Exploring discordance between Health Literacy Questionnaire scores of people with RMDs and assessment by treating health professionals

OBJECTIVES: We studied discordance between health literacy of people with rheumatic and musculoskeletal diseases (RMDs) and assessment of health literacy by their treating health professionals, and explored whether discordance is associated with the patients' socioeconomic background. METHODS: Patients with rheumatoid arthritis (RA), spondyloarthritis (SpA), or gout from three Dutch outpatient rheumatology clinics completed the nine-domain Health Literacy Questionnaire (HLQ). Treating health professionals assessed their patients on each HLQ domain. Discordance per domain was defined as a ≥ 2-point difference on a 0-10 scale (except if both scores were below three or above seven), leading to three categories: "negative discordance" (i.e. professional scored lower), "probably the same", or "positive discordance" (i.e. professional scored higher). We used multivariable multilevel multinomial regression models with patients clustered by health professionals to test associations with socioeconomic factors (age, gender, education level, migration background, employment, disability for work, living alone). RESULTS: We observed considerable discordance (21-40% of patients) across HLQ domains. Most discordance occurred for "Critically appraising information" (40.5%, domain 5). Comparatively, positive discordance occurred more frequently. Negative discordance was more frequently and strongly associated with socioeconomic factors, specifically lower education level and non-Western migration background (for five HLQ domains). Associations between socioeconomic factors and positive discordance were less consistent. CONCLUSION: Frequent discordance between patients' scores and professionals' estimations indicates there may be hidden challenges in communication and care, which differ between socioeconomic groups. Successfully addressing patients' health literacy needs cannot solely depend on health professionals' estimations but will require measurement and dialogue

UvA-DARE (Digital Academic Repository) Synthesis, structure and spectroscopic properties of novel metal-metal bonded manganese-ruthenium complexes with t -diimine ligands. X-ray structure of [(CO)sMn-Ru(Me)(CO)a(a(N),a(N')-iPr-PyCa)] (iPr-PyCa -pyridine-2

Synthesis, structure and spectroscopic properties of novel metal-metal bonded manganeseruthenium complexes with alpha-diimine ligands. X-ray structure of [(CO)5Mn-Ru(Me)(CO)2(sigma(N')-iPr-PyCa)](iPr-PyCa = pyridine-2-carbaldehyde-N-isopropylimine) Oskam, A., & Goubitz, K. (1995). Synthesis, structure and spectroscopic properties of novel metal-metal bonded manganese-ruthenium complexes with alpha-diimine ligands. X-ray structure of [(CO)5Mn-Ru(Me)(CO)2(sigma(N')-iPr-PyCa)](iPr-PyCa = pyridine-2-carbaldehyde-N-isopropylimine). Inorganica Chimica Acta, 232, 19-25. https://doi.org/10.1016/0020-1693(94)04360-8 General rights It is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), other than for strictly personal, individual use, unless the work is under an open content license (like Creative Commons). Disclaimer/Complaints regulations If you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the material inaccessible and/or remove it from the website. Please Ask the Library: https://uba.uva.nl/en/contact, or a letter to: Library of the University of Amsterdam, Secretariat, Singel 425, 1012 WP Amsterdam, The Netherlands. You will be contacted as soon as possible. Synthesis, structure and spectroscopic properties of novel metal-metal bonded manganese-ruthenium complexes with t -diimine ligands. X-ray structure of [(CO)sMn-Ru(Me) Abstract The synthesis and spectroscopy of the complexes [(CO)sMn-Ru(Me)(CO)2(a-diimine)] (a-diimine=N,N'-diisopropyl-l,4-diaza-l,3-butadiene (iPr-DAB), pyridine-2-carbaldehyde-N-isopropylimine (iPr-PyCa)) are reported. The metal fragments are bonded to each other by an uncommon manganese-ruthenium bond. The single crystal X-ray structure has been determined. The purple crystals of [(CO)sMn-Ru(Me)(CO)2(iPr-PyCa)] are monoclinic, space group P21/n, Z=4, with unit cell dimensions a = 9.6297(7), b = 20.923(1), c = 10.166(1) ~ and fl = 92.190(8) °. The structure refinement converged to R = 0.035 for 3277 observed reflections. Both complexes show a strong, solvatochromic absorption band in the visible region, which is assigned to Ru (d,~)~a-diimine (~-*) transitions. In agreement with this assignment, the Raman spectra show resonance enhancement of Raman intensity for vs(CO) and vs(CN) of the Ru(Me)(CO)2(a-diimine) fragment

