Diplomatic response to global health challenges in recognizing patient needs: A qualitative interview study

BackgroundGlobal health diplomacy is the applied practice of foreign affairs to further national goals that focus on health issues requiring international cooperation and collective action. We aimed to determine how international diplomats and health policy-related professionals in the EU understand the concept of health diplomacy, which impacts both diplomatic relations as well as patients' rights.MethodsIn a qualitative interview study, we used a heterogeneous stratified purposeful sampling to reach participants from different countries and different practitioners from the Pyramid of Health Diplomacy: core, multi-stakeholder, and informal. Reflexive thematic analysis was used to identify the main themes.FindingsWe contacted 131 practitioners of GHD, of which 37 responded, and nine agreed to be interviewed. From 11 interview questions, four main themes emerged from the analysis of the individual interview. The participants reported limited knowledge about the definition of GHD but also that they engaged in daily activities and decisions of inter-governmental bodies. They were not aware of existing special education and training for health attachés and made suggestions for improving the field and practice of GHD. They were not fully familiar with the European Charter of Patients' Rights. There was a consensus from all participants that patient rights need to improve as a fundamental right. They stressed the fact that the hospital lockdown and the right access to healthcare were impaired during the COVID pandemic.InterpretationThe role of health diplomacy in linking public health and foreign affairs is key to respecting patients' rights. Health over other interests is becoming an increasingly critical element in foreign policy. Establishing a clear career path for health attachés is necessary to foster effective global health agreements and coordination across countries

Languages for Different Health Information Readers: Multitrait-Multimethod Content Analysis of Cochrane Systematic Reviews Textual Summary Formats

Background: Although subjective expressions and linguistic fluency have been shown as important factors in processing and interpreting textual facts, analyses of these traits in textual health information for different audiences are lacking. We analyzed the readability and linguistic psychological and emotional characteristics of different textual summary formats of Cochrane systematic reviews. Methods: We performed a multitrait-multimethod cross-sectional study of Press releases available at Cochrane web site (n= 162) and corresponding Scientific abstracts (n= 158), Cochrane Clinical Answers (n= 35) and Plain language summaries in English (n= 156), French (n= 101), German (n= 41) and Croatian (n=156). We used SMOG index to assess text readability of all text formats, and natural language processing tools (IBM Watson Tone Analyzer, Stanford NLP Sentiment Analysis and Linguistic Inquiry and Word Count) to examine the affective states and subjective information in texts of Scientific abstracts, Plain language summaries and Press releases. Results: All text formats had low readability, with SMOG index ranging from a median of 15.6 (95% confidence interval (CI) 15.3–15.9) for Scientific abstracts to 14.7 (95% CI 14.4–15.0) for Plain language summaries. In all text formats, “Sadness” was the most dominantly perceived emotional tone and the style of writing was perceived as “Analytical”and “Tentative”. At the psychological level, all text formats exhibited the predominant “Openness”tone, and Press releases scored higher on the scales of “Conscientiousness”,“Agreeableness”and “Emotional range”. Press releases had significantly higher scores than Scientific abstracts and Plain languagesummariesonthedimensionsof“Clout”,and“Emotional ton

Bone mineral density in adolescents with chronic kidney disease: a follow-up study

Cilj istraživanja jest odrediti promjenu koštane gustoće u bolesnika adolescentne dobi s kroničnim zatajenjem bubrega i odrediti utjecaj visine i težine, odnosno veličine skeleta na koštanu gustoću. U ispitivanju je sudjelovalo 30 bolesnika, prosječne dobi 13,5±3,5 godina. Svim ispitanicima denzitometrijski je određena mineralna gustoća kosti na kralježnici i cijelom skeletu metodom dvoenergetske apsorpciometrije X zraka (DXA). Laboratorijski su određeni kalcij, fosfor i PTH u serumu i izračunat je klirens kreatinina. Prosječno vrijeme između početnoga i kontrolnoga mjerenja bilo je 15,7 mjeseci. Utvrđenje značajan porast visine i težine u ispitanika, ali su u oba mjerenja antropometrijske varijable bile ispod referentnoga prosjeka (Z vrijednost za visinu i težinu < -1). Mineralna gustoća skeleta na kralježnici i cijelom skeletu je također značajno porasla između dva mjerenja, ali nakon korekcije prema visini i težini, taj porast više nije bio značajan. Zato je kod djece s kroničnim zatajenjem bubrega potrebno izvršiti korekciju koštane gustoće u odnosu na njihovu visinu i težinu, obzirom daje brzina njihovoga rasta usporena.The aim of this follow-up study was to analyze the change of bone mineral density in adolescents with chronic kidney disease and to determine the influence of height, weight and bone size on bone density The study included 30 patients, aged 13.513.5 years. Regular biochemistry included serum calcium, phosphorus and PTH. Bone mineral density (BMD) was measured by dual energy absorptiometry (DXA). The mean time between baseline and follow up measurements was 15.7 months. Despite the significant increase in weight and height in all participants, anthropometric variables were below one standard deviation from reference values in both measurements (Z value < -1, for height and weight). After correction for height and weight, the increase of BMAD between two measurements was not significant. It is necessary to correct the bone density for height and weight in children with chronic kidney disease, due to their retarded growth velocity

