechanism of action of NENF in this process might implicate neurosteroids modulation, at least in the DG.This work was funded by the Bial Foundation through Grant 217/12 (to JS), by the European Regional Development Fund (FEDER), through the Competitiveness Factors Operational Programme (COMPETE), and by National funds, through the Foundation for Science and Technology (FCT), under the scope of the project POCI-01-0145-FEDER-007038, and by the project NORTE-01-0124-FEDER-000023, supported by the Northern Portugal Regional Operational Programme (NORTE 2020), under the Portugal 2020 Partnership Agreement, through FEDERinfo:eu-repo/semantics/publishedVersio