The Development and Evaluation of an e-Learning Course That Promotes Digital Health Literacy in School-age Children: Pre-Post Measurement Study

Background

Experts agree that the promotion of (digital) health literacy should be an integral part of the school curriculum. However, promoting (digital) health literacy within the German school system is difficult because (digital) health education is not a mandatory school subject in all the German states. Therefore, experts suggest that (digital) health literacy could be addressed as part of the mandatory framework for digital education and digital literacy in schools developed by the German Conference on Education Ministries and Cultural Affairs (Kultusministerkonferenz).

Objective

The goal of this study was to evaluate a newly developed e-learning course that was designed to improve (digital) health literacy in school-age children and concurrently to teach skills specified in the mandatory framework for digital education and digital literacy in schools. It was hypothesized that participants’ health literacy and digital health literacy levels would be higher after completing the e-learning course than they were before doing the course. Furthermore, it was hypothesized that after completing the e-learning course, participants’ subjective and objective knowledge in the domain of (digital) health literacy would be higher than it was before doing the course.

Methods

The pre-post measurement study was conducted online. After participants (N=323) gave their informed consent to participate in the study, they provided demographic information and answered all measures (premeasurement). Following this, participants had 7 days to complete the e-learning course. After finishing the e-learning course, participants answered all the measures again (postmeasurement).

Results

To test the hypotheses, Bayesian paired samples t tests (1-sided) were conducted. After completing the e-learning course, participants showed higher health literacy levels. Specifically, they showed higher competency levels in the domains of theoretical knowledge (Bayes factor [BF]_–0=676,000; δ=–0.316), practical knowledge (BF_–0=92,300; δ=–0.294), critical thinking (BF_–0=7.42e+13; δ=–0.482), self-awareness (BF_–0=11,500,000; δ=–0.345), and citizenship (BF_–0=266,000; δ=–0.306). Furthermore, participants achieved higher digital health literacy levels. Specifically, they achieved higher competency levels in the domains of information searching (BF_–0=2.339; δ=–0.135), evaluating reliability (BF_–0=2.03e+11; δ=–0.434), and determining relevance (BF_–0=316,000; δ=–0.308). Moreover, participants demonstrated higher subjective (BF_–0=3.58e+82; δ=–1.515) and objective knowledge (BF_–0=3.82e+97; δ=–1.758) in the domain of (digital) health literacy.

Conclusions

The newly designed e-learning course provides an easy way for schools and teachers from all German states to integrate (digital) health literacy education into their school curriculums and lessons. The evaluated course is especially attractive because it was designed to improve (digital) health literacy and at the same time to teach skills specified in the mandatory framework for digital education and digital literacy in schools developed by the German Conference on Education Ministries and Cultural Affairs (Kultusministerkonferenz).

Early suppression of peripheral mononuclear blood cells in sepsis in response to stimulation with cytomegalovirus, OKT3, and pokeweed mitogen

Critically ill patients are at risk for sepsis, and immunosuppressive mechanisms may prevail. Whether functional tests are helpful to detect immune alterations is largely unknown. Therefore, we tested the hypotheses that reactivity of peripheral blood mononuclear cells (PBMCs) to secrete interferon-γ (IFNγ) following stimulation in vitro is decreased in patients with early sepsis compared with postoperative patients. IFNγ secretion [enzyme-linked immunospot (ELISpot)] in response to stimulation with cytomegalovirus (CMV), pokeweed mitogen (PWM), muromonab-anti-CD3 (OKT3), and human leukocyte antigen (HLA)-DRA-mRNA expression and serum cytokine concentrations were repeatedly [days 1, 3, 5, and 7 after intensive care unit (ICU) admission] determined in patients with sepsis (n = 7) and patients undergoing major abdominal surgery (radical prostatectomy, cystectomy, n = 10). In a second cohort, HLA-DRA expression was assessed in 80 patients with sepsis, 30 postoperative patients, and 44 healthy volunteers (German clinical trials database no. 00007694). In patients with sepsis, IFNγ secretion (ELISpot) was decreased compared with controls after stimulation with CMV (P = 0.01), OKT3 (P = 0.02), and PWM (P = 0.02 on day 5), whereas unstimulated IFNγ secretion did not differ. HLA-DRA expression was also significantly decreased in patients with sepsis at all time points (P = 0.004) compared with postoperative surgical patients, a finding confirmed in the larger cohort. Reactivity of PBMCs to stimulation with CMV, PWM, and OKT3 as well as HLA-DRA expression was already decreased upon ICU admission in patients with sepsis when compared with postoperative controls, suggesting early depression of acquired immunity. ELISpot assays may help to clinically characterize the time course of immunocompetence in patients with sepsis.NEW & NOTEWORTHY We observed suppression of reactivity to stimulation with cytomegalovirus, muromonab-anti-CD3, and pokeweed mitogen in mononuclear blood cells of patients with early sepsis when compared with postoperative controls. Thus, there is early depression of acquired immunity in sepsis. Enzyme-linked immunospot assays may help to characterize immunocompetence in patients with sepsis.