Bone mineral density in adolescents with chronic kidney disease: a follow-up study

Cilj istraživanja jest odrediti promjenu koštane gustoće u bolesnika adolescentne dobi s kroničnim zatajenjem bubrega i odrediti utjecaj visine i težine, odnosno veličine skeleta na koštanu gustoću. U ispitivanju je sudjelovalo 30 bolesnika, prosječne dobi 13,5±3,5 godina. Svim ispitanicima denzitometrijski je određena mineralna gustoća kosti na kralježnici i cijelom skeletu metodom dvoenergetske apsorpciometrije X zraka (DXA). Laboratorijski su određeni kalcij, fosfor i PTH u serumu i izračunat je klirens kreatinina. Prosječno vrijeme između početnoga i kontrolnoga mjerenja bilo je 15,7 mjeseci. Utvrđenje značajan porast visine i težine u ispitanika, ali su u oba mjerenja antropometrijske varijable bile ispod referentnoga prosjeka (Z vrijednost za visinu i težinu < -1). Mineralna gustoća skeleta na kralježnici i cijelom skeletu je također značajno porasla između dva mjerenja, ali nakon korekcije prema visini i težini, taj porast više nije bio značajan. Zato je kod djece s kroničnim zatajenjem bubrega potrebno izvršiti korekciju koštane gustoće u odnosu na njihovu visinu i težinu, obzirom daje brzina njihovoga rasta usporena.The aim of this follow-up study was to analyze the change of bone mineral density in adolescents with chronic kidney disease and to determine the influence of height, weight and bone size on bone density The study included 30 patients, aged 13.513.5 years. Regular biochemistry included serum calcium, phosphorus and PTH. Bone mineral density (BMD) was measured by dual energy absorptiometry (DXA). The mean time between baseline and follow up measurements was 15.7 months. Despite the significant increase in weight and height in all participants, anthropometric variables were below one standard deviation from reference values in both measurements (Z value < -1, for height and weight). After correction for height and weight, the increase of BMAD between two measurements was not significant. It is necessary to correct the bone density for height and weight in children with chronic kidney disease, due to their retarded growth velocity

Readability of health information, patients 'rights in the healthcare system and patients' rights in healthcare diplomacy : a multimethodological research

