Health literacy among the new wave of migrants from the MENAP region in the metropolitan area of Lisbon

ABSTRACT - Health literacy refers to one’s abilities and resources required to access, understand, and use health information in managing health. Health literacy is a key determinant of health that can be modified to reduce health disparities and improve health equity, especially among vulnerable groups such as migrant communities due to the cumulative effects of other life conditions and existed factors. Research on health literacy in Portugal is still scarce, especially research on migrant’s health literacy. The aim of this study was to examine health literacy levels in a population of the new wave of migrants from the Middle East, North Africa, Afghanistan, and Pakistan (MENAP) region in the metropolitan area of Lisbon, and to explore the relationship between health literacy and socio-demographic characteristics of this population. The study was of a quantitative nature with a descriptive cross-sectional and analytical design. Data were collected from 86 migrants from the MENAP region using the health literacy questionnaire through interviews and online platforms. Socio-demographic data were also collected. Data were analyzed using descriptive statistics. Effect sizes (ES) for differences in means were calculated to determine the magnitude of differences between socio-demographic groups. Higher mean scores were seen for the scales ‘Social support for health’ and ‘Understanding health information’, lower mean scores were seen for ‘Feeling understood and supported by healthcare providers’ and ‘Navigating the healthcare system’. Associations were seen between lower HLQ scores on various scales and socio-demographic characteristics such as shorter period of time in Portugal, household composition, lower Portuguese proficiency, and irregular migration status. The study showed that migrants of the MENAP region have difficulties in navigating the Portuguese healthcare system, and in their relationships with healthcare providers. The study also showed that recent migrants, those who do not live with their close families, who are undocumented, and those with lower Portuguese proficiency have lower health literacy compered to their counterparts. These findings provide insight into the areas of health literacy weaknesses and difficulties of the MENAP region migrants in Lisbon and provide guidance for more equitable health interventions.RESUMO - A literacia em saúde refere-se às capacidades e recursos necessários para aceder, compreender e usar as informações de saúde na gestão da saúde. A literacia em saúde é um fator determinante da saúde que pode ser modificado para reduzir as disparidades e melhorar a equidade na saúde, especialmente entre grupos vulneráveis, onde se incluem migrantes devido aos efeitos cumulativos do processo migratório, das condições de vida e outros fatores existentes. A investigação sobre a literacia em saúde em Portugal ainda é escassa, especialmente sobre a literacia em saúde de populações migrantes. O objetivo deste estudo foi examinar os níveis de literacia em saúde de uma população de migrantes recentes da região do Médio Oriente, Norte da África, Afeganistão e Paquistão (MENAP) na área metropolitana de Lisboa, e explorar a relação entre literacia em saúde e as características sociodemográficas desta população. Realizou-se um estudo quantitativo, transversal, descritivo e analítico. Os dados foram recolhidos de 86 migrantes da região MENAP através da aplicação do questionário de literacia em saúde por meio de entrevistas e plataformas online. Dados sociodemográficos também foram recolhidos. Os dados foram analisados por meio de estatística descritiva. Os tamanhos de efeito para diferenças nas médias foram calculados para determinar a magnitude das diferenças entre os grupos sociodemográficos. Pontuações médias mais altas foram observadas para as escalas ‘Apoio social para a saúde’ e ‘Compreensão das informações de saúde’, pontuações médias mais baixas foram observadas para ‘Sentir-se compreendido e apoiado por profissionais de saúde’ e ‘Navegar no sistema de saúde’. Foram observadas associações entre pontuações mais baixas em várias escalas e características sociodemográficas, como menor tempo de residência em Portugal, composição familiar, menor proficiência em português e a situação irregular de migração. O estudo mostrou que os migrantes da região MENAP têm dificuldade em navegar no sistema de saúde português e nas suas relações com os prestadores de cuidados de saúde. Verificou-se que migrantes recentes, aqueles que não vivem com as suas famílias próximas, migrantes sem situação regularizada e aqueles com menor proficiência em português têm menor nível de literacia em saúde. Estes resultados fornecem uma visão sobre os recursos, lacunas e dificuldades em literacia em saúde dos migrantes da região MENAP em Lisboa e fornecem orientação para intervenções em saúde mais equitativas

Effects of diabetes definition on global surveillance of diabetes prevalence and diagnosis: a pooled analysis of 96 population-based studies with 331 288 participants.

