Future directions for the concept of salutogenesis: a position article.

Aaron Antonovsky advanced the concept of salutogenesis almost four decades ago (Antonovsky, Health, Stress and Coping. Jossey-Bass, San Francisco, CA, 1979; Unravelling the Mystery of Health. Jossey-Bass, San Francisco, CA, 1987). Salutogenesis posits that life experiences shape the sense of coherence (SOC) that helps to mobilize resources to cope with stressors and manage tension successfully (determining one's movement on the health Ease/Dis-ease continuum). Antonovsky considered the three-dimensional SOC (i.e. comprehensibility, manageability, meaningfulness) as the key answer to his question about the origin of health. The field of health promotion has adopted the concept of salutogenesis as reflected in the international Handbook of Salutogenesis (Mittelmark et al., The Handbook of Salutogenesis. Springer, New York, 2016). However, health promotion mostly builds on the more vague, general salutogenic orientation that implies the need to foster resources and capacities to promote health and wellbeing. To strengthen the knowledge base of salutogenesis, the Global Working Group on Salutogenesis (GWG-Sal) of the International Union of Health Promotion and Education produced the Handbook of Salutogenesis. During the creation of the handbook and the regular meetings of the GWG-Sal, the working group identified four key conceptual issues to be advanced: (i) the overall salutogenic model of health; (ii) the SOC concept; (iii) the design of salutogenic interventions and change processes in complex systems; (iv) the application of salutogenesis beyond health sector. For each of these areas, we first highlight Antonovsky's original contribution and then present suggestions for future development. These ideas will help guide GWG-Sal's work to strengthen salutogenesis as a theory base for health promotion.

Enhancing the effectiveness of diabetes self-management education: the diabetes literacy project.

Patient empowerment through self-management education is central to improving the quality of diabetes care and preventing Type 2 Diabetes. Although national programs exist, there is no EU-wide strategy for diabetes self-management education, and patients with limited literacy face barriers to effective self-management. The Diabetes Literacy project, initiated with the support of the European Commission, aims to fill this gap. The project investigates the effectiveness of diabetes self-management education, targeting people with or at risk of Type 2 Diabetes in the 28 EU Member States, as part of a comprehensive EU-wide diabetes strategy. National diabetes strategies in the EU, US, Taiwan, and Israel are compared, and diabetes self-management programs inventorized. The costs of the diabetes care pathway are assessed on a per person basis at national level. A comparison is made of the (cost)-effectiveness of different methods for diabetes self-management support, and the moderating role of health literacy, organization of the health services, and implementation fidelity of education programs are considered. Web-based materials are developed and evaluated by randomized trials to evaluate if interactive internet delivery can enhance self-management support for people with lower levels of health literacy. The 3-year project started in December 2012. Several literature reviews have been produced and protocol development and research design are in the final stages. Primary and secondary data collection and analysis take place in 2014. The results will inform policy decisions on improving the prevention, treatment, and care for persons with diabetes across literacy levels.

Human rhinovirus-induced ISG15 selectively modulates epithelial antiviral immunity.

Human rhinovirus (HRV) infections trigger exacerbations of lower airway diseases. HRV infects human airway epithelial cells and induces proinflammatory and antiviral molecules that regulate the response to HRV infection. Interferon (IFN)-stimulated gene of 15 kDa (ISG15) has been shown to regulate other viruses. We now show that HRV-16 infection induces both intracellular epithelial ISG15 expression and ISG15 secretion in vitro. Moreover, ISG15 protein levels increased in nasal secretions of subjects with symptomatic HRV infections. HRV-16-induced ISG15 expression is transcriptionally regulated via an IFN regulatory factor pathway. ISG15 does not directly alter HRV replication but does modulate immune signaling via the viral sensor protein RIG-I to impact production of CXCL10, which has been linked to innate immunity to viruses. Extracellular ISG15 also alters CXCL10 production. We conclude that ISG15 has a complex role in host defense against HRV infection, and that additional studies are needed to clarify the role of this molecule.

Orbital angular momentum contribution to the magneto-optical behavior of a binuclear cobalt(II) complex.

