Health literacy, a more complex concept than knowledge, is a required capacity to obtain, understand, integrate and act on health information [1], in order to enhance individual and community health, which is defined by different levels, according to the autonomy and personal capacitation in decision making [2]. Medium levels of Health literacy in an adolescent population were found in a study conducted in 2013/2014, being higher in sexual and reproductive health and lower in substance use. It was also noticed that the higher levels of health literacy were in the area adolescents refer to have receipt more health information. The health literacy competence with higher scores was communication skills, and the lower scores were in the capacity to analyze factors that influence health. Higher levels were also found in younger teenagers, but in a higher school level, confirming the importance of health education in these age and development stage. Adolescents seek more information in health professionals and parents, being friends more valued as a source information in older adolescents, which enhance the importance of peer education mainly in older adolescents [3]. As a set of competences based on knowledge, health literacy should be developed through education interventions, encompassing the cultural and social context of individuals, since the society, culture and education system where the individual is inserted can define the way the development and enforcement of the health literacy competences [4]. The valued sources of information should be taken into account, as well as needs of information in some topics referred by adolescents in an efficient health education. Schizophrenia is a serious and chronic mental illness which has a profound effect on the health and well-being related with the well-known nature of psychotic symptoms. The exercise has the potential to improve the life of people with schizophrenia improving physical health and alleviating psychiatric symptoms. However, most people with schizophrenia remains sedentary and lack of access to exercise programs are barriers to achieve health benefits. The aim of this study is to evaluate the effect of exercise on I) the type of intervention in mental health, II) in salivary levels of alpha-amylase and cortisol and serum levels of S100B and BDNF, and on III) the quality of life and selfperception of the physical domain of people with schizophrenia. The sample consisted of 31 females in long-term institutions in the Casa de Saúde Rainha Santa Isabel, with age between 25 and 63, and with diagnosis of schizophrenia according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). Physical fitness was assessed by the six-minute walk distance test (6MWD). Biological variables were determined by ELISA (Enzyme-Linked Immunosorbent Assay). Psychological variables were assessed using SF-36, PSPP-SCV, RSES and SWLS tests. Walking exercise has a positive impact on physical fitness (6MWD -p = 0.001) and physical components of the psychological test...

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erogeneous clinical expression. It is becoming increasingly Hemochromatosis is a hereditary iron-overload disevident that the ''clinical scene'' of diagnosis of hemochromaease linked to HLA. The clinical expression of hemochrotosis is changing 5 with less severe, or even asymptomatic, matosis is influenced by sex and age. However, other forms of the disease becoming increasingly frequent. This factors must account for the notorious heterogeneity of change is in part the result of the existence of an established expression of the disease independent of sex, age, and link between the disease and HLA. 6,7 HLA linkage studies HLA phenotype. The present study attempts to clarify have permitted localization of the putative hemochromatosis some of these additional factors based on exhaustive stagene in a short region around the HLA-A locus. [8][9][10] Therefore, tistical analysis of data collected from 43 selected pa-HLA phenotyping, by permitting the detection of cases tients with hemochromatosis. The statistical analysis fothrough family screening, allows identification of cases much cused on three groups of variables: the first group before the classical clinical symptoms develop. 11 To a certain included variables reflecting the clinical expression of extent, the latter development has exposed further the ignothe disease; the second group represented the biochemirance of the factors underlying the heterogeneity in presentacal and hematological values at the time of diagnosis; tion and progression of the disease. 12 and the third group consisted of the independent variIn the course of our early studies in hemochromatosis, disables sex, age, HLA phenotype, and T-cell subset profile, tinct clinical groups of patients could be defined with the i.e., the percentages and total numbers of CD4/ and different CD4-CD8 ratios and distinct responses to intensive CD8/ cells and the CD4-CD8 ratios. The results show phlebotomy treatment. 3,4 that the relative expansion of the two main T-cell sub-The present study consists of an extensive comparative sets, in the context of the HLA phenotype, correlates analysis of the relative impact of HLA phenotype and CD4-significantly with the clinical expression of hemochro-CD8 ratios on the clinical expression of the disease. Other matosis and the severity of iron overload. The present factors known for some time to influence presentation and findings substantiate further the postulate that T cells course of disease, namely sex and age, were also included. have a role in the regulation of iron metabolism. (HEPA-The results substantiate the existence of a significant associ-TOLOGY 1997;25:397-402.) ation between HLA phenotype, CD4-CD8 ratios, and clinical progression of the disease, illustrating the importance of a A recent study by Amadori et al. 1 showing considerable major histocompatibility complex (MHC) applying the princivariation in CD4-CD8 ratios in the normal population was ples discussed by Amadori et al. 1 to an class I-linked disease, received with a commentary stressing its ''se...

Aim Testing the validity and reliability of the Scale for the Environments Evaluation of Professional Nursing Practice (SEE‐Nursing Practice). Background The environment of professional nursing practice is key to achieve better results for clients, nurses and institutions. Therefore, instruments enabling the assessment of all its attributes are required. Method Cross‐sectional methodological study. The SEE‐Nursing Practice, based on a previous qualitative study and literature review, was applied as a questionnaire. Exploratory and confirmatory factor analyses were used to assess construct validity. Results A total of 752 nurses participated in the study. Exploratory factor analysis of the SEE‐Nursing Practice led to a factor solution with 93 items and three subscales. The Structure, Process and Outcome subscales, respectively, have 43, 37 and 13 items, loaded in 6 factors, 6 factors and 2 factors and explaining 62.6%, 59.2% and 67.4% of the total variance. Cronbach's alpha of the overall scale and of the 3 subscales was greater than 0.90. Confirmatory factor analysis showed a good fit. Conclusion SEE‐Nursing Practice is a good valid and reliable instrument. Implications for nursing management The SEE‐Nursing Practice enables assessing practice environments and is a tool for nursing managers in the definition of strategies ensuring favourable environments for nursing care quality.

In the present study we report a serial investigation of the numbers of the peripheral blood cells — erythrocytes, polymorphonuclear neutrophils, total lymphocytes, T‐lymphocyte subpopulations (CD2, CD4, CD8), B lymphocytes and monocytes — in a group of 21 patients with haemochromatosis during the time of intensive phlebotomy treatment, i.e., from iron overload until the onset of iron deficiency. A remarkable individual stability of all blood cell populations studied was found in all patients. Patients differed in their relative proportions of CD4+ and CD8+. Each individual's CD4/CD8 ratio, as well as the absolute numbers, remained unaffected with time, confirming the existence of a strict homeostatic regulation of the relative numbers of the two major peripheral T lymphocytes. A significant positive correlation between CD4/CD8 ratios and the amount of iron mobilised by phlebotomy was found during this study. A novel correlation between the relative proportions of CD4+ and CD8+ cells and iron overload is confirmed by the follow‐up of iron re‐entry in the serum transferrin pool in the treated patients.

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Objective: To identify the instruments used to evaluate the professional nursing practice environments in the hospital context. Method: An integrative review, whose research process was conducted independently by two researchers in the period from July to August 2019 in the CINHAL, PubMed and SciELO databases. Results: Based on the inclusion and exclusion criteria, 53 studies published between 2009 and 2019 were considered for analysis. Ten instruments and three thematic areas were identified: instruments for the assessment of the nursing professional practice environments; implications of the use of instruments for the assessment of nursing professional practice environments; limitations of the instruments for the assessment of nursing professional practice environments. Conclusion: Despite the relevance of the instruments identified, this integrative review provides contributions that support the need to use specific tools to assess the nursing practice environments that include the structure, process and outcome components.

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