Knowledge Production on Congenital Chagas Disease across Time, Borders and Disciplines: A Comprehensive Scoping Review.

Congenital transmission is a key route of Trypanosoma cruzi infection in Latin America and globally, contributing significantly to the burden of Chagas disease. The interruption of transmission from mother to child has recently become a focus issue. However, the research landscape on congenital Chagas disease remains largely unexplored. The purpose of this scoping review is to assess the production of knowledge on congenital Chagas disease (CCD), aiming to identify research trends and potential gaps. Our initial hypothesis was that the CCD literature overly represents the medical sciences and that there is a need for socio-cultural research on the subject. We conducted a systematic search of publications focusing on congenital Chagas disease in six languages (English, Spanish, Portuguese, French, German and Italian). This comprehensive literature search identified 876 studies that met the inclusion criteria, out of a total of 8893 sources. The relevant literature was analyzed by language, year of publication, discipline, source type and research location. The main outcome of this study has been to prove our hypothesis that there is a scarcity of knowledge produced within the non-biomedical sciences on CCD. This underscores the need for further exploration into the social and structural issues surrounding this disease. Visually clear data concerning congenital Chagas disease produced by this study can contribute to hone in future research efforts and support funding applications. Additionally, this article provides a reference list that other researchers can consult for their own studies.

Women's views and experiences of occasional alcohol consumption during pregnancy: A systematic review of qualitative studies and their recommendations.

OBJECTIVE: Official guidelines advocate abstinence from alcohol during pregnancy. However, a number of women consume alcohol while pregnant. Understanding women's reasons and the context for drinking during pregnancy outside the context of an alcohol use disorder may be helpful for interventions of healthcare providers and health policymakers. This paper reports a systematic review of qualitative studies focusing on women's perspectives of the issue of alcohol consumption during pregnancy on one hand, and on recommendations on the other. DESIGN: Seven electronic databases and citation lists of published papers were searched for peer-reviewed articles published between 2002 and 2019 in English and French, reporting primary empirical research, using qualitative design and exploring women's views and experiences about the issue of alcohol and pregnancy. Studies involving participant women identified as having an alcohol use disorder while pregnant were excluded. Using the thematic synthesis method, we extracted and coded findings and recommendations from the selected studies. SETTING AND PARTICIPANTS: Women who mostly reported being abstinent or having reduced their alcohol consumption during pregnancy, and non-pregnant women FINDINGS: We included 27 studies from 11 different countries. The quality of studies was assessed using the CASP tool. We developed five analytical themes synthesising women's views and experiences of abstinence and occasional alcohol consumption during pregnancy: lack of reliable information; inadequate information from health professionals; women's perception of public health messages; women's experiences and perception of risk; and social norms and cultural context. Six analytical themes synthesising recommendations were generated: improving health professionals' knowledge and screening practice; diversification of information sources; improving women's information; empowering women's choice; delivering appropriate messages; and addressing socio-structural factors. KEY CONCLUSIONS: Our review provides evidence that information on the issue of alcohol consumption during pregnancy should be improved in both qualitative and quantitative terms. However, the reasons for pregnant women's occasional drinking are complex and influenced by a range of socio-cultural factors. Therefore, healthcare professionals and policymakers should take into account women's experiences and the context of their everyday lives when conveying preventive messages. Our review demonstrates that awareness strategies should not focus solely on women's individual responsibility. They should also address a wider audience and foster a more supportive socio-structural environment. IMPLICATIONS FOR PRACTICE: The understanding of women's perspective is essential to designing sound prevention interventions and credible messages. Our review provides a comprehensive summary of the state of qualitative research on women's experience of the risk of alcohol use during pregnancy, as well as the literature's recommendations about how to address this issue. This review also contributes to identifying overlooked areas of recommendations that require further reflection and research.

Medication Literacy in Hospitalized Older Adults: Concept Development.

BACKGROUND: Medication literacy encompasses the cognitive and social skills necessary for individuals to obtain, comprehend, communicate, calculate, and process medication-related information necessary to make informed decisions. Personal and contextual factors are widely recognized to influence the way that individuals acquire and maintain medication literacy skills. Despite a growing number of studies on medication literacy, current definitions remain general, lacking consideration for the specificities of older adults and hospitalization. OBJECTIVE: The project was conducted to identify, compare, and summarize the attributes, antecedents, and consequences of medication literacy in hospitalized older adults and to propose a refined definition. METHODS: A three-phase hybrid model of concept development was performed that included a literature review and focus groups with hospital nurses. In the final analytic phase, findings from the literature and focus groups were compared, and a refined definition of the concept was elaborated. KEY RESULTS: From the synthesis of 24 publications and the narrative data of 14 hospital nurses, 19 themes were described: 4 related to attributes, 8 to antecedents, and 7 to consequences. Medication literacy of hospitalized older adults has been further defined as the degree to which older adults and/or their natural caregivers can develop and maintain multidimensional skills, namely functional, interactive, and critical medication literacy skills. Adjustment of these skills is characterized by a dynamic and potentially complex process. In practice, optimal medication literacy might be achieved through control of and involvement in the medication regimen and the decisions related to it, and/or by using practical means to facilitate medication self-management (e.g., using lists, notes, reminders). CONCLUSIONS: The proposed refined definition might enhance professionals' common understanding of the concept and its application in practice, policy, and research. Managing a medication regimen is a complex activity that requires a high level of integration and coordination of cognitive and social skills. [HLRP: Health Literacy Research and Practice. 2022;6(2):e70-e83.] Plain Language Summary: Based on the literature on medication literacy and the experiences of nurses working in hospitals, this article defines medication literacy in hospitalized older adults. This definition will help professionals to better understand challenges related to medication literacy in older patients and to propose adequate support (i.e., provide education, simplify medication prescriptions, propose practical aids such as a pillbox).

Chagas Congenital Screening in Switzerland: Processes of Recognition and Knowledge-Sharing.

Disparities in control mechanisms to prevent the spread of Chagas disease in Switzerland raise questions about the process of its recognition as a public health problem, particularly as it concerns migrant populations. With a focus on congenital screening practices, I explore the way in which health care providers experience, problematize and respond to the disease, acting as key agents not only in the provision of care but also in the recognition of Chagas disease as a problem that needs to be addressed. Such an approach contributes to the understanding of processes of public health agenda creation around neglected tropical diseases in non-endemic countries.

Malaria infection in mosquitoes decreases the personal protection offered by permethrin-treated bednets.

BACKGROUND: Insecticides targeting adult mosquitoes are the main way of controlling malaria. They work not only by killing mosquitoes, but also by repelling and irritating them. Indeed their repellent action gives valuable personal protection against biting mosquitoes. In the context of malaria control this personal protection is especially relevant when mosquitoes are infectious, whereas to protect the community we would prefer that the mosquitoes that are not yet infectious are killed (so, not repelled) by the insecticide. As the infectious stage of malaria parasites increases the motivation of mosquitoes to bite, we predicted that it would also change their behavioural response to insecticides. RESULTS: With two systems, a laboratory isolate of the rodent malaria Plasmodium berghei infecting Anopheles gambiae and several isolates of P. falciparum obtained from schoolchildren in Tanzania that infected Anopheles arabiensis, we found that mosquitoes harbouring the infectious stage (the sporozoites) of the parasite were less repelled by permethrin-treated nets than uninfected ones. CONCLUSIONS: Our results suggest that, at least in the laboratory, malaria infection decreases the personal protection offered by insecticide-treated nets at the stage where the personal protection is most valuable. Further studies must investigate whether these results hold true in the field and whether the less effective personal protection can be balanced by increased community protection.