1,677 research outputs found
The association between patient activation and accessing online health information: results from a national survey of US adults
ABCs or 123s? The independent contributions of literacy and numeracy skills on health task performance among older adults
AbstractObjectiveTo investigate the relationship between literacy and numeracy and their association with health task performance.MethodsOlder adults (n=304) completed commonly used measures of literacy and numeracy. Single factor literacy and numeracy scores were calculated and used to predict performance on an established set of health self-management tasks, including: (i) responding to spoken information; (ii) comprehension of print and (iii) multimedia information; and (iv) organizing and dosing medication. Total and sub-scale scores were calculated.ResultsLiteracy and numeracy measures were highly correlated (rs=0.68; ps<0.001). In multivariable models adjusted for age, gender, race, education, and comorbidity, lower literacy (β=0.44, p<0.001) and numeracy (β=0.44, p<0.001) were independently associated with worse overall task performance and all sub-scales (literacy range, β=0.23–0.45, ps<0.001; numeracy range, β=0.31–0.41, ps<0.001). Multivariable analyses with both constructs entered explained more variance in overall health task performance compared with separate literacy and numeracy models (8.2% and 10% respectively, ps<0.001).ConclusionLiteracy and numeracy were highly correlated, but independent predictors of health task performance. These skill sets are complementary and both are important for health self-management.Practice implicationsSelf-management interventions may be more effective if they consider both literacy and numeracy skills rather than focusing on one specific ability
Older Adult Preferences of Mobile Application Functionality Supporting Medication Self-Management
Health systems and insurers alike are increasingly interested in leveraging mHealth (mobile health) tools to support patient health-related behaviors
including medication adherence. However, these tools are not widely used by older patients. This study explores patient preferences for
functionality in a smartphone application (app) that supports medication self-management among older adults with multiple chronic conditions.
We conducted six discussion groups in Chicago, Miami, and Denver (N = 46). English-speaking older adults (55 and older) who owned
smartphones and took five or more prescription medicines were invited to participate. Discussions covered familiarity with and use of current
apps and challenges with taking multidrug regimens. Participants reviewed a range of possible mobile app functions and were asked to give
feedback regarding the acceptability and desirability of each to support medication management. Very few participants (n = 3) reported current use
of a mobile app for medication support, although all were receptive. Challenges to medication use were forgetfulness, fear of adverse events, and
managing medication information from multiple sources. Desired features included (1) a list and consolidated schedule of medications, (2)
identification and warning of unsafemedication interactions, (3) reminder alerts to take medicine, and (4) the ability record when medications were
taken. Features relating to refill ordering, pharmacy information, and comparing costs for medication were not considered to be as important for an
app
The associations between objective numeracy and colorectal cancer screening knowledge, attitudes and defensive processing in a deprived community sample.
We examined associations between numeracy and sociocognitive factors associated with colorectal cancer screening uptake (n = 964). Nearly half (45.7%) of the respondents incorrectly answered a numeracy question (low numeracy). Low numeracy respondents were less knowledgeable about colorectal cancer (p < .001), less positive towards screening (emotional, p < .001 and practical, p = .001) and less likely to intend to participate in screening (p = .001). They also reported greater defensive processing of cancer information (p = .001). Sociocognitive factors fully mediated the relationship between numeracy and screening intention. Addressing numeracy issues may reduce inequalities in CRC screening participation, but communication strategies could be limited by the tendency process cancer information defensively
The development and testing of a brief ('gist-based') supplementary colorectal cancer screening information leaflet.
