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This article analyses the statistical reporting of UK Music, the umbrella organization that provides a collective voice for British music industry trade bodies. It documents changes in methodology from the organization's earliest reports, which provide financial data for each industry sector and use the prosperity of the business as a platform from which to lobby, to the reports for the years of the COVID-19 pandemic, which turn away sectoral information to argue that the industry is an ecosystem and music is beneficial for national well-being. In the process, UK Music submerges evidence that record companies and music publishers fared well during the pandemic while music creators and live music industry workers suffered greatly. As well as uncovering this information, this article considers why it has been neglected. It has enabled UK Music to lobby for actions that work across the industry and sidestep arguments that music creators should receive a greater share of remuneration. It has also helped to keep UK Music intact. [ABSTRACT FROM AUTHOR]

In Britain, the Select Committee of the government department for Digital, Culture, Media and Sport has investigated the economics of streaming and recommended that the share of revenues for record companies should decrease so that songwriters can earn more. This article addresses lobbying activity that has resulted from this recommendation. To support their causes, songwriter representatives and record company organisations have made incorrect or misleading use of data from the report Music Creators' Earnings in the Digital Age. This article looks at the impact of these uses and provides corrections and alternatives to the statistics that have been employed. It also looks at the importance of the issues that have been raised. In conclusion, it addresses aspects of record company accounting that will need to be considered if an increase for songwriters is to be made at their expense. [ABSTRACT FROM AUTHOR]

Backgrounds: This study administered the Health Literacy Questionnaire (HLQ) among Korean adults to examine its factor structure, reliability, and validity. Methods: The HLQ items were translated and culturally adapted to the Korean context. The convenience sampling method was used, and data were collected. The difficulty level, confirmatory factor analysis (CFA) using diagonal weighted least squares (DWLS) estimator in R, discriminant validity, and composite reliability were performed. Results: The easiest scale to obtain a high score was "Scale 4. Social support for health" and the hardest was "Scale 7. Navigating the healthcare system." Nine one-factor models fitted well. The nine-factor structural equation model fitted the data well. All HLQ scales were homogenous, with composite reliability. Conclusions: The Korean version of the HLQ has a strong construct and high composite reliability when applied to Korean adults. [ABSTRACT FROM AUTHOR]

Indian women enter the informal workforce for a range of reasons. Women food vendors tend to dominate low-income, low-skill activities, such as selling perishable food items. The aim of this study was to investigate the experiences of women food vendors in India. Twenty-four women were interviewed in 2015 and 2016 about financial matters, livelihoods, family, and housing, and the experience of vending. Findings indicate that women vendors are financially vulnerable, need greater access to education, better work and living conditions, and greater financial management options. Policies and programmes aimed at informal sector workers must recognise gender-specific vulnerabilities facing women vendors. [ABSTRACT FROM AUTHOR]

Background: The Health Education Impact Questionnaire (heiQ) aims to evaluate eight self-management skills in people with chronic conditions. Knowledge about the relations between these self-management skills and different quality of life (QoL) outcomes has received little attention. It is also important to provide further evidence on its properties in non-English healthcare contexts, as the questionnaire is being used in cross-cultural research. Furthermore, in the Italian healthcare context, the relationship between the medical staff and the patients remains asymmetrical, with the latter having the role of passive recipients of medical prescriptions and services. The current study provided further evidence about the psychometric properties of the heiQ among Italian people with chronic conditions, specifically by assessing the factor structure, reliability, convergent/divergent and criterion validity (ie, the specific contribution of each of the self-management skills to QoL outcomes). Methods: Two hundred ninety-nine individuals with a chronic condition (mean age = 61.4 years, 50% females) completed the heiQ and the Medical Outcomes Study-Short Form (MOS SF-36). Confirmatory factor analyses, Composite Reliability Indices (CRI), bivariate correlations and linear regression analyses were computed. Results: A model with 8 correlated factors showed good fit, in a similar way to previous studies. CRI values were acceptable to good for all the subscales. Associations between some of the heiQ subscales and some of the MOS SF-36 subscales supported criterion validity. In particular, it was confirmed by the moderate associations between the constructive attitudes and approaches subscale and the MOS SF-36 vitality and perceived mental health and by the moderate correlations between the health directed activities subscale and the MOS SF-36 Vitality. In linear regressions, higher emotional distress predicted higher physical and mental QoL, while higher mental QoL was also associated with stronger constructive attitudes and approaches. Conclusion: The heiQ has robust properties across translations and it can also be used routinely in Italian healthcare contexts. The evidence that all the other self-management skills did not predict either physical or mental QoL could suggest that the self-management model of chronic diseases is still not sufficiently developed in the Italian context, where patients are passive recipients of medical instructions. [ABSTRACT FROM AUTHOR]