We report magnetic and magnetic circular dichroism investigations of a binuclear Co(II) compound. The Hamiltonian of the system involves an isotropic exchange interaction dealing with the real spins of cobalt(II) ions, spin-orbit coupling, and a low-symmetry crystal field acting within the (4)T(1g) ground manifold of each cobalt ion. It is shown that spin-orbit coupling between this ground term and the low-lying excited ones can be taken into consideration as an effective g factor in the Zeeman part of the Hamiltonian. The value of this g factor is estimated for the averaged experimental values of Racah and cubic ligand field parameters for high-spin cobalt(II). The treatment of the Hamiltonian is performed with the use of a irreducible tensor operator technique. The results of the calculation are in good agreement with experimental observations. Both a large effective g factor for the ground state and a large temperature-independent part of the magnetic susceptibility arise because of a strong orbital contribution to the magnetic behavior of the Co(II) dimer.

Brain studies--image co-registration and template creation.

Image co-registration requires special software, which is usually available for Unix workstations. This work presents two programs running under MS Windows, one for study co-registration and one for template creation. The co-registration can be done by minimising/maximising the count difference, squared difference, shape and mutual information. The quality of the fit can be estimated by evaluating the contours with different tools. The aligned images can be used for template creation. Both programs can be downloaded from http://www.homolka.cz/nm.

The health promoting hospital (HPH): concept and development.

Health promoting hospitals (HPH) is a concept for hospital development that builds upon the health promotion concept of the WHO Ottawa Charter for health promotion, where the reorientation of health care services is considered as one of five major action areas for an overall health promotion development. The article outlines what such a re-orientation may mean for the main hospital functions. These include: the health promoting hospital setting; health promoting workplaces, the provision of health (related) services, training, education and research; the hospital as an advocate and "change agent" for health promotion in its community/environment; the "healthy" (metaphorically speaking) hospital organisation. Based on the concept, an international network of WHO, Europe has been developing since the late 1980s. The main projects of the international network so far were the first model project "health and hospital" (Vienna, 1989-1996), the European pilot hospital project of HPH (1993-1996), and the development of national/regional HPH networks (ongoing since 1995). It is argued that the further development of the HPH network will have to take into account some major changes that have occurred in the hospital landscape since the start of the network: the quality movement and, as a sub-set of this, the increasing importance of evidence based medicine.

Athens and/or Jerusalem: cosmology and/or creation.

For all three cosmic questions--"Did the universe have a beginning?" "Is the universe designed?" and "Are we alone?"--it was the conjunction as well as the divergence between Athens (Classical philosophy, especially Plato's Timaeus and Aristotle's Physics) and Jerusalem (the Bible, especially the Book of Genesis and the apostle Paul) that illumined the questions themselves, provided material for the answers, and set the terms for the subsequent discussion of them in later centuries.

[Comparison of the hemodynamic properties of a reversed and an in situ bypass in an experiment]. / Porovnanie hemodynamických vlastností obráteného a in situ bypassu v experimente.

The authors compared under standard experimental conditions the flow through a reversed venous segment and a non-reversed segment after destruction of the valves by means of a valvulotome. They did not confirm the theoretical assumptions of more favourable haemodynamic properties of a venous bypass in situ.

Clinic management teams: integrators of professional service and environmental change.

Clinic management teams comprising an administrative director, a head nurse, and a physician manager are interdisciplinary management units in an ambulatory care setting of a large teaching hospital. This article reviews the development of these integrative teams and the factors critical to their success.

[Diagnosis of supravalvular aortic stenosis using 2-dimensional echocardiography]. / Diagnostika supravalvulárnej aortálnej stenózy pomocou dvojrozmernej echokardiografie.

In 13 children supravalvular aortic stenosis was diagnosed by two-dimensional echocardiography on the basis of a diminished inner diameter of the aorta in the supravalvular region "d2" compared with the inner diameter of the aortic annulus "d1". The differences in the values of "d2" and "d1" were only on the border of statistical significance. The difference in the d2/d1 ratio between the group of patients and healthy controls was statistically significant (p less than 0.001). Two-dimensional echocardiography is a very sensitive method for diagnosing supravalvular aortic stenosis. This sensitivity has been confirmed also by detecting the diminished inner diameter of the aorta in the supravalvular region in children with Williams-Beuren syndrome without clinical signs of a heart defect.