Background Diabetes has been defi ned on the basis of diff erent biomarkers, including fasting plasma glucose (FPG), 2-h plasma glucose in an oral glucose tolerance test (2hOGTT), and HbA1c. We assessed the eff ect of diff erent diagnostic defi nitions on both the population prevalence of diabetes and the classifi cation of previously undiagnosed individuals as having diabetes versus not having diabetes in a pooled analysis of data from population-based health examination surveys in diff erent regions. Methods We used data from 96 population-based health examination surveys that had measured at least two of the biomarkers used for defi ning diabetes. Diabetes was defi ned using HbA1c (HbA1c ≥6·5% or history of diabetes diagnosis or using insulin or oral hypoglycaemic drugs) compared with either FPG only or FPG-or-2hOGTT defi nitions (FPG ≥7·0 mmol/L or 2hOGTT ≥11·1 mmol/L or history of diabetes or using insulin or oral hypoglycaemic drugs). We calculated diabetes prevalence, taking into account complex survey design and survey sample weights. We compared the prevalences of diabetes using diff erent defi nitions graphically and by regression analyses. We calculated sensitivity and specifi city of diabetes diagnosis based on HbA1c compared with diagnosis based on glucose among previously undiagnosed individuals (ie, excluding those with history of diabetes or using insulin or oral hypoglycaemic drugs). We calculated sensitivity and specifi city in each survey, and then pooled results using a random-eff ects model. We assessed the sources of heterogeneity of sensitivity by meta-regressions for study characteristics selected a priori. Findings Population prevalence of diabetes based on FPG-or-2hOGTT was correlated with prevalence based on FPG alone (r=0·98), but was higher by 2–6 percentage points at diff erent prevalence levels. Prevalence based on HbA1c was lower than prevalence based on FPG in 42·8% of age–sex–survey groups and higher in another 41·6%; in the other 15·6%, the two defi nitions provided similar prevalence estimates. The variation across studies in the relation between glucose-based and HbA1c-based prevalences was partly related to participants’ age, followed by natural logarithm of per person gross domestic product, the year of survey, mean BMI, and whether the survey population was national, subnational, or from specifi c communities. Diabetes defi ned as HbA1c 6·5% or more had a pooled sensitivity of 52·8% (95% CI 51·3–54·3%) and a pooled specifi city of 99·74% (99·71–99·78%) compared with FPG 7·0 mmol/L or more for diagnosing previously undiagnosed participants; sensitivity compared with diabetes defi ned based on FPGor- 2hOGTT was 30·5% (28·7–32·3%). None of the preselected study-level characteristics explained the heterogeneity in the sensitivity of HbA1c versus FPG.Wellcome Trust, US National Institutes of Health

Factors Influencing the Adoption of Immersive Virtual Reality for Individuals with Autism Spectrum Disorder: Parents Perceptions

The purpose of this qualitative study was to identify factors that affect the adoption of a spherical video virtual reality (SVVR) mobile application among parents of adults with Autism Spectrum Disorder (ASD). The study used the diffusion of innovation theory by Rogers (2003) as a framework to explore parents’ perceptions of an SVVR transportation model designed to improve the quality of life of adults with ASD. In addition, the study sought to learn what might increase adoption of VR technology among other parents of individuals with ASD and what life skills that might be addressed using VR technology in the future. The study employed interviews, focus groups, and observation to collect data. The factors that negatively affected the perception of VR technology among parents were categorized into themes: awareness of VR learning applications, availability, disadvantages of SVVR, and technical issues related to the SVVR transportation model. Factors that positively affected the parents’ decision to adopt VR were immersion, realism, ease-of-use, enjoyment and motivation. To increase the adoption of VR by other parents of individuals with ASD, parents suggested that understanding of VR learning applications needs to increase, more teachers should be trained to use VR, the SVVR model should be improved, and there should be greater exposure to VR in schools and at home. Potential future life skills that need to be addressed through the VR technology were also identified. The findings of this study may help eliminate concerns about using VR technology as a therapy for ASD individuals and encourage more parents, teachers, and other stakeholders to adopt it

Progress in Green Energies, Sustainable Development and the Environment

Globally Buildings Are Responsible For Approximately 40 Of The Total World Annual Energy Consumption Most Of This Energy Is For The Provision Of Lighting Heating Cooling And Air Conditioning Increasing Awareness Of The Environmental Impact Of Co2 Nox And Cfcs Emissions Triggered A Renewed Interest In Environmentally Friendly Cooling And Heating Technologies Under The 1997 Montreal Protocol Governments Agreed To Phase Out Chemicals Used As Refrigerants That Have The Potential To Destroy Stratospheric Ozone It Was Therefore Considered Desirable To Reduce Energy Consumption And Decrease The Rate Of Depletion Of World Energy Reserves And Pollution Of The Environment This Article Discusses A Comprehensive Review Of Energy Sources Environment And Sustainable Development This Includes All The Renewable Energy Technologies Energy Efficiency Systems Energy Conservation Scenarios Energy Savings And Other Mitigation Measures Necessary To Reduce Climate Chang

