As briefly described above, after data collection, information will be anonymised by assigning a numerical code to each participant. Any original identifiable information will be destroyed once the study has been completed. Results will be disseminated through peer-reviewed scientific journals and conference presentations.
Moreover, grouped data will be made available to GPs. Finally, the results will be discussed with policy-makers of the Tuscany Region. To the best of our knowledge, this is the first study in Italy that comprehensively attempts to assess HL and its related antecedents and outcomes and to validate a variety of different measures.
HL levels will be assessed in a population-based sample via use of a validated measure NVS-IT , which has been applied in different countries and contexts 25—30 32 and has also been used in the HLS-EU. Comparability will be made easier via use of a population-based sample of adults, similar to those included in the HLS-EU. In addition, given that the NVS-IT is already validated in Italian, the analysis will enable the systematic testing of the concurrent validity of the newly validated measures.
In this study, telephone interviews are used to collect NVS-IT data, while in almost all the studies face-to-face interviews are used. To date, no data have been published concerning the comparison of NVS data collected using different methods of administration. Compared with face-to-face interviews, telephone interviews offer several advantages, 45 namely, the elimination of any bias caused by the appearance of the interviewer, lower costs related to the transfers of the interviewer or the person interviewed and lower administrative costs. Moreover, there is some evidence that people are more likely to report health-related events on the phone rather than in face-to-face interviews.
Therefore, the diagnostic accuracy of the newly validated measures will be compared with that identified in other studies. In any case, as noted by Reeve and Basalik, 53 HL tests were primarily designed to detect illiteracy, so they often show a ceiling effect when used in the general population. The ceiling effect can significantly skew distribution, giving rise to concern about attenuated correlation. Any possible ceiling effect or skewed distribution will be considered in the statistical analysis.
Another strength of this study is the direct involvement of the GPs who have signed the information sheet and agreed with the aims of the study. One limitation of this study is that while the sample was randomly selected among people living in Florence, it includes individuals registered as patients with different GPs. Moreover, the GPs were recruited using convenience criteria, which might introduce a selection bias. To curb some of the bias, GPs were chosen according to their geographical location, in the aim of covering different districts in Florence that may present different characteristics of the residents.
This study has a number of important implications. First of all, the results of the study will be useful in assessing the ability of community members to seek, locate and use health services. Moreover, obtaining validated HL measures in Italian will support current research efforts on HL and related outcomes in Italy—both at a population-based level and in the clinical setting. In addition, since the results will be presented and discussed with the Regional policy-makers, including the General Directors of Local and Hospital Health Units, data on HL will also be taken into account when planning community-based health and marketing activities, educational strategies to be used in educational campaigns or campaigns to support the introduction of new services, screening initiatives eg, bowel or skin cancer and vaccination programmes.
At a patient level, an important implication of the study relates to the direct involvement of the GPs. Apart from becoming more familiar with the concept of HL and its assessment tools, GPs will receive individual data for their patients, which will allow them to address findings in their day-to-day practice and potentially improve their care relationships. Contributors: CL, SM and GB: conception and design; drafted the article; gave final approval of the version to be submitted. AnB and SB: drafted the article; gave final approval of the version to be submitted.
Competing interests: None declared. Patient consent: Obtained. Provenance and peer review: Not commissioned; externally peer reviewed. National Center for Biotechnology Information , U. BMJ Open. Published online Nov Author information Article notes Copyright and License information Disclaimer. Correspondence to Dr Chiara Lorini; ti.
All rights reserved. No commercial use is permitted unless otherwise expressly granted. This article has been cited by other articles in PMC.
Sally is a woman who no longer has the will to fight
Associated Data Supplementary Materials Reviewer comments. Abstract Introduction Health literacy HL concerns the knowledge and competences necessary for people to meet complex health demands. Methods and analysis The study adopts a cross-sectional design and is being conducted in Florence, with information collected through telephone interviews. Keywords: health literacy, measures, validation, antecedents, consequences, Italian language. Strengths and limitations of this study. Background Health literacy HL concerns the knowledge and competences of individuals necessary for meeting the complex health demands of modern society.
Methods The study adopts a cross-sectional design and is being conducted in Florence, Italy and its surroundings. Open in a separate window.
Cantare e divertirsi con gli amici.
Figure 1. Sampling procedure.