Background: The health education impact Questionnaire (heiQ) measures eight self-management skills in people with chronic conditions. It seems to be important to provide cross-cultural evidence on its properties in non-English healthcare contexts. The present study assessed the psychometric properties of the heiQ in Italian adults with chronic conditions.Methods: Two hundred ninety-nine individuals with a chronic condition (mean age = 61.4 years, 50.16% females) completed the heiQ and the Medical Outcomes Study-Short Form (SF-36). Confirmatory factor analyses, Composite Reliability Indices, and bivariate correlations were performed.Results: Structural validity based on 8 correlated factors with good fit was in line with previous research. Concurrent validity was confirmed, as shown by moderate associations between the scores on the Constructive attitudes and approaches, Self-monitoring and insight, Health directed activities, Social integration and support, and Emotional distress subscales and the scores on SF-36 Physical functioning, General health perceptions, Vitality, Social functioning, Perceived mental health and Role limitations due to physical and emotional problems subscales.Conclusions: The Italian heiQ has strong properties and it can be used routinely also in the Italian healthcare services. [ABSTRACT FROM AUTHOR]

The announcement of effective and safe vaccines for COVID-19 has been greeted with enthusiasm. Discussions continue about the ethical challenges of ensuring fair access to COVID-19 vaccines within and across countries, and which groups should be prioritised.[[1]] There are concerns about equity in access to COVID-19 vaccines. [Extracted from the article]

Background: Communities of practice (CoPs) are frequently used in health settings to enhance knowledge and support action around public health issues. Yet, most are ineffective and often at risk of not delivering on this promise. To prevent loss of time and resources by organisations, facilitators, and members, this paper argues for a reliable assessment of the needs of people who intend to join and to set realistic expectations to assure effective communities of practice. This research proposes a valid and reliable needs assessment and analysis tool for starting communities of practice, by presenting the results of using such a tool. Methods: Inception needs assessments were developed, tested and administered to 246 respondents entering five communities of practice that focused on one of three public health issues: health literacy, mental health literacy and trauma-informed care. One community of practice had a global audience, four were based in Australia. Data from the needs assessments were analysed qualitatively and supplemented with descriptive statistics. Results were used to develop an analysis tool to support future communities of practice. Results: The short-term expectations of respondents included seeking to increase their knowledge and getting to know other members of the community of practice. Long-term expectations shifted towards undertaking action, collaborating and improving health outcomes. While respondents learning expectations included a wide range of topics, they articulated very specific knowledge they expected to share with others. There were high expectations of receiving practical support from the facilitator and a strong preference for meetings with synchronous interaction. Most respondents who planned to join focused initially on the direct and individual benefits and participation they expected from others, whereas they indicated limited intention to actively contribute to the learning needs of other community members. Respondents appeared to need to take time to build self-confidence and trust, and frequently applied a wait-and-see attitude. Conclusions: The findings of this study suggest that an inception needs assessment allows members to express their needs and expectations, which directly informs the direction and structure of a community of practice, gives voice to members, and supports facilitators in managing expectations. [ABSTRACT FROM AUTHOR]

