A life course approach to health literacy: The role of gender, educational attainment, and lifetime cognitive capability

OBJECTIVE: Social inequalities in health are believed to arise in part because individuals make use of social and economic resources in order to improve survival. In recent years, health literacy has received increased attention as a factor that can help explain differences in health outcomes. However, examination of life course predictors of health literacy has been limited. METHODS: Life course data from the Wisconsin Longitudinal Study 1957-2011 were used to examine predictors of health literacy in old age (N=2,122), using the Newest Vital Sign. Generalized structural equation modeling was used to model pathways to health literacy. RESULTS: Predictors of health literacy included educational attainment, and adolescent cognitive and non-cognitive skills, and, in men, rate of cognitive decline from middle to later life. DISCUSSION: Numerous studies have documented health literacy issues among older adults, and recommendations have been made for ways to improve health literacy for this population. This study reports on risk factors across the life course that are associated with health literacy later in life, identifying possible intervention targets to reduce risk of poor health as people age. Our results suggest that a range of life course factors, beginning in early life, predict health literacy. Further research studying health literacy over the life course is warrante

OH maser mapping of the evolved star HD 179821: evidence for interacting outllows

The evolved star HD 179821 continues to be the subject of much debate as to whether it is a nearby post-asymptotic giant branch (post-AGB) star or a distant high initial mass post-red supergiant. We have mapped the OH maser emission around HD 179821 in the 1612- and 1667-MHz lines with the MERLIN interferometer array at a resolution of 0.4 arcsec and 0.35 km s−1. The OH emission lies in a thick shell with inner and outer radii of 1.3 and and expansion velocity of 30 km s−1. Although we find some evidence for acceleration and for deviations from spherical symmetry, the bulk of the maser emission is consistent with a constant-velocity spherical shell. The extent of the shell agrees with H2O and OH dissociation models and supports a distance estimate of 6 kpc. However, the shell is incomplete and appears to have been disrupted by more recent collimated outflow activity within the last 1500 yr. We suggest that this activity is also responsible for the active envelope chemistry (in particular the presence of HCO+) and for the apparent offset of the star from the centre of the shell. The luminous yellow hypergiant star IRC +10420 also shows signs of recent outflows, and HD 179821 may be at a similar, perhaps slightly earlier, phase of evolution. We suggest that the SiO thermal emission arises from the same detached envelope as the OH maser emission as in IRC +10420. If so then this would strengthen the connection between these two stars and probably rule out a post-AGB status for HD 179821

Darbepoetin alfa given every 1 or 2 weeks alleviates anaemia associated with cancer chemotherapy.

In part A of this study, patients were randomised to cohorts receiving darbepoetin alfa at doses of 0.5 to 8.0 m.c.g x kg(-1) x wk(-1) or to a control group receiving epoetin alfa at an initial dose of 150 U x kg(-1) three times weekly. In part B, the cohorts were darbepoetin alfa 3.0 to 9.0 m.c.g x kg(-1) every 2 weeks or epoetin alfa, initial dose 40 000 U x wk(-1). Safety was assessed by adverse events, changes in blood pressure, and formation of antibodies to darbepoetin alfa. Efficacy was assessed by several haematologic endpoints, including change in haemoglobin from baseline. The adverse event profile of darbepoetin alfa was similar to that of epoetin alfa. No relationship between the rapidity of haemoglobin response and any adverse event was observed. No antibodies to darbepoetin alfa were detected. Higher doses of darbepoetin alfa increased the proportion of patients with a haemoglobin response and decreased the median time to response. The overall dose of darbepoetin alfa required to produce a mean increase in haemoglobin does not increase when the dosing interval is increased from 1 to 2 weeks. Therapy with darbepoetin alfa is safe and effective in producing a dose-related increase in haemoglobin levels in patients with cancer receiving chemotherapy

Co-propagation of maser emission at 1720 and 4765 MHz

MERLIN observations are presented of OH 4765-MHz and OH 1720-MHz masers in the massive star-forming region W3(OH). Two of the three intense spots of maser emission at 4765 MHz are spatially coincident with two similar spots at 1720 MHz in both left-hand circular (LHC) and right-hand circular (RHC) polarizations, to an accuracy of 15 mas. The spots also overlap in velocity when allowance is made for Zeeman splitting of the 1720-MHz line. We conclude that we have found two examples of masers in different rotational levels of OH which are co-propagating through the same column of gas and experiencing competitive gain effects. The third 4765-MHz maser spot was found to have no overlapping counterpart amongst the 1720-MHz masers