Table 1 Summary of the content of the two types of questionnaires that will be used in the study. How often do you have problems learning about your medical condition because of difficulty in understanding written information? Always 1 ; often 2 ; sometimes 3 ; occasionally 4 ; never 5 1. Sempre 1 ; spesso 2 ; a volte 3 ; raramente 4 ; mai 5 2.
How often do you have someone help you read hospital materials? Always 1 ; often 2 ; sometimes 3 ; occasionally 4 ; never 5 2. Sempre 1 ; spesso 2 ; a volte 3 ; raramente 4 ; mai 5 3. How confident are you in filling out medical forms by yourself? Extremely 1 ; quite a bit 2 ; somewhat 3 ; a little bit 4 ; not at all 5 3. Quanto si sente sicuro nel compilare da solo moduli medici? Moltissimo 1 ; Molto 2 ; abbastanza 3 ; poco 4 ; per niente 5 Two subjective numeracy items 1.
In general, how easy or hard do you find it to understand medical statistics?
Un italiano in America : Mario Buda, l’uomo che fece saltare Wall Street
Very easy 1 ; easy 2 ; hard 3 ; very hard 4 1. Molto facile 1 ; facile 2 ; difficile 3 ; molto difficile 4 2. How much do you agree or disagree with the following statement? In general, I depend on numbers and statistics to help me make decisions about my health. Strongly agree 1 ; somewhat agree 2 ; somewhat disagree 3 ; strongly disagree 4 2. In generale, mi baso su numeri e statistiche per prendere decisioni sulla mia salute.
Prior to the main analysis, data will be assessed for non-normality. Ethics and dissemination The study has been designed following the principles of the Declaration of Helsinki. Discussion Strengths and limitation To the best of our knowledge, this is the first study in Italy that comprehensively attempts to assess HL and its related antecedents and outcomes and to validate a variety of different measures. Implications This study has a number of important implications.
Supplementary Material Reviewer comments: Click here to view. Author's manuscript: Click here to view. References 1. Health literacy and public health: a systematic review and integration of definitions and models. BMC Public Health ; 12 Nutbeam D. The evolving concept of health literacy. Soc Sci Med ; 67 —8.
The causal pathways linking health literacy to health outcomes. Am J Health Behav ; 31 Suppl 1 — Schulz PJ, Nakamoto K. Health literacy and patient empowerment in health communication: the importance of separating conjoined twins. Patient Educ Couns ; 90 :4— Health literacy interventions and outcomes: an updated systematic review.
Evid Rep Technol Assess ; :1— Comparative report on health literacy in eight EU member states. Health literacy explains racial disparities in diabetes medication adherence. J Health Commun ; 16 Suppl 3 — Does literacy mediate the relationship between education and health outcomes? A study of a low-income population with diabetes. Public Health Rep ; — Health literacy and patient-reported outcomes: a cross-sectional study of underserved English- and Spanish-speaking patients with type 2 diabetes.
J Health Commun ; 20 Suppl 2 :4— Health literacy and online health information processing: unraveling the underlying mechanisms. J Health Commun ; 21 — Racial disparities in patient activation: evaluating the mediating role of health literacy with path analyses. Patient Educ Couns ; 99 —7.
The contribution of health literacy to disparities in self-rated health status and preventive health behaviors in older adults. Ann Fam Med ; 7 — Parents with high levels of communicative and critical health literacy are less likely to vaccinate their children.
Patient Educ Couns ; — Recommendations for advancing health literacy measurement. J Health Commun ; 18 Suppl 1 :9— Health literacy measurement: an inventory and descriptive summary of 51 instruments. J Health Commun ; 19 Suppl 2 — Critical appraisal of health literacy indices revealed variable underlying constructs, narrow content and psychometric weaknesses.
J Clin Epidemiol ; 64 — The evolution of health literacy assessment tools: a systematic review. BMC Public Health ; 14 Brief questions to identify patients with inadequate health literacy. Fam Med ; 36 — Validation of screening questions for limited health literacy in a large VA outpatient population.
J Gen Intern Med ; 23 —6. Different measures, different outcomes? A systematic review of performance-based versus self-reported measures of health literacy and numeracy. J Gen Intern Med ; 30 — The Italian health literacy project: insights from the assessment of health literacy skills in Italy. Health Policy ; — The missing link to patient engagement in Italy. J Health Organ Manag ; 30 — Health literacy in a population-based sample of adult men and women in a South Eastern European Country.
