A cross-sectional analysis of health literacy: patient- versus family doctor-reported and associations with self-efficacy and chronic disease

Background Adequate health literacy (HL) levels contribute to good health outcomes and successful disease self-management in patients with chronic disease. Hence, it is essential that family doctors recognize patients with inadequate HL in need of additional support. This study had two aims: (1) to assess and compare patient self-reported versus family doctor-rated HL estimates, and (2) to explore associations between patient-reported HL, self-efficacy and chronic diseases. Methods Participants in this cross-sectional survey were recruited through general practices in North Rhine-Westphalia, Germany. Patient self-reported HL was measured using the European Health Literacy Survey-16. Family doctor-rated HL was measured with an adapted version of this instrument. Using crosstabulations patient-reported and family doctor-rated HL estimates were compared for 346 patient-family doctor pairs. Associations between HL, self-efficacy and chronic disease were investigated using regression analyses. Results Patient-reported and family doctor-rated HL estimates were concordant in 38% of all cases. On average family doctors rated their patients’ HL lower than patients rated their own HL. The lower average family doctor ratings were more pronounced when patients were older, male and had more than one chronic disease. Female family doctors rated HL of male patients lower than their male colleagues. Patient reported HL had a significant positive association with self-efficacy. Mediation analysis provided support that self-efficacy acts as mediator between HL and the number of chronic diseases. Conclusions Our study findings indicate a significant discrepancy between patients’ self-reported HL and externally rated HL by family doctors. A more systematic utilization of HL screeners might help reduce this discrepancy. At the same time, consideration should be given to enhancing communication training for family doctors and addressing critical HL skills in patient education.

Optimal Sizing of Rooftop Rainwater Harvesting Tanks for Sustainable Domestic Water Use in the West Bank, Palestine

In highly water-poor areas, rooftop rainwater harvesting (RRWH) can be used for a self-sustaining and self-reliant domestic water supply. The designing of an optimal RRWH storage tank is a key parameter to implement a reliable RRWH system. In this study, the optimal size of RRWH storage tanks in the different West Bank governorates was estimated based on monthly (all governorates) and daily (i.e., Nablus) inflow (RRWH) and outflow (domestic water demand, DWD) data. In the estimation of RRWH, five rooftop areas varying between 100 m2 and 300 m2 were selected. Moreover, the reliability of the adopting RRWH system in the different West Bank governorates was tested. Two-time series scenarios were assumed: Scenario 1, S1 (12 months, annual) and scenario 2, S2 (8 months, rainy). As a result, reliable curves for preliminary estimation of optimal RRWH storage tanks for the different West Bank governorates were obtained. Results show that the required storage tank for S1 (annual) is more than that of the S2 (rainy) one. The required storage tank to fulfill DWD is based on the average rooftop area of 150 m2, the average family members of 4.8, and the average DWD of 90 L per capita per day (L/c/d) varies between (75 m3 to 136 m3) and (24 m3 to 84 m3) for S2 for the different West Bank governorates. Further, it is found that the optimal RRWH tank size for the 150 m2 rooftop ranges between 20 m3 (in Jericho) to 75 m3 (in Salfit and Nablus) and between 20 m3 (in Jericho) to 51 m3 (in Jerusalem) for S1 and S2 scenarios, respectively. Finally, results show that the implementation of an RRWH system for a rooftop area of 150 m2 and family members of 4.8 is reliable for all of the West Bank governorates except Jericho. Whereas, the reliability doesn’t exceed 19% for the two scenarios. However, the reduction of DWDv is highly affecting the reliability of adopting RRWH systems in Jericho (the least rainfall governorate). For instance, a family DWDv of 3.2 m3/month (25% of the average family DWDv in the West Bank) will increase the reliability at a rooftop area of 150 m2 to 51% and 76% for S1 and S2, respectively.

