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Health literacy is a relatively new concept that has been evolving at a rapid pace over the past decade. As recently as 2004, nursing researchers were contributing only a small portion of the existing body of knowledge as it related to the concept of health literacy. But in the last 4 to 5 years, this trend has changed. More interest demonstrated by nursing scholars has caused an exponential increase in the literature being produced. The research to date has shown a direct correlation between low health literacy and poor health. Older adults have been identified as a vulnerable population with an estimated two-thirds of US adults aged 60 and older having inadequate or marginal literacy skills. A concept analysis of health literacy in the older adult population is warranted at this time to further clarify the concept and provide standard terminology and definitions for future holistic nursing practice and research, leading to better identification of health-literacy deficits and intervention within vulnerable populations.

Fatal familial insomnia (FFI) is an inherited disease caused by a mutation in the protein prion gene. Symptoms of FFI closely resemble those of familial Creutzfeldt-Jakob disease, making genetic testing and histological examination of brain tissue the only means to determine a definitive diagnosis. The disease is rare--approximately 60 cases have been detected worldwide since 1986. Incubation time of the disease may be as long as 30 years; death generally occurs within 1 year of the onset of symptoms. There is no known procedure or treatment for delaying the onset of symptoms or modifying the disease course. Nurses who confront patients with FFI will be challenged to provide care to a patient and family who are facing certain death.

This article reports on the challenges of measuring health status in a study that tested whether there were differences in sleep and well-being between a group of persons with HIV who reduced their caffeine intake from baseline by 90% or greater for 30 days (n = 44) versus a group of persons with HIV who continued their usual caffeine consumption (n = 44). The MOS-HIV Health Survey summary scores were used as health status measures and as covariates. While results indicated that physical and mental health status improved among experimental group subjects, several methodological considerations are offered for further HIV/AIDS researchers: (1) How should health status with various degrees of disease progression be classified? (2) How can health status from different CD4 and HIV viral load measurements be properly inferred? (3) If opting to also employ a health status questionnaire, should general or disease-specific instruments be used?