Assessment of health literacy as a part of a university medication therapy management program for patients with chronic conditions

The role of pharmacists in the U.S. continues to evolve. Pharmacists are now being trained to be drug information specialists and medication counselors. More than ever, pharmacists are helping patients with chronic conditions manage their diseases through the use of medication therapy management programs. As a part of these programs, it is important that pharmacists are aware of what affect their patients\u27 health literacy level may have on health outcomes. The purpose of this study was to examine the extent to which health literacy was associated with different demographic factors and the extent to which health literacy was associated with clinical outcomes for patients with asthma, diabetes mellitus, cardiovascular disease/hypertension, and depression/anxiety in a well-defined, self-insured university population. To answer the research question, data from the pharmacist-led program Medication Therapy Management and Health Literacy Assessment through Health Horizons: Manage My Medications was analyzed. Data were collected on demographic, psychosocial, and physical functioning using standard assessment instruments and patient interviews. Additionally, certain clinical tests were performed to assess and gain an understanding of the control of patients\u27 disease state(s). Data was collected at two points - upon entering the program and at six months. This study only examined baseline data. For this study, patients were categorized by having either limited health literacy or adequate health literacy. Of the 90 participants enrolled, 11.11% had limited health literacy; 88.89% demonstrated adequate health literacy. The results revealed that at the p,\u3c0.05 level, men were significantly more likely to have limited health literacy than women (p=0.049). Age was also found to be associated with limited health literacy. When divided in groups \u3c50 years of age and \u3e 50, there was a significant association between limited health literacy and age (p=0.02). When considering years of formal education, patients with lower levels of educational had greater likelihood of having limited health literacy. Among different educational levels, there was a significant association between limited health literacy and education (p=0.024). When considered individually , limited health literacy was not found to be associated with any clinical outcomes of asthma, diabetes, mellitus, cardiovascular disease/hypertension, and depression/anxiety; higher body mass index (BMI), higher blood pressure, higher fasting blood glucose levels, and dyslipidemia; lower medication adherence; the need for patient education; and sub-optimal medication regimens

Dogs’ expectation about the signalers’ body size by virtue of their growls

Several studies suggest that dogs, as well as primates, utilize a mental representation of the signaler after hearing its vocalization and can match this representation with other features provided by the visual modality. Recently it was found that a dogs' growl is context specific and contains information about the caller's body size. Whether dogs can use the encoded information is as yet unclear. In this experiment, we tested whether dogs can assess the size of another dog if they hear an agonistic growl paired with simultaneous video projection of two dog pictures. One of them matched the size of the growling dog, while the other one was either 30% larger or smaller. In control groups, noise, cat pictures or projections of geometric shapes (triangles) were used. The results showed that dogs look sooner and longer at the dog picture matching the size of the caller. No such preference was found with any of the control stimuli, suggesting that dogs have a mental representation of the caller when hearing its vocalization

Endocrine changes related to dog domestication: Comparing urinary cortisol and oxytocin in hand-raised, pack-living dogs and wolves

Dogs are exceptionally well adapted to life close to humans, and alterations in their endocrine system during the domestication process may be an underlying mechanism. In particular, it has been suggested that low circulating cortisol concentrations in conjunction with simultaneously high oxytocin concentrations may have resulted in dogs' increased docility (‘selection for tameness’ hypothesis) and heightened propensity to interact and form relationships with humans (‘hypersociability’ hypothesis) compared to wolves. To investigate this, we analyzed cortisol and oxytocin metabolite concentrations from urine samples of hand-raised, pack-living domestic dogs and their non-domestic relatives, grey wolves. Based on the hypotheses outlined above, we predicted lower cortisol but higher oxytocin concentrations in dogs than wolves. In contrast to our prediction, we found higher cortisol concentrations in dogs than wolves. However, oxytocin concentrations were higher in dogs compared to wolves although the effect was relatively small. Indeed, male dogs had the highest oxytocin concentrations while female dogs' oxytocin concentrations were comparable to wolves'. Feeding status, reproductive phase, and conspecific social interactions also significantly affected cortisol and oxytocin concentrations. Furthermore, we compared two methods of correcting for variable water content of urine samples. We discuss our results in light of physiological and behavioral changes during domestication and highlight the importance of accounting for confounding variables in future studies

Life experience rather than domestication accounts for dogs’ increased oxytocin release during social contact with humans

Dogs’ increased human-directed sociability compared to wolves may be the result of increased oxytocin system activity and decreased stress responses, but comparative studies accounting for life experience are lacking. We compared hand-raised, pack-living wolves’ and dogs’ behavior and hormone concentrations after interacting with a closely bonded and a familiar human. Both preferred the bonded partner, but dogs showed less variability in human-directed sociability than wolves. Physical contact was not associated with oxytocin but correlated positively with glucocorticoids in the pack-living animals when the human was not bonded. To clarify the role of life experience, we tested pet dogs and found that oxytocin concentrations correlated positively with physical contact with their owners, while glucocorticoids remained unaffected. Results show that, given similar experiences, wolf-dog differences in human-directed sociability and associated hormones are subtle and indicate that factors related to life as a pet dog rather than domestication account for oxytocin release during human–dog interactions

Information processing at the foxa node of the sea urchin endomesoderm specification network

The foxa regulatory gene is of central importance for endoderm specification across Bilateria, and this gene lies at an essential node of the well-characterized sea urchin endomesoderm gene regulatory network (GRN). Here we experimentally dissect the cis-regulatory system that controls the complex pattern of foxa expression in these embryos. Four separate cis-regulatory modules (CRMs) cooperate to control foxa expression in different spatial domains of the endomesoderm, and at different times. A detailed mutational analysis revealed the inputs to each of these cis-regulatory modules. The complex and dynamic expression of foxa is regulated by a combination of repressors, a permissive switch, and multiple activators. A mathematical kinetic model was applied to study the dynamic response of foxa cis-regulatory modules to transient inputs. This study shed light on the mesoderm–endoderm fate decision and provides a functional explanation, in terms of the genomic regulatory code, for the spatial and temporal expression of a key developmental control gene

Why do dogs (Canis familiaris) select the empty container in an observational learning task?

Many argue that dogs show unique susceptibility to human communicative signals that make them suitable for being engaged in complex co-operation with humans. It has also been revealed that socially provided information is particularly effective in influencing the behaviour of dogs even when the human’s action demonstration conveys inefficient or mistaken solution of task. It is unclear, however, how the communicative nature of the demonstration context and the presence of the human demonstrator affect the dogs’ object-choice behaviour in observational learning situations. In order to unfold the effects of these factors, 76 adult pet dogs could observe a communicative or a non-communicative demonstration in which the human retrieved a tennis ball from under an opaque container while manipulating another distant and obviously empty (transparent) one. Subjects were then allowed to choose either in the presence of the demonstrator or after she left the room. Results showed a significant main effect of the demonstration context (presence or absence of the human’s communicative signals), and we also found some evidence for the response-modifying effect of the presence of the human demonstrator during the dogs’ choice. That is, dogs predominantly chose the baited container, but if the demonstration context was communicative and the human was present during the dogs’ choice, subjects’ tendency to select the baited container has been reduced. In agreement with the studies showing sensitivity to human’s communicative signals in dogs, these findings point to a special form of social influence in observational learning situations when it comes to learning about causally opaque and less efficient (compared to what comes natural to the dog) action demonstrations