J Public Health ; 38 :6— Quick assessment of literacy in primary care: the newest vital sign. Ann Fam Med ; 3 — Cardiovascular disease risk and secondary prevention of cardiovascular disease among patients with low health literacy. Neth Heart J ; 25 — Health literacy among youth in Guatemala city. Soc Work Public Health ; 32 —7. Health literacy, associated lifestyle and demographic factors in adult population of an English city: a cross-sectional survey.
The characters all seemed pretty shallow and a lot of the content was shocking just to be shocking rather than working to forward the plot. Forse sarebbe stato meglio restare ignoranti su questi bambini. Simona Vinci mi piace molto. Nov 05, Nikita rated it liked it.
What we don't know about children by Simona Vinci. Translated from Italian by Minna Proctor and first published under the name 'A game we play' in , this book portrays exactly what its name suggests. The book is very dark and sometimes you feel you cannot take the violent graphic imagery mostly because the characters in it are kids entering into their adolescence. The novel takes a horrific turn in its last 25 pages.
It makes you feel claustrophobic and uneasy. The books highlights some important issues about the pornographic world. How it not only affects the young minds and feeds into their curiosity and makes them do things that they shouldn't but also how this horrible part of the world is not only restricted to displaying sexual intercourse between 2 consenting adults but also how it covers and normalises rape and pedophiles having their way with children. Makes you wonder who exactly is the audience of such horrific activities directed towards a child.
The reading experience is very difficult because it contains descriptions of kids' bodies and the things they do to each other. Maybe if the author had toned down on the raw and violent imagery of the sexual acts that are depicted not only in the magazines but also what these children themselves resort to the book would be a better read. However I do get the part where this was necessary to bring out the terrible and horrific images shown in the magazines. Do I recommend reading it- No. But if you have a brave appetite for sexual and gross content then maybe you could give it a try.
Storia di un gruppo di bambini che, guidati da un adolescente, scoprono il sesso, quasi senza rendersene conto. Una scrittura semplice, molto lineare ma efficace. So triggering. At least that is how it is for me.
Even the first part made me throw back to that feeling of guilt and shame of when I was young. Worst book for me. I genuinely wish I could unread it. La storia poi ha una deriva che arriva come un pugno nello stomaco. Bello, anche nell'ambientazione resa con dovizia di particolari in modo estremamente evocativo. Ci ho creduto, ma ho pensato di farcela, tranquillamente. Il tema sapevo quale fosse, non mi spaventava. Non troppo almeno.
Sep 13, Ajalverson rated it really liked it. I read this novel in Italian while studying in Italy, and the author actually came to our class to give a lecture. Oct 09, Kasandra rated it it was ok. Disturbing and creepy and not totally plausible. The descriptions of childhood sexual awakening and discovery are realistic and quite good, but the story seems to focus not enough on particulars and plot development and ends rather abruptly.
Could induce nightmares. Might have worked better as a short story and not a novella. L'ho letto anni fa, quindi non potrei sinceramente dare un parere ragionato. Disturbingly provocative but captivating at the same time. Vinci offers an entirely new perspective on the modern conception of the "paessagio" of adolescence in its rawest form. A page-turner that at times has the power to make your skin crawl. Jan 13, E W rated it liked it Shelves: adultfiction. This book is crazy and disturbing. But watch the news enough and I guess anything is believable.
Aug 02, kim McRad rated it liked it Shelves: fiction. Descriptive, decadent, detached, disturbing. Dat's all. Shelves: This book is a beautifully written creepfest. I forget about it every so often and then it pops back in my mind. Childhood exploratory sexuality through a Lord of the Flies lens. Aug 04, Louise rated it it was ok.
I was a little bored. It had potential, but I couldn't "feel" the book so to speak. Maybe it's because I couldn't read it in it's original language. It seemed almost clumsy. Disturbing, but very good. Aug 04, Jade Allen rated it it was ok. The writing is excellent for a first book Dec 31, Kittyki rated it it was amazing. BookScorpion rated it it was ok Sep 14, There are no discussion topics on this book yet.
Readers also enjoyed. About Simona Vinci. Simona Vinci. Vive a Budrio, in provincia di Bologna. Il suo esordio letterario risale al , con il romanzo Dei bambini non si sa niente , edito da Einaudi nella collana Stile libero; il libro, vincitore nel del Premio Elsa Morante opera prima, fa ottenere alla scrittrice un grande successo di pubblico e di critica, suscitando anche scandalo e polemiche per il tema trattato. Books by Simona Vinci. No trivia or quizzes yet.
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