embracing diversity in a strengths-based approach to promote health and equity, and avoid epistemic injustice

APP1155125. Publisher Copyright: © 2022 Author(s) (or their employer(s)).Definitions of health literacy have evolved from notions of health-related literacy to a multidimensional concept that incorporates the importance of social and cultural knowledge, practices and contexts. This evolution is evident in the development of instruments that seek to measure health literacy in different ways. Health literacy measurement is important for global health because diverse stakeholders, including the WHO, use these data to inform health practice and policy, and to understand sources of inequity. In this Practice paper, we explore the potential for negative consequences, bias and epistemic injustice to occur when health literacy instruments are used across settings without due regard for the lived experiences of people in various contexts from whom data are collected. A health literacy measurement approach that is emic-sensitive, strengths based and solution oriented is needed to minimise biased data interpretation and use and to avoid epistemic injustice.publishersversionpublishe

Self-reported health and health risky behaviour of Roma adolescents in Slovakia : a comparison with the non-Roma

Roma people form one of the largest and the oldest minorities in Europe. Roma adults’ health has been found to be worse than the health of non-Roma but systematic research on Roma adolescents’ health in particular is almost entirely lacking. The aim of this study was to assess the health status and health-endangering behaviours of Roma adolescents living in poor Roma settlements in the Eastern part of Slovakia and to compare them with their non-Roma counterparts, and to assess the impact of socioeconomic status, social desirability and perceived discrimination on the results. We used a cross-sectional study design, and compared a sample of Roma adolescents (N=330; boys 48.5%; mean age=14.50, SD=1.03) with non-Roma adolescents (N=722; boys 53.2%; mean age=14.86, SD=0.63). Compared to non-Roma adolescents Roma adolescents reported poorer self-rated health, more accidents and injuries and more frequent use of healthcare, though fewer health complaints, higher social support from parents, higher life satisfaction and higher hopelessness rates, less delinquent behaviour and less physically aggressive behaviour, but more hostility. Our study supported the mediating role of socioeconomic status (parental education) in the pathway from ethnicity to health outcomes as proposed by previous research. Discrimination, hopelessness and social support seem to mediate this pathway. The social desirability in health assessment seems to be a confounder that should not be neglected in the assessment of psychosocial outcomes and antisocial behaviour of Roma adolescents. Our findings imply that health-related interventions should be concentrated more on groups with increased health risk originating from low socioeconomic status.

Vaccination, Risk Factors and Outcomes of COVID-19 Infection in Patients with Psoriasis—A Single Centre Real-Life Experience from Eastern Slovakia

Coronavirus disease (COVID-19) represents a threat for people with immune-mediated diseases. It seems that patients with psoriasis appear to have a similar SARS-CoV-2 infection rate as the general population. Our study aimed to identify factors associated with contracting COVID-19 and determining the severity of COVID-19 among psoriatic patients in a real practice setting. We conducted a cross-sectional study with 379 respondents. About one-quarter (n = 78; 25.8%) of the respondents who provided information on their COVID-19 (n = 302) status had contracted COVID-19. Most variables tested for their effect on getting COVID-19 proved to be statistically insignificant, except education, age and gender. Our study proved the protective effect of vaccination, especially the third dose, against the COVID-19 outcome. From all the potential variables, we found that non-Roma ethnicity increased the chance of being vaccinated at least once by 2.6-fold. Patients with a longer psoriasis duration had a higher chance of being vaccinated. We consider biological treatment of psoriasis safe during COVID-19. Vaccination of patients was a statistically significant protector against COVID-19. It is important to point out that only three doses of vaccine decreased with statistical significance the chance of getting the illness. Our findings should be confirmed on larger samples in further studies

Prevalence of Microalbuminuria and Its Association with Subclinical Carotid Atherosclerosis in Middle Aged, Nondiabetic, Low to Moderate Cardiovascular Risk Individuals with or without Hypertension