Ciljevi: Provedenim istraživanjima u ovoj doktorskoj disertaciji željeli smo analizirati kako se rješavaju potrebe i problemi pacijenata kroz tri razine: zdravstvenu informaciju - prepoznati zašto je pacijentima teško razumjeti zdravstvene informacije, prava u zdravstvenom sustavu - probleme pacijenata sa kojima se suočavaju u pristupu zdravstvenoj zaštiti te prava i potreba na globalnoj razini - odgovoriti na pitanje kako zdravstvena diplomacija može pomoći zdravstvenim djelatnicima u borbi sa pandemijom COVID-19. Metode: Za procjenu čitkosti teksta koristili smo dizajn presječne studije i pristup s više osobina i više metoda za analizu jezične karakteristike svih 164 priopćenja za javnost o Cochrane sustavnim pregledima. U presječnom istraživanju analizirati smo pritužbe pacijenata na dvije razine: a) pritužbe pacijenata zaprimljene putem službenog e-maila Hrvatskoj udruzi za promicanje prava pacijenata u 2017. i 2018. godini te b) godišnja izvješća 21 županijskih povjerenstava za prava pacijenata poslani Ministarstvu zdravstva u 2017. i 2018. godini (javni podaci, dostupni na zahtjev). U kvalitativnoj studiji koristili smo metodu intervjua relevantnih sudionika zdravstvene diplomacije u EU i stručnjaka povezanih sa zdravstvenom politikom da bismo identificirali i razumjeli ključne trenutne i buduće promjene koje utječu na globalno javno zdravstvo, prikupili iskustva i mišljenja o najboljim načinima balansiranja globalnog zdravstvenog djelovanja i zaštite osobnih prava pacijenata. Rezultati: Formati sažetih informacija za Cochrane sustavne preglede imaju nisku čitkost i niske jezične karakteristike. Jezik kojim su napisane najkvalitetnije zdravstvene informacije, kao što su laički sažetci je nečitak. Sustav za pritužbe pacijenata u Hrvatskoj nije učinkovit u preciznom bilježenju i odražavanju stvarnog stanja zaštite prava pacijenata u hrvatskom zdravstvenom sustavu. Na globalnoj razini ispitanici utvrđuju da je uloga zdravstvene diplomacije ključna te da je potrebno uspostavljanje jasnog puta u karijeri za zdravstvene atašee i za poticanje učinkovite globalne zdravstvene diplomacije koja usklađuje javno zdravstvo i vanjsku politiku. Potrebna je veća transparentnost i jasan proces podnošenja pritužbi kako bi se bolje razumjele potrebe pacijenata, razriješile optužbe, spriječile buduće pritužbe, čime bi se povećala kvaliteta i sigurnost zdravstvenog sustava. Zaključak: Središte zdravstvenog sustava je pacijent koji koristi zdravstveni sustav i zdravstvenu zaštitu. Zdravstvena pismenost za razumijevanje zdravstvenih informacija i predviđanje zdravstvenog stanja te učinkovita komunikacija pokazuju pozitivan utjecaj na zadovoljstvo pacijenata, istodobno smanjujući troškove zdravstvu. Potreban je sustavni pristup sadržaju i formatu zdravstvenih informacija za pacijente kako bi se osiguralo da su prikladni za ciljanu publiku. Zdravlje postaje sve kritičniji element u vanjskoj politici, a uloga zdravstvene diplomacije je ključna. Zdravstveni radnici i pacijenti imaju isti cilj: imati dobru kvalitetu zdravstvene zaštite koja omogućava partnerski odnos liječnika i pacijenta u zdravstvenom sustavu. Zdravstvena politika mora štititi zdravstvene djelatnike, kako bi oni mogli zaštiti pacijente.Aims: The research conducted in this doctoral dissertation aimed to analyze how the needs and problems of patients are solved through three levels: health information - identify why patients find it difficult to understand health information, rights in the health system - problems of patients in accessing health care and rights and global need - to answer the question of how health diplomacy can help health professionals fight the COVID-19 pandemic. Methods: To assess the readability of the text, we used a cross-sectional study design and a multi-feature and multi-method approach to analyze the linguistic characteristics of all 164 press releases on Cochrane systematic reviews. In the cross-sectional study, we analyzed patient complaints at two levels: a) patient complaints received via official e-mail to the Croatian Association for the Promotion of Patients' Rights in 2017 and 2018 and b) annual reports of 21 county patient rights commissions sent to the Ministry of Health in 2017 and 2018 (public data, available on request). In the qualitative study, we used the interview method of relevant EU health diplomacy participants and health policy experts to identify and understand key current and future changes affecting global public health, gather experiences and opinions on the best ways to balance global health and personal protection. patient rights. Results: Summary information formats for Cochrane systematic reviews have low readability and low language characteristics. The language in which the highest quality health information is written, such as plain language summaries, is illegible. The patient complaints system is not effective in accurately recording and reflecting the actual state of protection of patients' rights in the Croatian healthcare system. At the global level, participants identify that the role of health diplomacy is crucial and that a clear career path needs to be established for health attaches and to promote effective global health diplomacy that aligns public health and foreign policy. Greater transparency and a clear process of complaints submission are needed to better understand patients' needs, resolve complaints and prevent future complaints, thus increasing the quality and security of the health care system. Conclusion: The center of the health system is the patient who uses the health system and health care. Health literacy for understanding health information and predicting health status and effective communication show a positive impact on patient satisfaction while reducing healthcare costs. A systematic approach to the content and format of health information for patients is needed to ensure that it is appropriate for the target audience. Health is becoming an increasingly critical element in foreign policy, and the role of health diplomacy is crucial. Healthcare professionals and patients have the same goal: to have a good quality of healthcare that enables a partnership between doctors and patients in the healthcare system. Health policy must protect health professionals so that they can protect patients