To design and user-test a 'gist-based' colorectal cancer screening information leaflet, which promotes comprehension of the screening offer
How do people interpret information about colorectal cancer screening: observations from a think-aloud study
The English NHS Bowel Cancer Screening Programme biennially invites individuals aged 60-74 to participate in screening. The booklet, 'Bowel Cancer Screening: The Facts' accompanies this invitation. Its primary aim is to inform potential participants about the aims, advantages and disadvantages of colorectal cancer screening
Household-level predictors of the presence of servants in Northern Orkney, Scotland, 1851–1901
Servants were an important part of the northwestern European household economy in the preindustrial past. This study examines household-level characteristics that are predictive of the presence of rural servants using data from Orkney, Scotland. The number of servants present in a household is related to household composition, landholding size, and the marital status of the household head. In addition, the sex of the particular servant hired reveals that the labor of male and female servants is not fungible. The sex of the servant hired is related to the ratio of male and female household members of working age, the occupation of the head, household composition, and the size of the household\u27s landholding
The Pioneer Anomaly
Radio-metric Doppler tracking data received from the Pioneer 10 and 11
spacecraft from heliocentric distances of 20-70 AU has consistently indicated
the presence of a small, anomalous, blue-shifted frequency drift uniformly
changing with a rate of ~6 x 10^{-9} Hz/s. Ultimately, the drift was
interpreted as a constant sunward deceleration of each particular spacecraft at
the level of a_P = (8.74 +/- 1.33) x 10^{-10} m/s^2. This apparent violation of
the Newton's gravitational inverse-square law has become known as the Pioneer
anomaly; the nature of this anomaly remains unexplained. In this review, we
summarize the current knowledge of the physical properties of the anomaly and
the conditions that led to its detection and characterization. We review
various mechanisms proposed to explain the anomaly and discuss the current
state of efforts to determine its nature. A comprehensive new investigation of
the anomalous behavior of the two Pioneers has begun recently. The new efforts
rely on the much-extended set of radio-metric Doppler data for both spacecraft
in conjunction with the newly available complete record of their telemetry
files and a large archive of original project documentation. As the new study
is yet to report its findings, this review provides the necessary background
for the new results to appear in the near future. In particular, we provide a
significant amount of information on the design, operations and behavior of the
two Pioneers during their entire missions, including descriptions of various
data formats and techniques used for their navigation and radio-science data
analysis. As most of this information was recovered relatively recently, it was
not used in the previous studies of the Pioneer anomaly, but it is critical for
the new investigation.Comment: 165 pages, 40 figures, 16 tables; accepted for publication in Living
Reviews in Relativit
Atomic transition frequencies, isotope shifts, and sensitivity to variation of the fine structure constant for studies of quasar absorption spectra
Theories unifying gravity with other interactions suggest spatial and
temporal variation of fundamental "constants" in the Universe. A change in the
fine structure constant, alpha, could be detected via shifts in the frequencies
of atomic transitions in quasar absorption systems. Recent studies using 140
absorption systems from the Keck telescope and 153 from the Very Large
Telescope, suggest that alpha varies spatially. That is, in one direction on
the sky alpha seems to have been smaller at the time of absorption, while in
the opposite direction it seems to have been larger.
To continue this study we need accurate laboratory measurements of atomic
transition frequencies. The aim of this paper is to provide a compilation of
transitions of importance to the search for alpha variation. They are E1
transitions to the ground state in several different atoms and ions, with
wavelengths ranging from around 900 - 6000 A, and require an accuracy of better
than 10^{-4} A. We discuss isotope shift measurements that are needed in order
to resolve systematic effects in the study. The coefficients of sensitivity to
alpha-variation (q) are also presented.Comment: Includes updated version of the "alpha line" lis
Health-care costs of losartan and candesartan in the primary treatment of hypertension
A recent study of two widely used angiotensin receptor blockers reported a reduced risk of cardiovascular events (−14.4%) when using candesartan compared with losartan in the primary treatment of hypertension. In addition to clinical benefits, costs associated with treatment strategies must be considered when allocating scarce health-care resources. The aim of this study was to assess resource use and costs of losartan and candesartan in hypertensive patients. Resource use (drugs, outpatient contacts, hospitalizations and laboratory tests) associated with losartan and candesartan treatment was estimated in 14 100 patients in a real-life clinical setting. We electronically extracted patient data from primary care records and mandatory Swedish national registers for death and hospitalization. Patients treated with losartan had more outpatient contacts (+15.6%), laboratory tests (+13.8%) and hospitalizations (+13.8%) compared with the candesartan group. During a maximum observation time of 9 years, the mean total costs per patient were 10 369 Swedish kronor (95% confidence interval: 3109–17 629) higher in the losartan group. In conclusion, prescribing candesartan for the primary treatment of hypertension results in lower long-term health-care costs compared with losartan
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