Assessing COVID-19 vaccine literacy: a preliminary online survey

The COVID-19 infodemic can be countered by scientific evidence, clear and consistent communication, and improved health literacy of both individuals in need of information and those providing it. A rapid online survey was carried out to evaluate vaccine literacy (VL) skills in the general population and perceptions about COVID-19 vaccine candidates, along with behavior and beliefs about current vaccinations. Observed VL levels were consistent with previous observations – where comparable self-reported tools were administered face-to-face and by paper-and-pencil – the mean functional score being = 2.92, while the interactive-critical score was = 3.27, out of a maximum of 4. Perceptions regarding future COVID-19 vaccines, along with beliefs about vaccination, were mostly positive and significantly associated with functional and interactive-critical VL scales. Despite limitations, the study confirms that surveys via the web are a suitable method to evaluate and track attitudes during infectious disease outbreaks and assess health literacy skills about vaccination, which can be useful to adapt medical communication strategies, for a better understanding of the value of immunization

Health literacy, emotionality, scientific evidence: Elements of an effective communication in public health

The importance of healthcare providers' communication abilities is still underestimated. Informing the population on the basis of documented evidence is essential but not enough to induce a change in the beliefs of who is doubtful or does not accept preventive interventions, such as vaccination. Lining up the offer of prevention to the knowledge of the citizens, also improving Health Literacy skills, is a critical step toward their empowerment and behavior change. The 2017 Erice Declaration was drafted to propose to the Institutions and the scientific community the main goals to improve communication and counteract Vaccine Hesitancy, at a very critical time, when mandatory vaccination was introduced in Italy

New Insight on the Bioactivity of Solanum aethiopicum Linn. Growing in Basilicata Region (Italy): Phytochemical Characterization, Liposomal Incorporation, and Antioxidant Effects

Food extract’s biological effect and its improvement using nanotechnologies is one of the challenges of the last and the future decades; for this reason, the antioxidant effect of scarlet eggplant extract liposomal incorporation was investigated. Scarlet eggplant (Solanum aethiopicum L.) is a member of the Solanaceae family, and it is one of the most consumed vegetables in tropical Africa and south of Italy. This study investigated the antioxidant activity and the phytochemical composition of S. aethiopicum grown in the Basilicata Region for the first time. The whole fruit, peel, and pulp were subjected to ethanolic exhaustive maceration extraction, and all extracts were investigated. The HPLC-DAD analysis revealed the presence of ten phenolic compounds, including hydroxycinnamic acids, flavanones, flavanols, and four carotenoids (one xanthophyll and three carotenes). The peel extract was the most promising, active, and the richest in specialized metabolites; hence, it was tested on HepG2 cell lines and incorporated into liposomes. The nanoincorporation enhanced the peel extract’s antioxidant activity, resulting in a reduction of the concentration used. Furthermore, the extract improved the expression of endogenous antioxidants, such as ABCG2, CAT, and NQO1, presumably through the Nrf2 pathway

Assessment of health literacy skills in family doctors’ patients by two brief, self-administered Italian measures

Health Literacy (HL) is an important health determinant: low HL skills result in less healthy choices, riskier behavior, poorer health, less self-management and more hospitalization. An observational study was conducted in a selected population, attending the waiting rooms of family general practitioners, with the aim of assessing HL capabilities through the administration of two HL screeners (IMETER and SILS-IT), and comparing the two measures. An anonymous questionnaire was administered, consisting of the Italian versions of the two tests on a single sheet. Demographic data, as well as concomitant chronic diseases and vaccines received, were also collected. HL skills were asured by the scores observed at both tests, and by the frequency of subjects with low HL levels according to the respective cut-off values. Overall, 305 questionnaires were collected and analyzed. Regarding IMETER, the observed frequency of subjects with low HL skills was 25.2% and the mean score and mean adjusted-score (26.3 ・} 8.8 and 23.2 ・} 9.4, respectively) were lower than those observed in previous studies. Similarly, at SILS-IT the percentage of subjects with low skills (49.9%) was higher than observed previously. IMETER showed high internal consistency (Cronbach’s alpha > 0.9). The two measures were significantly correlated, although with a low Spearman’s coefficient, and IMETER did not provide significant information about the probability to predict low HL according to SILS-IT. These results are explainable by the differences in assessment and domains between the two tests, both reliable and suitable to screen patients with low functional HL.

Vaccine literacy is undervalued

Despite weak health literacy is considered a concause of vaccine hesitancy, it is rarely taken into account when discussing about this subject. The association between health literacy skills and vaccine acceptance has been shown to be uneven when using general measures, also depending on the population settings and type of vaccine considered. Vaccine literacy has been built on the same idea of health literacy, but very few specific measuring tools have been developed until now. It is desirable that more of these instruments are validated and extensively used with the objective of assessing peoples’ vaccine literacy skills and defining interventions aimed at their improvement