Readability of health information, patients 'rights in the healthcare system and patients' rights in healthcare diplomacy : a multimethodological research

Ciljevi: Provedenim istraživanjima u ovoj doktorskoj disertaciji željeli smo analizirati kako se rješavaju potrebe i problemi pacijenata kroz tri razine: zdravstvenu informaciju - prepoznati zašto je pacijentima teško razumjeti zdravstvene informacije, prava u zdravstvenom sustavu - probleme pacijenata sa kojima se suočavaju u pristupu zdravstvenoj zaštiti te prava i potreba na globalnoj razini - odgovoriti na pitanje kako zdravstvena diplomacija može pomoći zdravstvenim djelatnicima u borbi sa pandemijom COVID-19. Metode: Za procjenu čitkosti teksta koristili smo dizajn presječne studije i pristup s više osobina i više metoda za analizu jezične karakteristike svih 164 priopćenja za javnost o Cochrane sustavnim pregledima. U presječnom istraživanju analizirati smo pritužbe pacijenata na dvije razine: a) pritužbe pacijenata zaprimljene putem službenog e-maila Hrvatskoj udruzi za promicanje prava pacijenata u 2017. i 2018. godini te b) godišnja izvješća 21 županijskih povjerenstava za prava pacijenata poslani Ministarstvu zdravstva u 2017. i 2018. godini (javni podaci, dostupni na zahtjev). U kvalitativnoj studiji koristili smo metodu intervjua relevantnih sudionika zdravstvene diplomacije u EU i stručnjaka povezanih sa zdravstvenom politikom da bismo identificirali i razumjeli ključne trenutne i buduće promjene koje utječu na globalno javno zdravstvo, prikupili iskustva i mišljenja o najboljim načinima balansiranja globalnog zdravstvenog djelovanja i zaštite osobnih prava pacijenata. Rezultati: Formati sažetih informacija za Cochrane sustavne preglede imaju nisku čitkost i niske jezične karakteristike. Jezik kojim su napisane najkvalitetnije zdravstvene informacije, kao što su laički sažetci je nečitak. Sustav za pritužbe pacijenata u Hrvatskoj nije učinkovit u preciznom bilježenju i odražavanju stvarnog stanja zaštite prava pacijenata u hrvatskom zdravstvenom sustavu. Na globalnoj razini ispitanici utvrđuju da je uloga zdravstvene diplomacije ključna te da je potrebno uspostavljanje jasnog puta u karijeri za zdravstvene atašee i za poticanje učinkovite globalne zdravstvene diplomacije koja usklađuje javno zdravstvo i vanjsku politiku. Potrebna je veća transparentnost i jasan proces podnošenja pritužbi kako bi se bolje razumjele potrebe pacijenata, razriješile optužbe, spriječile buduće pritužbe, čime bi se povećala kvaliteta i sigurnost zdravstvenog sustava. Zaključak: Središte zdravstvenog sustava je pacijent koji koristi zdravstveni sustav i zdravstvenu zaštitu. Zdravstvena pismenost za razumijevanje zdravstvenih informacija i predviđanje zdravstvenog stanja te učinkovita komunikacija pokazuju pozitivan utjecaj na zadovoljstvo pacijenata, istodobno smanjujući troškove zdravstvu. Potreban je sustavni pristup sadržaju i formatu zdravstvenih informacija za pacijente kako bi se osiguralo da su prikladni za ciljanu publiku. Zdravlje postaje sve kritičniji element u vanjskoj politici, a uloga zdravstvene diplomacije je ključna. Zdravstveni radnici i pacijenti imaju isti cilj: imati dobru kvalitetu zdravstvene zaštite koja omogućava partnerski odnos liječnika i pacijenta u zdravstvenom sustavu. Zdravstvena politika mora štititi zdravstvene djelatnike, kako bi oni mogli zaštiti pacijente.Aims: The research conducted in this doctoral dissertation aimed to analyze how the needs and problems of patients are solved through three levels: health information - identify why patients find it difficult to understand health information, rights in the health system - problems of patients in accessing health care and rights and global need - to answer the question of how health diplomacy can help health professionals fight the COVID-19 pandemic. Methods: To assess the readability of the text, we used a cross-sectional study design and a multi-feature and multi-method approach to analyze the linguistic characteristics of all 164 press releases on Cochrane systematic reviews. In the cross-sectional study, we analyzed patient complaints at two levels: a) patient complaints received via official e-mail to the Croatian Association for the Promotion of Patients' Rights in 2017 and 2018 and b) annual reports of 21 county patient rights commissions sent to the Ministry of Health in 2017 and 2018 (public data, available on request). In the qualitative study, we used the interview method of relevant EU health diplomacy participants and health policy experts to identify and understand key current and future changes affecting global public health, gather experiences and opinions on the best ways to balance global health and personal protection. patient rights. Results: Summary information formats for Cochrane systematic reviews have low readability and low language characteristics. The language in which the highest quality health information is written, such as plain language summaries, is illegible. The patient complaints system is not effective in accurately recording and reflecting the actual state of protection of patients' rights in the Croatian healthcare system. At the global level, participants identify that the role of health diplomacy is crucial and that a clear career path needs to be established for health attaches and to promote effective global health diplomacy that aligns public health and foreign policy. Greater transparency and a clear process of complaints submission are needed to better understand patients' needs, resolve complaints and prevent future complaints, thus increasing the quality and security of the health care system. Conclusion: The center of the health system is the patient who uses the health system and health care. Health literacy for understanding health information and predicting health status and effective communication show a positive impact on patient satisfaction while reducing healthcare costs. A systematic approach to the content and format of health information for patients is needed to ensure that it is appropriate for the target audience. Health is becoming an increasingly critical element in foreign policy, and the role of health diplomacy is crucial. Healthcare professionals and patients have the same goal: to have a good quality of healthcare that enables a partnership between doctors and patients in the healthcare system. Health policy must protect health professionals so that they can protect patients