Microalbuminuria is closely associated with the risk of cardiovascular disease and all-cause mortality in the general population. Less is known about its relationship with subclinical atherosclerosis. We aimed to assess the prevalence of microalbuminuria and its relationship with subclinical atherosclerosis in middle-aged, nondiabetic, apparently healthy individuals (N = 187; 40.1% men, 59.9% women; aged 35–55 years) as well as to evaluate its potential associations with established risk modifiers, especially with the presence of carotid plaque. Clinical and laboratory parameters, the estimated 10-year fatal cardiovascular risk (SCORE), as well as circulating, functional (flow mediated vasodilation, ankle-brachial index, augmentation index, and pulse wave velocity), and morphological markers (mean carotid intima–media thickness, and carotid plaque) of subclinical atherosclerosis were analysed in group with vs. without microalbuminuria. Microalbuminuria was present in 3.8% of individuals with SCORE risk 0.43 ± 0.79%. Functional markers predominated in both groups. Carotid intima–media thickness (mean ± SD) in both groups was in range: 0.5–0.55 ± 0.09–0.14 mm. Carotid plaque was more frequent in group with (14.3%) vs. without (4.4%) microalbuminuria. Microalbuminuria had no statistically significant effect on most markers of subclinical atherosclerosis, but the increasing value of microalbuminuria was significantly associated with the occurrence of carotid plaque (p = 0.035; OR = 1.035; 95% CI = 1.002–1.07). Additional multiple logistic regression analysis, where variables belonged to microalbuminuria, number of risk factors, and family history, finally showed only two variables: microalbuminuria (p = 0.034; OR = 1.04; 95%CI = 1.003–1.09) and the number of risk factors (p = 0.006; OR = 2.15; 95% CI = 1.24–3.73) with independent and significant impact on the occurrence of carotid plaque. Our results may indicate an association of microalbuminuria with the presence of carotid atherosclerotic plaque; in addition, microalbuminuria and the number of risk factors appear to be possible predictors of the carotid plaque occurrence. Monitoring microalbuminuria may improve the personalized cardiovascular risk assessment in nondiabetic, low-to-moderate cardiovascular risk individuals with or without hypertension

Štruktúra zdravotnej gramotnosti u adolescentov [The structure of health literacy in adolescents]

Objectives: The current study dealt with the concept of health literacy in adolescents. The main aim of the study was to examine the structure of adolescents, health literacy. The aim was also to discuss the current need and potential for the development of adolescents, health literacy in educational setting. - Sample and settings: The sample comprised 290 participants from four Slovak elementary schools. The participants were in the 7th and 9th grade. Adolescents, health literacy was measured using HLSAC with additional items approved by the HBSC expert group (Health Behaviour in School-aged Children). Hypothesis. The authors assumed that in the given population, health literacy falls along 5 theory-based distinct dimensions. - Statistical analysis: Confirmatory factor analy- sis explicitly modeling the ordered categorical nature of the data was carried out. - Results: As opposed to the hypothesized 5-factor structure, unequivocally collinear relationships between the proposed factors strongly suggested that health literacy is unitary in the given population. An overall sum score can thus be regarded an internally consistent proxy for the underlying construct. - Study limitations: Cluster sampling. Sample size not allowing for the comparison of the latent structure across levels of age and gender.peerReviewe

Validation of a 16-Item Short Form of the Czech Version of the Experiences in Close Relationships Revised Questionnaire in a Representative Sample

The aim of this study was to create a shorter Czech version (ECR-R-16) of the Revised Experiences in Close Relationships (ECR-R) questionnaire and to assess its psychometric properties. Data from a representative sample of the Czech population from 15 to 90 years old (N = 1000, M age = 46.0 years, SD = 17.3) were collected using a face-to-face structured interview in 2014. The developed short form of the Czech version of the ECR-R showed good internal consistency (alphas varied from .84 to .90), and both exploratory and confirmatory factor analyses replicated the two-dimensional model. The results also demonstrated concurrent validity with measures of neuroticism, self-esteem, and positive and negative affect. People living with a partner and people with higher educational levels had significantly lower Avoidance scores than people living alone and people with lower educational levels. It was concluded that the ECR-R-16 questionnaire has good psychometric properties and is a valid assessment method in the Czech cultural context, suitable for research and clinical studies, when the shorter form of a measure is desirable