Background: Health literacy refers to an individual's ability to find, understand and use health information in order to promote and maintain health. An individual's health literacy may also be influenced by the way health care organisations deliver care. The aim of this study was to investigate the influence of hospital service type (public versus private) on individual health literacy.Methods: Two cross-sectional surveys were conducted using the Health Literacy Questionnaire (HLQ), a multi-dimensional self-report instrument covering nine health literacy domains. Recently discharged private patients (n = 3121) were sent the survey in English, public patients (n = 384) were sent the survey in English, Arabic, Chinese, Vietnamese, Italian or Greek. Eligibility included hospitalisation ≥24 h in last 30 days, aged ≥18 years, no cognitive impairment. Odds ratios were used to assess differences between hospital sociodemographic and health related variables. ANOVA and Cohen's effect sizes compared HLQ scores between hospitals. Chi square and multiple logistic regression were used to determine whether differences between private and public hospital HLQ scores was independent of hospital population sociodemographic differences. ANOVA was used to review associations between HLQ scores and subgroups of demographic, health behaviour and health conditions and these were then compared across the two hospital populations.Results: Public hospital participants scored lower than private hospital participants on eight of the nine health literacy domains of the HLQ (scores for Active Appraisal did not differ between the two samples). Six domains, five of which in part measure the impact of how care is delivered on health literacy, remained lower among public hospital participants after controlling for age, education, language and income. Across both hospital populations, participants who were smokers, those who had low physical activity, those with depression and/or anxiety and those with 3 or more chronic conditions reported lower scores on some HLQ domains.Conclusions: Our finding of lower health literacy among patients who had received care at a public hospital in comparison to a private hospital, even after adjustment for sociodemographic and language differences, suggests that private hospitals may possess organisational attributes (environment, structure, values, practices and/or workforce competencies) that result in improved health literacy responsiveness. [ABSTRACT FROM AUTHOR]

The Soundwatch Boater Education Program is a vessel monitoring and public education outreach program. Soundwatch has been run by The Whale Museum (TWM) during the whale watch season (May through September) in the Haro Strait Region of the Central Salish Sea since 1993. Data collection has been in a consistent manner since 1998 and is presented here. The program compiles data on vessel types and vessel interactions with marine mammals with a focus on the Southern Resident killer whale (SRKW), Orcinas orca, which was listed as endangered under the U.S. Endangered Species Act (ESA) in 2005. The primary goal of the Soundwatch program is to reduce vessel disturbance to SRKWs and other marine wildlife through the education of boaters on regional, local and federal guidelines and regulations and the systematic monitoring of vessel activities around cetaceans. Since 1998, the number of active commercial whale watching vessels has increased over time; ranging from a low of 63 in 1999, to a high of 96 in 2015. In addition, the number of vessel incidents or violation of regulations and guidelines has also increased; ranging from a low of 398 in 1998 to a high of 2621 in 2012. Soundwatch collected data on 23 incident types, some remaining the same over the 18-year data set and some changing over time. The most common incidents over the 18 years were “Within 880 m of Lime Kiln” and “Crossing the path of whales”. The numbers of people kayaking near whales also significantly increased since 2004 with the incident “kayaks spread out” with a significantly increasing trend making it difficult for whales to avoid vessels. These results suggest a need for further outreach for effective education and enforcement of whale watching guidelines and regulations in the Central Salish Sea. [ABSTRACT FROM AUTHOR]

British musicians receive “equitable remuneration” when their recordings are played in public or are broadcast. Performers’ rights are weaker than those of songwriters, however. This is largely because songwriters are the first owners of their copyrights, whereas performers rarely own the copyright in their sound recordings. This article concerns the remuneration of musicians’ labor. It looks at the legislative evolution of performers’ rights in the UK and addresses the influence that songwriters, record companies, and the Musicians’ Union have had on this area of copyright law. It argues that performers will only achieve legislative parity with songwriters if the ownership and conceptualization of sound recording copyright are reconfigured. This copyright should be awarded to performers for their creative labor, rather than to record companies for their financial and administrative endeavors. [ABSTRACT FROM PUBLISHER]