Readability of health information, patients 'rights in the healthcare system and patients' rights in healthcare diplomacy : a multimethodological research

Ciljevi: Provedenim istraživanjima u ovoj doktorskoj disertaciji željeli smo analizirati kako se rješavaju potrebe i problemi pacijenata kroz tri razine: zdravstvenu informaciju - prepoznati zašto je pacijentima teško razumjeti zdravstvene informacije, prava u zdravstvenom sustavu - probleme pacijenata sa kojima se suočavaju u pristupu zdravstvenoj zaštiti te prava i potreba na globalnoj razini - odgovoriti na pitanje kako zdravstvena diplomacija može pomoći zdravstvenim djelatnicima u borbi sa pandemijom COVID-19. Metode: Za procjenu čitkosti teksta koristili smo dizajn presječne studije i pristup s više osobina i više metoda za analizu jezične karakteristike svih 164 priopćenja za javnost o Cochrane sustavnim pregledima. U presječnom istraživanju analizirati smo pritužbe pacijenata na dvije razine: a) pritužbe pacijenata zaprimljene putem službenog e-maila Hrvatskoj udruzi za promicanje prava pacijenata u 2017. i 2018. godini te b) godišnja izvješća 21 županijskih povjerenstava za prava pacijenata poslani Ministarstvu zdravstva u 2017. i 2018. godini (javni podaci, dostupni na zahtjev). U kvalitativnoj studiji koristili smo metodu intervjua relevantnih sudionika zdravstvene diplomacije u EU i stručnjaka povezanih sa zdravstvenom politikom da bismo identificirali i razumjeli ključne trenutne i buduće promjene koje utječu na globalno javno zdravstvo, prikupili iskustva i mišljenja o najboljim načinima balansiranja globalnog zdravstvenog djelovanja i zaštite osobnih prava pacijenata. Rezultati: Formati sažetih informacija za Cochrane sustavne preglede imaju nisku čitkost i niske jezične karakteristike. Jezik kojim su napisane najkvalitetnije zdravstvene informacije, kao što su laički sažetci je nečitak. Sustav za pritužbe pacijenata u Hrvatskoj nije učinkovit u preciznom bilježenju i odražavanju stvarnog stanja zaštite prava pacijenata u hrvatskom zdravstvenom sustavu. Na globalnoj razini ispitanici utvrđuju da je uloga zdravstvene diplomacije ključna te da je potrebno uspostavljanje jasnog puta u karijeri za zdravstvene atašee i za poticanje učinkovite globalne zdravstvene diplomacije koja usklađuje javno zdravstvo i vanjsku politiku. Potrebna je veća transparentnost i jasan proces podnošenja pritužbi kako bi se bolje razumjele potrebe pacijenata, razriješile optužbe, spriječile buduće pritužbe, čime bi se povećala kvaliteta i sigurnost zdravstvenog sustava. Zaključak: Središte zdravstvenog sustava je pacijent koji koristi zdravstveni sustav i zdravstvenu zaštitu. Zdravstvena pismenost za razumijevanje zdravstvenih informacija i predviđanje zdravstvenog stanja te učinkovita komunikacija pokazuju pozitivan utjecaj na zadovoljstvo pacijenata, istodobno smanjujući troškove zdravstvu. Potreban je sustavni pristup sadržaju i formatu zdravstvenih informacija za pacijente kako bi se osiguralo da su prikladni za ciljanu publiku. Zdravlje postaje sve kritičniji element u vanjskoj politici, a uloga zdravstvene diplomacije je ključna. Zdravstveni radnici i pacijenti imaju isti cilj: imati dobru kvalitetu zdravstvene zaštite koja omogućava partnerski odnos liječnika i pacijenta u zdravstvenom sustavu. Zdravstvena politika