POSEIDON - Bringing Assistive Technology to People with Down Syndrome: Results of a Three Year European Project

The POSEIDON project aimed to increase the independence and autonomy of people with Down syndrome with the help of technical assistants. It followed a user-centered approach by involving people with Down syndrome and their parents, carers etc. A requirement analysis was the first step of the project. It became clear that people with Down syndrome especially need support in the areas of time management, mobility and money handling. Different applications were developed which were tested and evaluated in two field tests in three countries. Results indicate that POSEIDON can help to overcome daily challenges and that it can increase the autonomy and independence of people with Down syndrome.

Weakened [corrected] taste-LPS association during endotoxin tolerance

In naive individuals, the administration of bacterial lipopolysaccharide (LPS) provokes a rapid systemic increase in pro-inflammatory cytokines such as tumor necrosis factor (TNF)-alpha, interleukin (IL)-1beta and IL-6, inducing an acute phase response including sickness behavior. Strong associative learning occurs when relevant gustatory/olfactory stimuli precede the activation of the immune system, affecting long-term individual food selection and nutritional strategies. Repeated LPS administration results in the development of an endotoxin tolerance status, characterized by a drastic reduction in the LPS-induced cytokine response. Here we investigated how the postprandial categorization of a relevant taste (0.2% saccharin) changed after administration of a high dose of LPS (0.5 mg/kg i.p.) in LPS-tolerant animals. Determination of the consummatory fluid intake revealed that, in contrast to LPS-naive rats, taste-LPS association did not occur during endotoxin tolerance. Ninety minutes after the single association trial, the plasma responses of TNF-alpha, IL-1beta and IL-6 were completely blunted in LPS-tolerant animals, which also resulted in low LPS-adipsogenic and LPS-anorexic effects. These findings indicate that an identical immune challenge can result in completely different neuro-behavioral consequences depending on the immune history of the individual, thus revealing part of the complex interconnection between the immune and neuro-endocrine systems in regulating food selection and consumption during the infectious process.

Solution structure of human immunodeficiency virus type 1 Vpr(13-33) peptide in micelles

Human immunodeficiency virus type 1 protein R (HIV-1 Vpr) promotes nuclear entry of viral nucleic acids in nondividing cells, causes G2 cell cycle arrest and is involved in cellular differentiation and cell death. Also, Vpr subcellular localization is as variable as its functions. It is known that, consistent with its role in nuclear transport, Vpr localizes to the nuclear envelope of human cells. Further, a reported ion channel activity of Vpr obviously is dependent on its localization in or at membranes. We focused our structural studies on the secondary structure of a peptide consisting of residues 13-33 of HIV-1 Vpr in micelles. Employing nuclear magnetic resonance and circular dichroism spectroscopy we found this part of Vpr, known to be essential for nuclear localization, to be almost completely alpha helical. Our results provide structural data suggesting residues 13-33 of Vpr to form an amphipathic, leucine-zipper-like alpha helix that serves as a basis for interactions with a variety of viral and cellular factors.