This article addresses the uses that record companies have made of two rhetorical tropes. The first is that only one in 10 artists succeed. The second is that they are investing in new music. These two notions have been combined to give the impression that record companies are taking risks both economically and aesthetically. They have been employed to justify the companies’ ownership of sound recording copyright and their system of exclusive, long-term recording contracts. More recently, the rhetoric has been employed to combat piracy, extend the term of sound recording copyright and account for the continuing usefulness of record companies. It is the argument of this article that investment in new music is not necessarily risk-taking; rather, it is the policies derived from risk-taking that provide the financial security of record companies. [ABSTRACT FROM PUBLISHER]

The Health Literacy Questionnaire (HLQ), developed in Australia in 2012 using a ‘validity-driven’ approach, has been rapidly adopted and is being applied in many countries and languages. It is a multidimensional measure comprising nine distinct domains that may be used for surveys, needs assessment, evaluation and outcomes assessment as well as for informing service improvement and the development of interventions. The aim of this paper is to describe the German translation of the HLQ and to present the results of the validation of the culturally adapted version. The HLQ comprises 44 items, which were translated and culturally adapted to the German context. This study uses data collected from a sample of 1,058 persons with chronic conditions. Statistical analyses include descriptive and confirmatory factor analyses. In one-factor congeneric models, all scales demonstrated good fit after few model adjustments. In a single, highly restrictive nine-factor model (no cross-loadings, no correlated errors) replication of the original English-language version was achieved with fit indices and psychometric properties similar to the original HLQ. Reliability for all scales was excellent, with a Cronbach’s Alpha of at least 0.77. High to very high correlations between some HLQ factors were observed, suggesting that higher order factors may be present. Our rigorous development and validation protocol, as well as strict adaptation processes, have generated a remarkable reproduction of the HLQ in German. The results of this validation provide evidence that the HLQ is robust and can be recommended for use in German-speaking populations. Trial Registration: German Clinical Trial Registration (DRKS): . Registered 23 March 2011. [ABSTRACT FROM AUTHOR]

Background: Health literacy is simply defined as an individual's ability to access, understand and use information in ways that promote and maintain good health. Lower health literacy has been found to be associated with increased emergency department presentations and potentially avoidable hospitalisations. This study aimed to determine the health literacy of hospital inpatients, and to examine if associations exist between different dimensions of their health literacy, sociodemographic characteristics and hospital services use.Methods: A written survey was sent to 3,252 people aged ≥18 years in English, Arabic, Chinese, Vietnamese, Italian or Greek. The survey included demographic and health questions, and the Health Literacy Questionnaire (HLQ). The HLQ is a multidimensional instrument comprising nine independent scales. Use of hospital services was measured by length of stay, number of admissions in 12 months and number of emergency department presentations. Effect size (ES) for standardised differences in means described the magnitude of differences in HLQ scale scores between demographic and socioeconomic groups.Results: 385 questionnaires were returned (13%); mean age 64 years (SD 17), 49% female. Aged ≥65 years (55%), using the Internet < once a month (37%), failure to complete high school (67%), low household income (39%), receiving means-tested government benefits (61%) and being from a culturally and linguistically diverse (CALD) background (24%), were all associated with lower scores in some health literacy scales. Being aged ≥65 years, not currently employed, receiving government benefits, and being from a CALD background were also associated with increased use of some hospital services. There was no association between lower scores on any HLQ scale and greater use of hospital services.Conclusion: We found no association between lower health literacy and greater use of hospital health services. However increased age, having a CALD background and not speaking English at home were all associated with having the most health literacy challenges Strategies to address these are needed to reduce health inequalities. [ABSTRACT FROM AUTHOR]