mora štititi zdravstvene djelatnike, kako bi oni mogli zaštiti pacijente.Aims: The research conducted in this doctoral dissertation aimed to analyze how the needs and problems of patients are solved through three levels: health information - identify why patients find it difficult to understand health information, rights in the health system - problems of patients in accessing health care and rights and global need - to answer the question of how health diplomacy can help health professionals fight the COVID-19 pandemic. Methods: To assess the readability of the text, we used a cross-sectional study design and a multi-feature and multi-method approach to analyze the linguistic characteristics of all 164 press releases on Cochrane systematic reviews. In the cross-sectional study, we analyzed patient complaints at two levels: a) patient complaints received via official e-mail to the Croatian Association for the Promotion of Patients' Rights in 2017 and 2018 and b) annual reports of 21 county patient rights commissions sent to the Ministry of Health in 2017 and 2018 (public data, available on request). In the qualitative study, we used the interview method of relevant EU health diplomacy participants and health policy experts to identify and understand key current and future changes affecting global public health, gather experiences and opinions on the best ways to balance global health and personal protection. patient rights. Results: Summary information formats for Cochrane systematic reviews have low readability and low language characteristics. The language in which the highest quality health information is written, such as plain language summaries, is illegible. The patient complaints system is not effective in accurately recording and reflecting the actual state of protection of patients' rights in the Croatian healthcare system. At the global level, participants identify that the role of health diplomacy is crucial and that a clear career path needs to be established for health attaches and to promote effective global health diplomacy that aligns public health and foreign policy. Greater transparency and a clear process of complaints submission are needed to better understand patients' needs, resolve complaints and prevent future complaints, thus increasing the quality and security of the health care system. Conclusion: The center of the health system is the patient who uses the health system and health care. Health literacy for understanding health information and predicting health status and effective communication show a positive impact on patient satisfaction while reducing healthcare costs. A systematic approach to the content and format of health information for patients is needed to ensure that it is appropriate for the target audience. Health is becoming an increasingly critical element in foreign policy, and the role of health diplomacy is crucial. Healthcare professionals and patients have the same goal: to have a good quality of healthcare that enables a partnership between doctors and patients in the healthcare system. Health policy must protect health professionals so that they can protect patients

Languages for different health information readers: multitrait-multimethod content analysis of Cochrane systematic reviews textual summary formats