In vitro antimicrobial activity of intercalated Modified Chitosan-Clay nanocomposite against different microorgamnisms

Unmodified sodium montmorillonite (Na-MMT) used to intercalate chitosan (CS) and modified chitosan. Their structures were characterized by XRD, TEM and IR techniques. The results showed that CS chains were inserted into silicate layers. The interlayer distance of the layered silicates in the nanocomposites enlarged as the amount of polymer increased. The thermal stability of the nanocomposites are characterized by TGA. In vitro antimicrobial assay showed that pristine montmorillonite could not inhibit the growth of bacteria. Chitosan was less effective in inhibiting bacterial growth than chitosan modified triphenyl phosphine ( mod- CS).  CS/MMT and mod-Cs/MMT nanocomposites had strong antimicrobial activity, particularly against Gram-positive bacteria. With the increase of the amount and the interlayer distance of the layered silicates in the nanocomposites, the nanocomposites showed a stronger antibacterial effect. Keywords: Chitosan; Nanocomposite; Antimicrobia

Renewable Energy Technologies for Future and Sustainable Development

People are relying upon oil for primary energy and this will continue for a few more decades. Other conventional sources may be more enduring, but are not without serious disadvantages. The renewable energy resources are particularly suited for the provision of rural power supplies and a major advantage is that equipment such as flat plate solar driers, wind machines, etc., can be constructed using local resources. Without the advantage results from the feasibility of local maintenance and the general encouragement such local manufacture gives to the build-up of small-scale rural based industry. This communication comprises a comprehensive review of energy sources, the environment and sustainable development. It includes the renewable energy technologies, energy efficiency systems, energy conservation scenarios, energy savings in greenhouses environment and other mitigation measures necessary to reduce climate change. This study gives some examples of small-scale energy converters, nevertheless it should be noted that small conventional, i.e., engines are currently the major source of power in rural areas and will continue to be so for a long time to come. There is a need for some further development to suit local conditions, to minimise spares holdings, to maximise the interchangeability of the engine parts, and of the engine applications. Emphasis should be placed on full local manufacture. It is concluded that renewable environmentally friendly energy must be encouraged, promoted, implemented and demonstrated by a full-scale plant (device) especially for use in remote rural areas

Space Heating And Air Conditioning with Heat Exchanger Under Groundwater

Globally buildings are responsible for approximately 40% of the total world annual energy consumption. Most of this energy is for the provision of lighting, heating, cooling and air conditioning. An increase in awareness of the environmental impact of CO2, NOx and CFCs emissions triggered a renewed interest in environmentally friendly cooling and heating technologies. Under the 1997 Montreal Protocol, governments agreed to phase out chemicals used as refrigerants that have the potential to destroy stratospheric ozone. It was therefore considered desirable to reduce energy consumption in order to decrease the rate of depletion of world energy reserves as well as the pollution to the environment. One way of reducing building energy consumption is to design buildings, which are more efficient in their use of energy for heating, lighting, cooling and ventilation. Passive measures, particularly natural or hybrid ventilation rather than air-conditioning, can dramatically reduce primary energy consumption. Therefore, promoting innovative renewable energy applications including the ground source energy may contribute to preservation of the ecosystem by reducing emissions at local and global levels. This will also contribute to the amelioration of environmental conditions by replacing conventional fuels with renewable energies that produce no air pollution or the greenhouse gases (GHGs). An approach is needed to integrate renewable energies in a way to achieve high building performance standards. However, because renewable energy sources are stochastic and geographically diffuse, their ability to match demand is determined by the adoption of one of the following two approaches: the utilisation of a capture area greater than that occupied by the community to be supplied, or the reduction of the community’s energy demands to a level commensurate with the locally available renewable resources. Ground source heat pump (GSHP) systems (also referred to as geothermal heat pump systems, earth-energy systems and GeoExchange systems) have received considerable attention in recent decades as an alternative energy source for residential and commercial space heating and cooling applications. The GSHP applications are one of three categories of geothermal energy resources as defined by ASHRAE and include high-temperature (>150°C) for electric power production, intermediate temperature (<150°C) for direct-use applications and GSHP applications (generally (<32°C). The GSHP applications are distinguished from the others by the fact that they operate at relatively low temperatures