Highlights • The PEMAT a new instrument to assess patient education materials. • It assesses understandability and actionability of print and audiovisual materials. • The PEMAT demonstrated strong ...internal consistency and reliability. • Consumer testing and readability assessments produced evidence of construct validity.
Toxic DNA-protein crosslinks (DPCs) arise by ionizing irradiation and UV light, are particularly caused by endogenously produced reactive compounds such as formaldehyde, and also occur during ...compromised topoisomerase action. Although nucleotide excision repair and homologous recombination contribute to cell survival upon DPCs, hardly anything is known about mechanisms that target the protein component of DPCs directly. Here, we identify the metalloprotease Wss1 as being crucial for cell survival upon exposure to formaldehyde and topoisomerase 1-dependent DNA damage. Yeast mutants lacking Wss1 accumulate DPCs and exhibit gross chromosomal rearrangements. Notably, in vitro assays indicate that substrates such as topoisomerase 1 are processed by the metalloprotease directly and in a DNA-dependent manner. Thus, our data suggest that Wss1 contributes to survival of DPC-harboring cells by acting on DPCs proteolytically. We propose that DPC proteolysis enables repair of these unique lesions via downstream canonical DNA repair pathways.
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•The metalloprotease Wss1 targets DNA-protein crosslinks•Wss1 cleaves its substrates in a DNA-dependent manner•DNA-protein crosslink repair by Wss1 promotes genome stability•Wss1 action enables translesion synthesis of DNA-protein crosslinks
The metalloprotease Wss1 enables the repair of DNA-protein crosslinks by targeting their protein components in a DNA-dependent manner.
To review the evidence on the association between age and limited health literacy, overall and by health literacy test, and to investigate the mediating role of cognitive function.
The Embase, ...MEDLINE, and PsycINFO databases were searched. Eligible studies were conducted in any country or language, included participants aged ≥50 years, presented a measure of association between age and health literacy, and were published through September 2013.
Seventy analyses in 60 studies were included in the systematic review; 29 of these were included in the meta-analysis. Older age was strongly associated with limited health literacy in analyses that measured health literacy as reading comprehension, reasoning, and numeracy skills (random-effects odds ratio OR = 4.20; 95% confidence interval CI: 3.13-5.64). By contrast, older age was weakly associated with limited health literacy in studies that measured health literacy as medical vocabulary (random-effects OR = 1.19; 95% CI: 1.03-1.37). Evidence on the mediating role of cognitive function was limited.
Health literacy tests that utilize a range of fluid cognitive abilities and mirror everyday health tasks frequently observe skill limitations among older adults. Vocabulary-based health literacy skills appear more stable with age. Researchers should select measurement tests wisely when assessing health literacy of older adults.
To explore the variation in understanding of, attitudes towards, and uptake of, health advice on coronavirus disease 2019 (COVID-19) during the 2020 pandemic stage 3 restrictions ('lockdown') by ...health literacy in the Australian population.
National cross-sectional community survey.
Australian general public.
Adults aged over 18 years (N = 4362).
Knowledge, attitudes and behaviours related to COVID-19; health literacy and sociodemographic factors.
People with inadequate health literacy had poorer understanding of COVID-19 symptoms (49% vs 68%; p < 0.001), were less able to identify behaviours to prevent infection (59%% vs 72% p < 0.001), and experienced more difficulty finding information and understanding government messaging about COVID-19 than people with adequate health literacy. People with inadequate health literacy were less likely to rate social distancing as important (6.1 vs 6.5; p < 0.001) and reported more difficulty with remembering and accessing medicines since lockdown (3.6 vs 2.7; p < 0.001). People with lower health literacy were also more likely to endorse misinformed beliefs about COVID-19 and vaccinations (in general) than those with adequate health literacy. The same pattern of results was observed among people who primarily speak a language other than English at home.
Our findings show that there are important disparities in COVID-19-related knowledge, attitudes and behaviours according to people's health literacy and language. These have the potential to undermine efforts to reduce viral transmission and may lead to social inequalities in health outcomes in Australia. People with the greatest burden of chronic disease are most disadvantaged, and are also most likely to experience severe disease and die from COVID-19. Addressing the health literacy, language and cultural needs of the community in public health messaging about COVID-19 must now be a priority in Australia.
The evolving outbreak of coronavirus disease 2019 (COVID-19) is requiring social distancing and other measures to protect public health. However, messaging has been inconsistent and unclear.
To ...determine COVID-19 awareness, knowledge, attitudes, and related behaviors among U.S. adults who are more vulnerable to complications of infection because of age and comorbid conditions.
Cross-sectional survey linked to 3 active clinical trials and 1 cohort study.
5 academic internal medicine practices and 2 federally qualified health centers.
630 adults aged 23 to 88 years living with 1 or more chronic conditions.
Self-reported knowledge, attitudes, and behaviors related to COVID-19.
A fourth (24.6%) of participants were "very worried" about getting the coronavirus. Nearly a third could not correctly identify symptoms (28.3%) or ways to prevent infection (30.2%). One in 4 adults (24.6%) believed that they were "not at all likely" to get the virus, and 21.9% reported that COVID-19 had little or no effect on their daily routine. One in 10 respondents was very confident that the federal government could prevent a nationwide outbreak. In multivariable analyses, participants who were black, were living below the poverty level, and had low health literacy were more likely to be less worried about COVID-19, to not believe that they would become infected, and to feel less prepared for an outbreak. Those with low health literacy had greater confidence in the federal government response.
