Health literacy and public health: A systematic review and integration of definitions and models

<p>Abstract</p> <p>Background</p> <p>Health literacy concerns the knowledge and competences of persons to meet the complex demands of health in modern society. Although its importance is increasingly recognised, there is no consensus about the definition of health literacy or about its conceptual dimensions, which limits the possibilities for measurement and comparison. The aim of the study is to review definitions and models on health literacy to develop an integrated definition and conceptual model capturing the most comprehensive evidence-based dimensions of health literacy.</p> <p>Methods</p> <p>A systematic literature review was performed to identify definitions and conceptual frameworks of health literacy. A content analysis of the definitions and conceptual frameworks was carried out to identify the central dimensions of health literacy and develop an integrated model.</p> <p>Results</p> <p>The review resulted in 17 definitions of health literacy and 12 conceptual models. Based on the content analysis, an integrative conceptual model was developed containing 12 dimensions referring to the knowledge, motivation and competencies of accessing, understanding, appraising and applying health-related information within the healthcare, disease prevention and health promotion setting, respectively.</p> <p>Conclusions</p> <p>Based upon this review, a model is proposed integrating medical and public health views of health literacy. The model can serve as a basis for developing health literacy enhancing interventions and provide a conceptual basis for the development and validation of measurement tools, capturing the different dimensions of health literacy within the healthcare, disease prevention and health promotion settings.</p

Les Lésions apicales dentaires chroniques d'origine infectieuse (élaboration d'un protocole d'étude des microorganismes pathogènes à partir d'une revue de la littérature)

RENNES1-BU Santé (352382103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

General Practitioners and Community Pharmacists’ Collaboration in Primary Care: Small Steps for a Major Change

Background: Healthcare authorities worldwide search for ways to develop integrated care and interprofessional collaboration. In Belgium, Medical-Pharmaceutical Concertation (MPC) was introduced as a format to promote constructive dialogues between GPs and community pharmacists (CPs) with a focus on pharmacotherapy. Objective: To evaluate the implementation of MPC from the perspective of healthcare authorities and GPs/CPs. Methods: Mixed-methods approach, including semi-structured interviews with stakeholders and service users, observations of MPC meetings and surveys in GPs/CPs. Quantitative data were analyzed using descriptive statistics. Qualitative data were analyzed inductively. Results: The implementation of MPC took a slow start. Parties involved had divergent views on the goals of the MPC: stakeholders focused on measurable results, while service users aimed on improving interprofessional communication. Additionally, service users felt that the lack of local structures hindered consensus building and implementation of agreements in daily practice. Support from professional associations was considered indispensable for the implementation of MPC. In order to organize this efficiently, the establishment of an independent institution, coordinating the MPC initiative, was highly recommended. Conclusion: The study confirms that a thorough context assessment prior to implementation of a complex project is needed and that a step-wise approach should be respected to achieve effective interprofessional relationships

Mapping public health capacity in the EU

Background: In the past decade, the so-called ‘Third Public Health revolution’ has confronted the public health community with important challenges due to changing goals, approaches and actors. Addressing these challenges requires an increased capacity of public health professionals and organizations. The EU Health Programme commissioned this work in order to inform actions by Member States (MS) and other stakeholders to help strengthen public health capacities. Methods: Based upon a comprehensive literature review, a consensus based conceptual model of public health capacity was developed and used as a framework for data collection on the public health capacities of the EU MS. Data were collected through a mixed methodology involving document analysis and key informant interviews, validated through focus groups and in depth case studies. Results: A quantified assessment was obtained of key public health capacities in the 27 EU MS in terms of six consensus-based dimensions of capacity: knowledge development, workforce, organizational structure, resources, partnerships and leadership and governance, along with qualitative information and case illustrations. Conclusions: Mapping the existing public health capacities allows identification of the main strengths and weaknesses with regard to public health capacities in the EU MS, and provides a basis for strategic planning and target setting to enhance the capacities for public health in the EU; including action to be taken at EU level

Mapping of the plant SnRK1 kinase signalling network reveals a key regulatory role for the class II T6P synthase-like proteins

The central metabolic regulator SnRK1 controls plant growth and survival upon activation by energy depletion, but detailed molecular insight into its regulation and downstream targets is limited. Here we used phosphoproteomics to infer the sucrose-dependent processes targeted upon starvation by kinases as SnRK1, corroborating the relation of SnRK1 with metabolic enzymes and transcriptional regulators, while also pointing to SnRK1 control of intracellular trafficking. Next, we integrated affinity purification, proximity labelling and crosslinking mass spectrometry to map the protein interaction landscape, composition and structure of the SnRK1 heterotrimer, providing insight in its plant-specific regulation. At the intersection of this multi-dimensional interactome, we discovered a strong association of SnRK1 with class II T6P synthase (TPS)-like proteins. Biochemical and cellular assays show that TPS-like proteins function as negative regulators of SnRK1. Next to stable interactions with the TPS-like proteins, similar intricate connections were found with known regulators, suggesting that plants utilize an extended kinase complex to fine-tune SnRK1 activity for optimal responses to metabolic stress

Immunovirological and environmental screening reveals actionable risk factors for fatal COVID-19 during post-vaccination nursing home outbreaks.

Coronavirus Disease 2019 (COVID-19) vaccination has resulted in excellent protection against fatal disease, including in older adults. However, risk factors for post-vaccination fatal COVID-19 are largely unknown. We comprehensively studied three large nursing home outbreaks (20-35% fatal cases among residents) by combining severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) aerosol monitoring, whole-genome phylogenetic analysis and immunovirological profiling of nasal mucosa by digital nCounter transcriptomics. Phylogenetic investigations indicated that each outbreak stemmed from a single introduction event, although with different variants (Delta, Gamma and Mu). SARS-CoV-2 was detected in aerosol samples up to 52 d after the initial infection. Combining demographic, immune and viral parameters, the best predictive models for mortality comprised IFNB1 or age, viral ORF7a and ACE2 receptor transcripts. Comparison with published pre-vaccine fatal COVID-19 transcriptomic and genomic signatures uncovered a unique IRF3 low/IRF7 high immune signature in post-vaccine fatal COVID-19 outbreaks. A multi-layered strategy, including environmental sampling, immunomonitoring and early antiviral therapy, should be considered to prevent post-vaccination COVID-19 mortality in nursing homes

Flow chart and distribution of study participants (VLM: visceral larva migrans).

<p>Flow chart and distribution of study participants (VLM: visceral larva migrans).</p

Epidemiological, clinical, laboratory and outcome features of patients diagnosed with toxocariasis (n = 28) at the Institute of Tropical Medicine, Antwerp, Belgium from 2000 to 2013.

<p>Note: rows 3, 12, 21, 23, and 24 represent asymptomatic cases</p><p>M denotes male; F female; WBC white blood cell; CSF cerebrospinal fluid; MRI magnetic resonance imaging; DEC diethylcarbamazine</p><p>Epidemiological, clinical, laboratory and outcome features of patients diagnosed with toxocariasis (n = 28) at the Institute of Tropical Medicine, Antwerp, Belgium from 2000 to 2013.</p