The importance of health literacy for self-management: A scoping review of reviews

Objectives Self-management of chronic diseases is rather complex, especially for patients with limited health literacy. In this review, we aim to disentangle the specific difficulties patients with limited health literacy face in relation to self-management and their associated needs with respect to self-management support. Methods We performed a literature search in five databases. We used a broad definition of health literacy and self-management was categorized into four types of activities: medical management, changing lifestyle, communicating and navigating through the health care system and coping. Included reviews described the relationship between health literacy and different domains of self-management and were published after 2010. Results A total of 28 reviews were included. Some clear difficulties of patients with limited health literacy emerged, predominantly in the area of medical management (especially adherence), communication and knowledge. Other associations between health literacy and self-management were inconclusive. Barriers from the patients' perspective described mainly medical management and the communication and navigation of the health care system. Discussion Patients with limited health literacy experience difficulties with specific domains of self-management. For a better understanding of the relationship between health literacy and self-management, a broader conceptualization of health literacy is warranted, including both cognitive and behavioural aspects

Time-of-day perception in paintings

The spectral shape, irradiance, direction, and diffuseness of daylight vary regularly throughout the day. The variations in illumination and their effect on the light reflected from objects may in turn provide visual information as to the time of day. We suggest that artists' color choices for paintings of outdoor scenes might convey this information and that therefore the time of day might be decoded from the colors of paintings. Here we investigate whether human viewers' estimates of the depicted time of day in paintings correlate with their image statistics, specifically chromaticity and luminance variations. We tested time-of-day perception in 17th- to 20th-century Western European paintings via two online rating experiments. In Experiment 1, viewers' ratings from seven time choices varied significantly and largely consistently across paintings but with some ambiguity between morning and evening depictions. Analysis of the relationship between image statistics and ratings revealed correlations with the perceived time of day: higher "morningness" ratings associated with higher brightness, contrast, and saturation and darker yellow/brighter blue hues; "eveningness" with lower brightness, contrast, and saturation and darker blue/brighter yellow hues. Multiple linear regressions of extracted principal components yielded a predictive model that explained 76% of the variance in time-of-day perception. In Experiment 2, viewers rated paintings as morning or evening only; rating distributions differed significantly across paintings, and image statistics predicted people's perceptions. These results suggest that artists used different color palettes and patterns to depict different times of day, and the human visual system holds consistent assumptions about the variation of natural light depicted in paintings.Human Information Communication Desig

Self-management interventions for adults living with obesity to improve patient-relevant outcomes: an evidence map.

Objectives To conduct an evidence map on self-management interventions and patient-relevant outcomes for adults living with overweight/obesity. Methods Following Arksey and O'Malley methodology, we searched in five electronical databases including randomized controlled trials (RCTs) on SMIs for overweight/obesity. We used the terms "self-management", "adult" and "obesity" for content. Two independent reviewers assessed eligible references; one reviewer extracted data, a second checked accuracy. Results We identified 497 RCTs (58% US, 20% Europe) including 99,741 (median 112, range 11-5145) adults living with overweight/obesity. Most research evaluated clinical outcomes (617, 55%) and behaviors adherence (255, 23%). Empowerment skills, quality of life and satisfaction were less targeted (8%, 7%, 0.2%, respectively). The most frequent techniques included sharing information (858, 99%), goal setting (619, 72%) and self-monitoring training (614, 71%), provided face-to-face (386, 45%) or in combination with remote techniques (256, 30%). Emotional management, social support and shared-decision were less frequent (18%, 26%, 4%). Socio-economic status, minorities or health literacy were seldom reported. Conclusion There is a need of widening the scope of research by focusing on outcomes important to patients, assessing emotional/social/share-decision support, exploring remote techniques and including vulnerable populations