Tooth wear: the view of the anthropologist

Anthropologists have for many years considered human tooth wear a normal physiological phenomenon where teeth, although worn, remain functional throughout life. Wear was considered pathological only if pulpal exposure or premature tooth loss occurred. In addition, adaptive changes to the stomatognathic system in response to wear have been reported including continual eruption, the widening of the masticatory cycle, remodelling of the temporomandibular joint and the shortening of the dental arches from tooth migration. Comparative studies of many different species have also documented these physiological processes supporting the idea of perpetual change over time. In particular, differential wear between enamel and dentine was considered a physiological process relating to the evolution of the form and function of teeth. Although evidence of attrition and abrasion has been known to exist among hunter-gatherer populations for many thousands of years, the prevalence of erosion in such early populations seems insignificant. In particular, non-carious cervical lesions to date have not been observed within these populations and therefore should be viewed as ‘modern-day’ pathology. Extrapolating this anthropological perspective to the clinical setting has merits, particularly in the prevention of pre-mature unnecessary treatment

The role of iron in the skin and cutaneous wound healing.

In this review article we discuss current knowledge about iron in the skin and the cutaneous wound healing process. Iron plays a key role in both oxidative stress and photo-induced skin damage. The main causes of oxidative stress in the skin include reactive oxygen species (ROS) generated in the skin by ultraviolet (UVA) 320-400 nm portion of the UVA spectrum and biologically available iron. We also discuss the relationships between iron deficiency, anemia and cutaneous wound healing. Studies looking at this fall into two distinct groups. Early studies investigated the effect of anemia on wound healing using a variety of experimental methodology to establish anemia or iron deficiency and focused on wound-strength rather than effect on macroscopic healing or re-epithelialization. More recent animal studies have investigated novel treatments aimed at correcting the effects of systemic iron deficiency and localized iron overload. Iron overload is associated with local cutaneous iron deposition, which has numerous deleterious effects in chronic venous disease and hereditary hemochromatosis. Iron plays a key role in chronic ulceration and conditions such as rheumatoid arthritis (RA) and Lupus Erythematosus are associated with both anemia of chronic disease and dysregulation of local cutaneous iron hemostasis. Iron is a potential therapeutic target in the skin by application of topical iron chelators and novel pharmacological agents, and in delayed cutaneous wound healing by treatment of iron deficiency or underlying systemic inflammation

Acquisition of growth-inhibitory antibodies against blood-stage Plasmodium falciparum

Background Antibodies that inhibit the growth of blood-stage Plasmodium falciparum may play an important role in acquired and vaccine-induced immunity in humans. However, the acquisition and activity of these antibodies is not well understood. Methods We tested dialysed serum and purified immunoglobulins from Kenyan children and adults for inhibition of P. falciparum blood-stage growth in vitro using different parasite lines. Serum antibodies were measured by ELISA to blood-stage parasite antigens, extracted from P. falciparum schizonts, and to recombinant merozoite surface protein 1 (42 kDa C-terminal fragment, MSP1-42). Results Antibodies to blood-stage antigens present in schizont protein extract and to recombinant MSP1-42 significantly increased with age and were highly correlated. In contrast, growth-inhibitory activity was not strongly associated with age and tended to decline marginally with increasing age and exposure, with young children demonstrating the highest inhibitory activity. Comparison of growth-inhibitory activity among samples collected from the same population at different time points suggested that malaria transmission intensity influenced the level of growth-inhibitory antibodies. Antibodies to recombinant MSP1-42 were not associated with growth inhibition and high immunoglobulin G levels were poorly predictive of inhibitory activity. The level of inhibitory activity against different isolates varied. Conclusions Children can acquire growth-inhibitory antibodies at a young age, but once they are acquired they do not appear to be boosted by on-going exposure. Inhibitory antibodies may play a role in protection from early childhood malaria

Density-Based Unsupervised Classification for Remote Sensing *

Most image classification methods are supervised and use a parametric model of the classes that have to be detected. The models of the different classes are trained by means of a set of training regions that usually have to be marked and classified by a human interpreter. Unsupervised classification methods are data-driven methods that do not use such a set of training samples. Instead, these methods look for (repeated) structures in the data. In this paper we describe a non-parametric unsupervised classification method. The method uses biased sampling to obtain a learning sample with little noise. Next, density estimation based clustering is used to find the structure in the learning data. The method generates a non-parametric model for each of the classes and uses these models to classify the pixels in the image