Family income and health in Canada: a longitudinal study of stability and change

Background Extensive research has shown strong associations between income and health. However, the health effects of income dynamics over time are less known. We investigated how stability, volatility and trajectory in family incomes from 2002 to 2011 predicted (1) fair/poor self-rated health and (2) the presence of a longstanding illness or health problem in 2012. Methods The data came from the 2012 wave of the Longitudinal and International Study of Adults linked to annual family income data for 2002 to 2011 from the Canada Revenue Agency. We executed a series of binary logistic regressions to examine associations between health and average family income over the decade (Model 1), number of years in the bottom quartile (Model 2) and top quartile (Model 3) of family incomes, standard deviation of family incomes (Model 4), absolute difference between family income at the end and start of the period (Model 5), and number of years in which inflation-adjusted family income went down by more than 1% (Model 6) and up by more than 1% (Model 7) from 1 year to the next. The analyses were conducted separately for women and men. Results Average family income over the decade was strongly associated with both self-rated health and the presence of a longstanding illness or health problem. More years spent in the bottom quartile of family incomes corresponded to elevated odds of fair/poor self-rated health and the presence of a longstanding illness or health problem. Steady decreases in family income over the decade corresponded to elevated odds of fair/poor self-rated health for men and more years spent in the top quartile of family incomes over the decade corresponded to elevated odds of fair/poor self-rated health for women. Conclusion Previous studies of the association between family income and health in Canada may have overlooked important issues pertaining to family income stability and change that are impactful for health.

Analysis of Medical Seeking Behavior and Influencing Factors in Patients With Chronic Obstructive Pulmonary Disease

Purpose: To explore the status of medical seeking behavior in patients with chronic obstructive pulmonary disease (COPD), and clarify relevant factors that may affect the diagnosis delay. Methods: A cross-sectional study was conducted in a Chinese tertiary hospital from July 2019 to February 2020. A total of 408 eligible outpatient COPD patients were recruited and relevant data were collected in the form of questionnaire. Diagnosis delay was compared among different characteristics using Wilcoxon test and Kruskal-Wallis H test. Correlation analysis were performed to further explore factors related to diagnosis delay. Results: The median (interquartile range [IQR]) duration of diagnosis delay was 230 (50 - 720) days. Proportions of COPD patients who chose tertiary hospitals, secondary hospitals, and first – level hospitals for the first visit were respectively 53.7%, 29.9% and 16.4%. Additionally, proportions of patients who received pulmonary function test for the first visit in tertiary hospitals, secondary hospitals, and first – level hospitals were namely, 83.9%, 15.5%, and 1.5% (p < 0.001). In terms of characteristics related to diagnosis delay, there is a significant difference in residence, resident manner, CAT , mMRC, age, FEV1% predicted, years of education, average family income(p < 0.001). Furthermore, diagnosis delay is correlated with patients’ knowledge level of COPD and other characteristic variables (including age, years of education, resident manner, average family income, CAT , mMRC, FEV1% predicted, and FEV1/FVC) to varying degrees. Conclusion: Our study indicates that varying degrees of diagnosis delay may exist in COPD patients. Measures are needed to intervene potential factors related to diagnosis delay.

Family member's awareness of cyber-security concepts and its correlation with the precautionary procedures taken against cyber-attacks during the Coronavirus pandemic

This research aimed to explore the correlation between family members' awareness of cybersecurity concepts and the precautionary procedures taken against cyberattacks during the Coronavirus pandemic. A descriptive-analytical method was used. Also, a questionnaire was conducted to assess the correlation between family members' awareness of cybersecurity concepts and the precautionary procedure taken against cyberattacks during the Corona pandemic. The study sample consisted of 215 family members, males, females, employed and non-employed, students of different ages and educational levels. The results revealed a significant correlation between family member's awareness of cybersecurity concepts and the precautionary procedures taken against cyberattacks during the Corona pandemic. Besides, a significant difference (p ≤ 0.05) in the family member's awareness level of the cybersecurity concepts, with some demographic variables (gender, employment status, age, education level, and average family income). Also, there was a significant difference (p ≤ 0.05) in the preventive procedures taken by family members to protect themselves from cyberattacks with the study variables (gender, employment status, age, education level, and average family income).