Cross-sectional study of adults with underlying health conditions in 1 city during the initial week of the COVID-19 U.S. outbreak.
Many adults with comorbid conditions lacked critical knowledge about COVID-19 and, despite concern, were not changing routines or plans. Noted disparities suggest that greater public health efforts may be needed to mobilize the most vulnerable communities.
National Institutes of Health.
To provide an evidence-based review of plausible causal pathways that could best explain well-established associations between limited health literacy and health outcomes.
Through analysis of current ...findings in medical and public health literature on health literacy we derived a conceptual causal model.
Health literacy should be viewed as both a patient and a system phenomenon. Three distinct points along a continuum of health care are suggested to be influenced by health literacy: (1) access and utilization of health care, (2) patient-provider relationship, and (3) self-care.
The conceptual model organizes what has been learned to date and underscores promising areas of future inquiry and intervention.
Abstract
Development of sensitive local probes of magnon dynamics is essential to further understand the physical processes that govern magnon generation, propagation, scattering, and relaxation. ...Quantum spin sensors like the NV center in diamond have long spin lifetimes and their relaxation can be used to sense magnetic field noise at gigahertz frequencies. Thus far, NV sensing of ferromagnetic dynamics has been constrained to the case where the NV spin is resonant with a magnon mode in the sample meaning that the NV frequency provides an upper bound to detection. In this work we demonstrate ensemble NV detection of spinwaves generated via a nonlinear instability process where spinwaves of nonzero wavevector are parametrically driven by a high amplitude microwave field. NV relaxation caused by these driven spinwaves can be divided into two regimes; one- and multi-magnon NV relaxometry. In the one-magnon NV relaxometry regime the driven spinwave frequency is below the NV frequencies. The driven spinwave undergoes four-magnon scattering resulting in an increase in the population of magnons which are frequency matched to the NVs. The dipole magnetic fields of the NV-resonant magnons couple to and relax nearby NV spins. The amplitude of the NV relaxation increases with the wavevector of the driven spinwave mode which we are able to vary up to 3 × 10
6
m
−1
, well into the part of the spinwave spectrum dominated by the exchange interaction. Increasing the strength of the applied magnetic field brings all spinwave modes to higher frequencies than the NV frequencies. We find that the NVs are relaxed by the driven spinwave instability despite the absence of any individual NV-resonant magnons, suggesting that multiple magnons participate in creating magnetic field noise below the ferromagnetic gap frequency which causes NV spin relaxation.
There is ongoing debate on whether health literacy represents a skill-based construct for health self-management, or if it also more broadly captures personal 'activation' or motivation to manage ...health. This research examines 1) the association between patient activation and health literacy as they are most commonly measured and 2) the independent and combined associations of patient activation and health literacy skills with physical and mental health.
A secondary analysis of baseline cross-sectional data from the LitCog cohort of older adults was used. Participants (n = 697) were recruited from multiple US-based health centers. During structured face-to-face interviews, participants completed the Test of Functional Health Literacy in Adults (TOFHLA), the Patient Activation Measure (PAM), the SF-36 physical health summary subscale, and Patient Reported Outcomes Measurement Information Service (PROMIS) short form subscales for depression and anxiety.
The relationship between health literacy and patient activation was weak, but significant (r = 0.11, p<0.01). In models adjusted for participant characteristics, lower health literacy was associated with worse physical health (β = 0.13, p<0.001) and depression (β = -0.16, p<0.001). Lower patient activation was associated with worse physical health (β = 0.19, p<0.001), depression (β = -0.27, p<0.001) and anxiety (β-0.24, p<0.001).
The most common measures of health literacy and patient activation are weakly correlated with each other, but also independently correlated with health outcomes. This suggests health literacy represents a distinct skill-based construct, supporting the Institute of Medicine's definition. Deficits in either construct could be useful targets for behavioral intervention.
The association between performance on health literacy measures and health outcomes is well established. The next step is to understand the processes through which health literacy affects health. ...This review introduces a framework drawing on ideas from health psychology and proposing that associations between health literacy and health outcomes could be mediated by a range of health actions involving access and use of health care, patient-provider interactions, and the management of health and illness. The framework outlines routes through which health literacy might affect either health actions themselves or the motivational and volitional determinants that have been identified in social cognition models. The implications of the framework for future research and intervention strategies are discussed.
It is established that increased autophagy is readily detectable after various types of acute brain injury, including trauma, focal and global cerebral ischemia. What remains controversial, however, ...is whether this heightened detection of autophagy in brain represents a homeostatic or pathologic process, or an epiphenomenon. The ultimate role of autophagy after acute brain injury likely depends upon: 1) the degree of brain injury and the overall autophagic burden; 2) the capacity of individual cell types to ramp up autophagic flux; 3) the local redox state and signaling of parallel cell death pathways; 4) the capacity to eliminate damage associated molecular patterns and toxic proteins and metabolites both intra- and extracellularly; and 5) the timing of the pro- or anti-autophagic intervention. In this review, we attempt to reconcile conflicting studies that support both a beneficial and detrimental role for autophagy in models of acute brain injury.
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