Health Literacy Levels and Predictors Among Lebanese Adults Visiting Outpatient Clinics in Beirut.

BACKGROUND: To date, there has been a dearth of research on health literacy in the Eastern Mediterranean Region and in particular Lebanon. OBJECTIVES: This cross-sectional study assessed the levels and correlates of health literacy in Lebanese adults. METHODS: A total of 587 participants (54.5% women) were recruited from the outpatient clinics of five health facilities in Beirut. The questionnaire consisted of the Arabic version of the Functional Health literacy Scale, the Arabic short version of the European Health Literacy Survey, and questions on sociodemographic and health-related factors. Descriptive and inferential statistics were performed to assess the association of these factors with functional health literacy (FHL) and comprehensive health literacy (CHL) levels. KEY RESULTS: About 65.8% had inadequate or problematic FHL and 43.8% had inadequate or problematic CHL. Although FHL was negatively correlated with long-term illness, it was positively correlated with ability to pay and health status. CHL was positively correlated with education, income, ability to pay for treatment, health status, and FHL level, whereas it was negatively correlated with long-term illness. Binary logistic regression showed that low education, low socioeconomic status, and being a widow were predictive of inadequate FHL. Moreover, having inadequate FHL and low income increased the likelihood of having inadequate CHL. CONCLUSION: This study has identified those with risk factors for inadequate health literacy and unfavorable health outcomes. A national action plan can guide the promotion of health literacy and its embeddedness in society to instill competencies and the environment that would eliminate health inequities and sustain health in Lebanon. [HLRP: Health Literacy Research and Practice. 2021;5(4):e295-e309.] Plain Language Summary: This study examined health literacy levels and correlates in 587 Lebanese adults using two recognized screening tools. The first tool measured functional health literacy (FHL), which represents the ability of a person to acquire information on health through reading or writing. The second tool assessed comprehensive health literacy (CHL), which encompasses the ability of a person to use their social skills to acquire health information from different media and make appropriate health decisions based on this information. Close to two-thirds of the participants had inadequate or problematic FHL. More specifically, low education, low socioeconomic status, and widowhood were predictive of inadequate FHL. Nearly one-half of the participants had inadequate or problematic CHL with an increased likelihood of inadequate levels in people with low FHL and low income.

GCC185 plays independent roles in Golgi structure maintenance and AP-1-mediated vesicle tethering.

GCC185 is a long coiled-coil protein localized to the trans-Golgi network (TGN) that functions in maintaining Golgi structure and tethering mannose 6-phosphate receptor (MPR)-containing transport vesicles en route to the Golgi. We report the identification of two distinct domains of GCC185 needed either for Golgi structure maintenance or transport vesicle tethering, demonstrating the independence of these two functions. The domain needed for vesicle tethering binds to the clathrin adaptor AP-1, and cells depleted of GCC185 accumulate MPRs in transport vesicles that are AP-1 decorated. This study supports a previously proposed role of AP-1 in retrograde transport of MPRs from late endosomes to the Golgi and indicates that docking may involve the interaction of vesicle-associated AP-1 protein with the TGN-associated tethering protein GCC185.

Staff injuries from patient attack: five years' data.

We report on five years' experience of staff injuries from patient attack in a large state hospital. In 1984 to 1988, with a total of 6,225 staff person-years of exposure, 209 employees suffered 236 injuries from patient attack. Ward nursing staff sustained 185 of the injuries (5.7 injuries per hundred person-years), professional staff 17 (rate = 2.3), psychiatric technician trainees 27 (rate = 6.2), and nonclinical staff 7 (rate = 0.4). The annual rate of injury by attack was 50 percent higher among male nursing staff (6.9 injuries per hundred) than among females (4.5). The annual rate of injury by attack was slightly higher among psychiatrists (6.0 per hundred person-years) than among nursing staff. Two three-hour peak periods for injury from patient attack were identified: 8:00 am to 10:59 am and 4:00 pm to 6:59 pm. These six hours accounted for half the injuries. We observed more injuries on Mondays and Tuesdays (42.5 per day), compared with the rest of the week (30.4 per day). No difference in staff injuries was noted between Wednesday-Thursday-Friday and weekend days; 74 percent of staff injuries from attack occurred on the victim's own ward; 70.7 percent of injuries from patient attack were head injuries.

Physician staffing and patient violence.

We found an inverse relation between physical aggression by patients and physician staffing--when more physicians were available, physical aggression decreased. Episodes of nonphysical aggression increased with higher levels of psychiatrist staffing, but were not related to general physician staffing.

Psychiatrists injured by patient attack.

The seven staff psychiatrists injured by patient attack in a large forensic hospital in five years were compared with the 47 who were not injured by attack. Thirteen percent of the psychiatrists were injured by patient attack (2.6 percent per year); 5.5 injuries per 100 person-years occurred. This rate is comparable to the rate of injury from patient attack noted among ward nursing staff during the same period. Younger psychiatrists, and psychiatrists more recently out of residency, were more likely to be injured. Male psychiatrists were injured at a rate approximately 50 percent higher than female psychiatrists, and graduates of university-affiliated residencies were three times as likely to be injured as graduates of public-sector residencies, though these differences did not reach statistical significance. A slightly higher rate of injury was noted among graduates from non-North American medical schools. Board-certification and length of service in the hospital were not related to being injured.

Staff injuries from inpatient violence.

A one-year study of staff injuries from inpatient violence at a large forensic state hospital found that 121 staff members sustained 135 injuries. Nursing staff sustained 120 of the injuries, for a rate of 16 injuries per 100 staff, and professional staff sustained three injuries, for a rate of 1.9 injuries per 100 staff. The majority of injuries to nursing staff (9.9 per 100 staff) were sustained while containing patient violence, and the rest were the result of assault (6.1 per 100 staff). Male nursing staff were nearly twice as likely as female staff to be injured and nearly three times as likely to receive containment-related injuries. The highest rates of injury were noted among ward nursing leadership. Injuries by assault were more likely than containment-related injuries to be head injuries, to cause more than three weeks' absence from work, and to affect more recently hired staff. The usefulness of the methodology in analyzing patterns of staff injury from inpatient violence is discussed.

Overweight and obesity in preschool children in New York City.

In an effort to ascertain the prevalence of obesity in young children, 48 nursery schools in Manhattan and Queens, New York City were surveyed. The weights and heights of 2606 children, ages 3 to 6 yr, were obtained. Three-hundred seventeen children (12.2%) were above 120% of ideal body weight and 122 (4.7%) were above 130% of ideal weight. Twenty percent of the children from schools attended by youngsters from low income families, 12% from schools attended by pupils from middle income families, and 5% from schools with pupils from families with a high income were classified as obese. Of the obese children's actual body weights 90% were at or greater than the 75th percentile for age while mean higher percentiles of the obese and nonobese children were not significantly different. Sex specific prevalence rates were similar for boys and girls. These data indicate that obesity is already prevalent in the nursery school population and that such obese children can be easily identified from weight and height measurements at a time when programs for successful permanent weight reduction and maintenance may be feasible.