An Italian validation of "METER", an easy-to-use Health Literacy (hl) screener

L’alfabetizzazione sanitaria corrisponde alla capacità individuale di ottenere, capire e trattare le informazioni di salute necessarie per prendere decisioni adatte alla propria salute. Essa condiziona la capacità delle persone di accedere ed utilizzare il sistema sanitario, interagire con gli operatori e prendersi cura di se stessi. Esistono test consolidati, in grado di misurare i livelli di alfabetizzazione sanitaria, che hanno però limitazioni pratiche nella pratica clinica (necessità della presenza di un operatore, tempo per completare il test, ecc.): per limitare questi limiti in USA è stato introdotto un test breve, auto-somministrabile, il Medical Term Recognition Test (METER). In questo studio una versione italiana di questo test (IMETER) è stata validata somministrandolo a studenti universitari iscritti alle facoltà di Medicina e a quella di Lettere ed Ingegneria. I risultati mostrano un alto grado di affidabilità e validità del test nel confrontare il livello di alfabetizzazione sanitaria degli studenti educati in materie mediche rispetto alle materie non biologiche, indicandone la capacità potenziale di selezionare bassi livelli di alfabetizzazione sanitaria nella popolazione generale. Malgrado i limiti dello studio (pilota), la somministrazione rapida e semplice dell’IMETER sembra essere utile non solo nella pratica clinica, ma anche per facilitare l’esecuzione di studi più ampi.Health Literacy (HL) is the degree to which individuals have the capability to obtain, understand and process basic health information needed to make appropriate health decisions. It affects persons' ability to access and use health care, to interact with providers, and to care for themselves. Established literacy screeners have practical limitations (such as practictioner's attendance, time to complete, etc.): to address these, a short, self-administered measure of HL, the Medical Term Recognition Test (METER) was introduced in USA. In this study an Italian version (IMETER) of this measure has been validated administering it to undergraduate students, attending Medicine, Arts and Engineering faculties. The results of this study show a high degree of reliability and validity of the test when comparing the skills of students educated in medical matters and those of non-biological faculties, indicating the potential capability of the tool to screen low HL levels in larger population. Despite the limits of this pilot study, IMETER's quick and easy administration method seems useful not only in clinical settings, but also to ease the implementation of future larger studies

Italian Adults’ Likelihood of Getting COVID-19 Vaccine: A Second Online Survey

Rapid online surveys are an important tool for tracking the public’s knowledge and perceptions during infectious disease outbreaks. In June 2020, during the early phases of COVID-19 vaccines development, we conducted a survey in 885 Italian adults that aimed at assessing their attitudes and opinions about vaccination, in addition to their vaccine literacy levels (i.e., skills in finding, understanding, and using information about vaccines). In January 2021, the same questionnaire was administered to a similar population (n = 160). Interactive vaccine literacy was significantly higher in January 2021 than in June 2020 (mean score 3.38 vs. 3.27 respectively, p = 0.0021). The percentage of participants willing to be vaccinated against COVID-19 assessed by either-or questions, was equally high in both surveys (>90%), which is quite reassuring, although metrics based on categorical scales cannot identify hesitant subjects

Intravescical instillation of Calmette-Guérin bacillus and COVID-19 risk

It has been theorized that Calmette-Guérin bacillus may prevent or reduce the severity of COVID-19 through a nonspecific stimulation of the immune system. A preliminary assessment of SARS-CoV-2 infection rates and outcomes among 2803 individuals affected with high risk non-muscle-invasive bladder cancer and treated with intra-bladder instillation of BCG, showed no evidence of a protective effect. However, the interpretation of these data need some caution, due to the low prevalence of infection (<1%) observed within this population, along with the fact that intra-bladder administration cannot mirror the usual intradermal administration of BCG, in particular in patients partially immunocompromised. Confirmation by larger prospective studies is required

Low-Calorie Ketogenic Diet with Continuous Positive Airway Pressure to Alleviate Severe Obstructive Sleep Apnea Syndrome in Patients with Obesity Scheduled for Bariatric/Metabolic Surgery: a Pilot, Prospective, Randomized Multicenter Comparative Study

: Obstructive sleep apnea syndrome (OSAS) and obesity are frequently associated with hypertension (HTN), dyslipidemia (DLP), and insulin resistance (IR). In patients with obesity and OSAS scheduled for bariatric surgery (BS), guidelines recommend at least 4 weeks of preoperative continuous positive airway pressure (CPAP). Low-calorie ketogenic diets (LCKDs) promote pre-BS weight loss (WL) and improve HTN, DLP, and IR. However, it is unclear whether pre-BS LCKD with CPAP improves OSAS more than CPAP alone. We assessed the clinical advantage of pre-BS CPAP and LCKD in patients with obesity and OSAS. Seventy patients with obesity and OSAS were randomly assigned to CPAP or CPAP+LCKD groups for 4 weeks. The effect of each intervention on the apnea-hypopnea index (AHI) was the primary endpoint. WL, C-reactive protein (CRP) levels, HTN, DLP, and IR were secondary endpoints. AHI scores improved significantly in both groups (CPAP, p=0.0231; CPAP+LCKD, p=0.0272). However, combining CPAP and LCKD registered no advantage on the AHI score (p=0.863). Furthermore, body weight, CRP levels, and systolic/diastolic blood pressure were significantly reduced in the CPAP+LCKD group after 4 weeks (p=0.0052, p=0.0161, p=0.0008, and p=0.0007 vs baseline, respectively), and CPAP+LCKD had a greater impact on CRP levels than CPAP alone (p=0.0329). The CPAP+LCKD group also registered a significant reduction in serum cholesterol, LDL, and triglyceride levels (p=0.0183, p=0.0198, and p<0.001, respectively). Combined with CPAP, LCKD-induced WL seems to not have a significant incremental effect on AHI, HTN, DLP, and IR but lower CRP levels demonstrated a positive impact on chronic inflammatory status