Abstract Background Although subjective expressions and linguistic fluency have been shown as important factors in processing and interpreting textual facts, analyses of these traits in textual health information for different audiences are lacking. We analyzed the readability and linguistic psychological and emotional characteristics of different textual summary formats of Cochrane systematic reviews. Methods We performed a multitrait-multimethod cross-sectional study of Press releases available at Cochrane web site (n = 162) and corresponding Scientific abstracts (n = 158), Cochrane Clinical Answers (n = 35) and Plain language summaries in English (n = 156), French (n = 101), German (n = 41) and Croatian (n = 156). We used SMOG index to assess text readability of all text formats, and natural language processing tools (IBM Watson Tone Analyzer, Stanford NLP Sentiment Analysis and Linguistic Inquiry and Word Count) to examine the affective states and subjective information in texts of Scientific abstracts, Plain language summaries and Press releases. Results All text formats had low readability, with SMOG index ranging from a median of 15.6 (95% confidence interval (CI) 15.3–15.9) for Scientific abstracts to 14.7 (95% CI 14.4–15.0) for Plain language summaries. In all text formats, “Sadness” was the most dominantly perceived emotional tone and the style of writing was perceived as “Analytical” and “Tentative”. At the psychological level, all text formats exhibited the predominant “Openness” tone, and Press releases scored higher on the scales of “Conscientiousness”, “Agreeableness” and “Emotional range”. Press releases had significantly higher scores than Scientific abstracts and Plain language summaries on the dimensions of “Clout”, and “Emotional tone”. Conclusions Although the readability of Plain language summaries was higher than that of text formats targeting more expert audiences, the required literacy was much higher than the recommended US 6th grade level. The language of Press releases was generally more engaging than that of Scientific abstracts and Plain language summaries, which are written by the authors of systematic reviews. Preparation of textual summaries about health evidence for different audiences should take into account readers’ subjective experiences to encourage cognitive processing and reaction to the provided information

Identification of an Additional Metal-Binding Site in Human Dipeptidyl Peptidase III

Dipeptidyl peptidase III (DPP III, EC 3.4.14.4) is a monozinc metalloexopeptidase that hydrolyzes dipeptides from the N-terminus of peptides consisting of three or more amino acids. Recently, DPP III has attracted great interest from scientists, and numerous studies have been conducted showing that it is involved in the regulation of various physiological processes. Since it is the only metalloenzyme among the dipeptidyl peptidases, we considered it important to study the process of binding and exchange of physiologically relevant metal dications in DPP III. Using fluorimetry, we measured the Kd values for the binding of Zn2+, Cu2+, and Co2+ to the catalytic site, and using isothermal titration calorimetry (ITC), we measured the Kd values for the binding of these metals to an additional binding site. The structure of the catalytic metal’s binding site is known from previous studies, and in this work, the affinities for this site were calculated for Zn2+, Cu2+, Co2+, and Mn2+ using the QM approach. The structures of the additional binding sites for the Zn2+ and Cu2+ were also identified, and MD simulations showed that two Cu2+ ions bound to the catalytic and inhibitory sites exchanged less frequently than the Zn2+ ions bound to these sites

Table_1_Diplomatic response to global health challenges in recognizing patient needs: A qualitative interview study.docx

BackgroundGlobal health diplomacy is the applied practice of foreign affairs to further national goals that focus on health issues requiring international cooperation and collective action. We aimed to determine how international diplomats and health policy-related professionals in the EU understand the concept of health diplomacy, which impacts both diplomatic relations as well as patients' rights.MethodsIn a qualitative interview study, we used a heterogeneous stratified purposeful sampling to reach participants from different countries and different practitioners from the Pyramid of Health Diplomacy: core, multi-stakeholder, and informal. Reflexive thematic analysis was used to identify the main themes.FindingsWe contacted 131 practitioners of GHD, of which 37 responded, and nine agreed to be interviewed. From 11 interview questions, four main themes emerged from the analysis of the individual interview. The participants reported limited knowledge about the definition of GHD but also that they engaged in daily activities and decisions of inter-governmental bodies. They were not aware of existing special education and training for health attachés and made suggestions for improving the field and practice of GHD. They were not fully familiar with the European Charter of Patients' Rights. There was a consensus from all participants that patient rights need to improve as a fundamental right. They stressed the fact that the hospital lockdown and the right access to healthcare were impaired during the COVID pandemic.InterpretationThe role of health diplomacy in linking public health and foreign affairs is key to respecting patients' rights. Health over other interests is becoming an increasingly critical element in foreign policy. Establishing a clear career path for health attachés is necessary to foster effective global health agreements and coordination across countries.</p