Data from: Positive shrub-tree interactions facilitate woody encroachment in boreal peatlands

Boreal ecosystems are warming roughly twice as fast as the global average, resulting in woody expansion that could further speed up the climate warming. Boreal peatbogs are waterlogged systems that store more than 30% of the global soil carbon. Facilitative effects of shrubs and trees on the establishment of new individuals could increase tree cover with profound consequences for the structure and functioning of boreal peatbogs, carbon sequestration and climate. We conducted two field experiments in boreal peatbogs to assess the mechanisms that explain tree seedling recruitment and to estimate the strength of positive feedbacks between shrubs and trees. We planted seeds and seedlings of Pinus sylvestris in microsites with contrasting water-tables and woody cover and manipulated both shrub canopy and root competition. We monitored seedling emergence, growth and survival for up to four growing seasons and assessed how seedling responses related to abiotic and biotic conditions. We found that tree recruitment is more successful in drier topographical microsites with deeper water-tables. On these hummocks, shrubs have both positive and negative effects on tree seedling establishment. Shrub cover improved tree seedling condition, growth and survival during the warmest growing season. In turn, higher tree basal area correlates positively with soil nutrient availability, shrub biomass and abundance of tree juveniles. Synthesis. Our results suggest that shrubs facilitate tree colonization of peatbogs which further increases shrub growth. These facilitative effects seem to be stronger under warmer conditions suggesting that a higher frequency of warmer and dry summers may lead to stronger positive interactions between shrubs and trees that could eventually facilitate a shift from moss to tree-dominated systems

Table S3_cox regression (survival analysis)_Exp 1

Table S3: Data for Cox survival analysis for experimental pine seedlings in hummocks (circular and bands) versus adjacent lawns during 2010-2013. ST: Seedlings from seeds inserted on top of moss; SB: Seedlings from seeds inserted below moss; Small seedling (1 month old, 10 cm tall at plantation time); Large seedling (2 months old, 30 cm tall at plantation time)

Table S4_ regression seedling-environment 2011_Exp 1

Table S4: Data for generalized linear models assessing the responses of experimental pine seedlings in hummocks (circular and bands) and adjacent lawns for Experiment 1 in 2011. Small seedling (1 month old, 10 cm tall at plantation time); Large seedling (2 months old, 30 cm tall at plantation time). Condition = % healthy seedlings. Growth = stem growth

Table 3_regression seedling-environment_Exp 1

Table 3 data for generalized linear models assessing the responses of experimental pine seedlings in hummocks (circular and bands) and adjacent lawns for Experiment 1 during the whole experimental period (2010-2013). ST: Seedlings from seeds inserted on top of moss; SB: Seedlings from seeds inserted below moss; Small seedling (1 month old at plantation time); Large seedling (2 months old at plantation time). Condition = % healthy seedlings. Growth = stem growth

Figure 1data_Exp 2

Figure 1 data: Condition of experimental seedlings in hummocks with contrasting shrub density and tree canopy in Experiment 2: No Trees - Low Shrub biomass (NTLS), No Trees - High Shrub biomass (NTHS), Present Trees - Low Shrub biomass (PTLS) and Present Trees - High shrub biomass (PTHS) during the warmest growing season (2011) and at the end of the experiment (2013). Seedling condition was defined as: healthy (< 50% of the needles turned yellow or brown) or unhealthy (> 50% of the needles turned yellow or brown). Seedlings were 1 month old at plantation time in the July 2010

Table 1_environmental conditions_Exp 1

Table 1 data: Environmental conditions and vegetation characteristics in hummocks (circular and bands) and lawns for Experiment 1. Water table depth below surface is an average for the four growing seasons (2010-2013