Lebensrealität und Rente

The current pension debate focuses primarily on the issue of generational equity. However, this work addresses problems that do not concern intergenerational but intragenerational distribution processes in the statutory pension system: Given the plurality of forms of employment and lifestyles, the ‘structural conservatism’ of this system, including its normative concepts of the conventional employment relationship and the average family, appears to have become a challenge. Accordingly, this work presents inconsistencies and inequalities that result from this confrontation. At the same time, it offers a benchmark that allows for a normative assessment of the discrepancies it points out, viewed from a Christian social–ethical perspective.

An Analytical Geographical Survey of Indicators for Determining the Levels of Noise Pollution، Due to Electric Generators، and Impaired Air Quality in The City of Ramadi

The current study was conducted on the city of Ramadi to find out the noise pollution represented by the sounds of generators on the residents of the city and its effect on the air purity in Ramadi city، in other words، this study aims to highlight the role of generators and their impact on increasing the level of noise pollution and air purity disturbance in the study area. Where the method of the analytical approach was followed، based on the analysis of the data obtained by the questionnaire forms of the generators owners as well as the residents of the study area. This research was divided into an introduction، a study on noise pollution and its concept and the second section dealt with the analysis and interpretation of the answers to the questionnaire forms that included (33) questions which were answered by the generators owners and the residents of Ramadi. Whereas the third section، where the sound and gas measurement device (SVAN955) (Sound Leved Metr) was used. (8) sites of various uses (commercial - residential - industrial - service) were selected and the levels of sounds were determined and compared with the relative determinants. It was clarified through the study that the city of Ramadi includes (453) generators distributing among the neighborhoods. As a result of the study that was conducted in the city of Ramadi، it was found that there are many complaints from residents of the study area which is considered (80%) of the sample size because most of the generators do not contain a silencer. The study also showed that most of the pollutants resulting from the generators are discharged with the sewage network. The study highlighted that the generator sites are located near residential homes and schools and thus have high noise pollution as well as it is considered uncivilized phenomena being not surrounded by fences، isolators or trees. The study also indicated that most of the generators are not designed for this basis (modulated) with many problems and little cost. The study showed the effect of generators on the monthly income of families، as the study showed that the highest average family income is more than (550،000) dinars per month، and the average family spends more than (55) thousand dinars per month، this amount is not including household generators.

Associations between individual perceptions of PM2.5 pollution and pulmonary function in Chinese middle-aged and elderly residents

Background: PM2.5 pollution has become a major public health concern in urban China. Understanding the residents’ individual perceptions toward haze pollution is critical for policymaking and risk communication. However, the perceptions of middle-aged and elderly residents, who particularly vulnerable to haze pollution, are poorly understood. In this study, we aimed to explore their risk perceptions of haze pollution and investigate its relationship with health status and pulmonary function parameters. Methods: A cross-sectional study of 400 randomly sampled individuals (aged 40 to 90 years) was conducted in Wuxi, a typical PM2.5-polluted city in Jiangsu Province, China (during 2015-2017, daily average concentration of PM2.5 was 52.7 μg/m3). Each participant’s demographic and health information, individual perception and pulmonary function outcomes were collected to explore the relationships between perception factors and personal characteristics and pulmonary function parameters, using linear models. Results: We found that the mean values for controllability (5 ± 2.8) and dread of risk to oneself (levels of fear for haze-related harm to oneself) (6.9 ± 2.5) were the lowest and the highest values, respectively, in our study. Education and average family income were positively related with all individual perception factors, while age was negatively associated. A history of respiratory disease was positively associated with all individual perception factors except controllability. Significant positive associations were observed between PEF (coefficients ranged from 0.18 to 0.22) and FEF75% (coefficients ranged from 0.18 to 0.29) with a variety of individual perception factors. Conclusions: There were a lack of concern and knowledge, weak self-protection consciousness and a strong dread of PM2.5 pollution among the middle-aged and elderly residents in Wuxi. Their individual perceptions were associated with age, education levels, average family income, history of respiratory disease, PEF and FEF75%. Our findings may help policymakers develop effective policies and communication strategies to mitigate the hazards of haze among older residents.