Change in health literacy over a decade in a prospective cohort of community-dwelling older adults

BACKGROUND: Health literacy is often viewed as a static trait in longitudinal studies, which may over or underestimate an individual’s ability to manage one’s health. OBJECTIVES: We sought to examine health literacy over time among older adults using three widely used measures. DESIGN: A prospective cohort study. PARTICIPANTS: Community-dwelling adults ages 55 to 74 at baseline with at least one follow-up visit (N = 656) recruited from one academic internal medicine clinic and six community health centers in Chicago, IL. MEASURES: Health literacy was measured using the Test of Functional Health Literacy in Adults (TOFHLA), Newest Vital Sign (NVS), and Rapid Estimate of Adult Literacy in Medicine (REALM) at baseline and up to three follow-up time points. RESULTS: In unadjusted analyses, significant changes since baseline were found beginning at the second follow-up (mean (M) = 6.0 years, SD = 0.6) for the TOFHLA (M = − 0.9, SD = 0.95, p = 0.049) and the REALM (M = 0.3, SD = 2.5, p = 0.004) and at the last follow-up (M = 8.6 years, SD = 0.5) for the NVS (M = − 0.2, SD = 1.4, p = 0.02). There were non-linear effects of baseline age on TOFHLA and NVS scores over time (piecewise cubic spline p = 0.01 and p < 0.001, respectively) and no effect on REALM scores (B = 0.02, 95% CI − 0.01 to 0.04, p = 0.17) using multivariable mixed-effects linear regression models, controlling for race, education, income, and comorbidity. CONCLUSION: We found a negative relationship between age and health literacy over time as measured by the TOFHLA and NVS. Health literacy barriers appear to be more prevalent among individuals in later life, when self-care demands are similarly increasing. Clinicians might consider strategies to assess and respond to limited health literacy, particularly among patients 70 and older. REALM performance remained stable over 10 years of follow-up. This questions whether health literacy tools measure the same attribute. Prospective health literacy studies should carefully consider what measures to use, depending on their objective

Disentangling the influence of urbanization and invasion on endemic geckos in tropical biodiversity hot spots : a case study of Phyllodactylus martini (Squamata: Phyllodactylidae) along an Urban Gradient in Curaçao

Author Posting. © Peabody Museum of Natural History, 2016. This article is posted here by permission of Peabody Museum of Natural History for personal use, not for redistribution. The definitive version was published in Bulletin of the Peabody Museum of Natural History 57(2016): 147–164, doi:10.3374/014.057.0209.Predicting the response of endemic species to urbanization has emerged as a fundamental challenge in 21st century conservation biology. The factors that underlie population declines of reptiles are particularly nebulous, as these are often the least understood class of vertebrates in a given community. In this study, we assess correlations between feeding ecology and phenotypic traits of the Lesser Antillean endemic Dutch leaf-toed gecko, Phyllodactylus martini, along an urban gradient in the Caribbean island of Curaçao. There has been a marked decline of this species in developed habitats associated with the invasive tropical house gecko Hemidactylus mabouia. We find a correlation between aspects of locomotor morphology and prey in undeveloped habitats that is absent in developed habitats. Analyses of stomach contents further suggest that Phyllodactylus martini alters primary prey items in developed areas. However, changes in prey promote the overlap in foraging niches between Phyllodactylus martini and Hemidactylus mabouia, suggesting that direct resource competition is contributing to the decline of Phyllodactylus martini. In addition to competitive exclusion, we suggest that the urban extirpation of Phyllodactylus martini could also be attributed to a top-down control on population growth by Hemidactylus mabouia. Colonizations of walls put Phyllodactylus martini in direct contact with Hemidactylus mabouia increasing the chances for predation events, as evidenced by our observation of a predation event on a Phyllodactylus martini juvenile by an adult Hemidactylus mabuoia. In total, our results add to a growing body of literature demonstrating the threat that invasive synanthropic reptiles pose to endemics that might otherwise be able to cope with increased urbanization pressures

Magic numbers in exotic nuclei and spin-isospin properties of {\it NN} interaction

The magic numbers in exotic nuclei are discussed, and their novel origin is shown to be the spin-isospin dependent part of the nucleon-nucleon interaction in nuclei. The importance and robustness of this mechanism is shown in terms of meson exchange, G-matrix and QCD theories. In neutron-rich exotic nuclei, magic numbers such as N = 8, 20, etc. can disappear, while N = 6, 16, etc. arise, affecting the structure of lightest exotic nuclei to nucleosynthesis of heavy elements.Comment: 4 pages, 3 figures, revte

Allergen Sensitization and Asthma Outcomes among World Trade Center Rescue and Recovery Workers

A large number of World Trade Center (WTC) rescue and recovery workers are affected by asthma. While physical and mental health comorbidities have been associated with poor asthma control in this population, the potential role of allergen sensitization is unknown. This study examined the association of indoor sensitization and exposure as a risk factor for increased asthma morbidity in WTC workers. We used data from a prospective cohort of 331 WTC workers with asthma. Sensitization to indoor allergens was assessed by measurement of antigen-specific serum immunoglobulin E (IgE) levels. We used validated tools to evaluate the exposure to indoor allergens. Asthma morbidity outcomes included level of control (Asthma Control Questionnaire, ACQ), quality of life (Asthma Quality of Life Questionnaire, AQLQ) and acute resource utilization. The prevalence of sensitization to cat, dog, mouse, dust mite, cockroach, and mold allergens were 33%, 21%, 17%, 40%, 17%, and 17%, respectively. Unadjusted and regression analyses showed no significant relationship between sensitization and increased asthma morbidity (p \u3e 0.05 for all comparisons), except for sensitization to Aspergillus Fumigatus, cat and mouse epithelium, which were associated with decreased morbidity