Objective: To undertake a rigorous psychometric evaluation of the widely used eight-scale heiQ version 2.0 (evaluating immediate effects of self-management interventions) in diverse patient groups in Norway.Methods: Cross-sectional survey data were collected from 1019 Norwegians. Data were extracted from studies among people with musculoskeletal disorders (n=516), psoriasis (n=254), heart disease (n=97), and Type 2 diabetes (n=152). To investigate the factorial validity of the Norwegian heiQ, confirmatory factor analyses (CFA) were carried out using Mplus.Results: One-factor model fit, without modifications, was acceptable for the Emotional distress scale. Only one correlated residual was required to be fitted in each of the other scales to achieve satisfactory model fit. The postulated highly restricted full eight-factor model (no cross-loadings, no correlated residuals) showed good fit to the data. Internal consistency was acceptable for most scales (0.72-0.90) but low for Self-monitoring and insight.Conclusion: This study of the Norwegian heiQ replicates the factor structure of the original Australian heiQ, using robust and highly restricted CFA procedures, demonstrating a clean independent clusters model structure.Practice Implications: Researchers, program implementers and policymakers could use the Norwegian heiQ with confidence to generate reliable information on program outcomes and support quality improvement activities. [ABSTRACT FROM AUTHOR]

The article discusses barriers to the effective use of digital technologies in education and how educational technology research struggles to show precisely how to get the right alignment between the needs of teachers and the affordances provided by digital technologies.

Background: The SF36 Version 2 (SF36V2) is a revision of the SF36 Version 1, and is a widely used health status measure. It is important that guidelines for interpreting scores are available.Method: A population sample of Australians (n = 3015) weighted to achieve representativeness was administered the SF36V2. Comparisons between published US weights and sample derived weights were made, and Australian population norms computed and presented.Major Findings: Significant differences were observed on 7/8 scales and on the mental health summary scale. Possible causes of these findings may include different sampling and data collection procedures, demographic characteristics, differences in data collection time (1998 vs. 2004), differences in health status or differences in cultural perception of the meaning of health. Australian population norms by age cohort, gender and health status are reported by T-score as recommended by the instrument developers. Additionally, the proportions of cases within T-score deciles are presented and show there are important data distribution issues.Principal Conclusions: The procedures reported here may be used by other researchers where local effects are suspected. The population norms presented may be of interest. There are statistical artefacts associated with T-scores that have implications for how SF36V2 data are analysed and interpreted. [ABSTRACT FROM AUTHOR]

The chapter captures the tensions around the research and 'common wisdom' that college is an imperative for all young Black males. [ABSTRACT FROM AUTHOR]

Objective: To comprehensively identify components of the physical limitation concept in knee osteoarthritis (OA) and to rate the clinical importance of these using perspectives of both patients and health professionals. Design: Concept mapping, a structured group process, was used to identify and organize data in focus groups (patients) and via a global web-based survey (professionals). Ideas were elicited through a nominal group technique and then organized using multidimensional scaling, cluster analysis, participant validation, rating of clinical importance, and thematic analyses to generate a conceptual model of physical limitations in knee OA. Results: Fifteen Danish patients and 200 international professionals contributed to generating the conceptual model. Five clusters emerged: 'Limitations/physical deficits'; 'Everyday hurdles'; 'You're not the person you used to be'; 'Need to adjust way of living'; and 'External limitations,' each with sub-clusters. Patients generally found their limitations more important than the professionals did. Conclusion: Patients and professionals agreed largely on the physical limitation concept in knee OA. Some limitations of high importance to patients were lower rated by the professionals, highlighting the importance of including patients when conceptualizing patient outcomes. These data offer new knowledge to guide selection of clinically relevant outcomes and development of outcome measures in knee OA. [ABSTRACT FROM AUTHOR]

This article examines the popularity of the Sex Pistols' song “Friggin' in the Riggin'” and its parent albumThe Great Rock ‘n’ Roll Swindle. It argues that in 1979 the Sex Pistols attracted a new and younger audience, one that has been neglected in previous studies of the band, which tend instead to focus on the years 1976 and 1977 and the band's original coterie of followers. This article locates the teenage appeal of “Friggin' in the Riggin'” in its themes of swearing, sex, and piracy. It also explores the media infrastructure that enabled young adolescents to access this music. Following on from this, the article charts the triumph of Johnny Rotten's Sex Pistols' narrative over that of Malcolm McLaren.The Great Rock‘n’Roll Swindlefell prey to notions of authenticity, coherence, and the canonical tastes of young adults. [ABSTRACT FROM PUBLISHER]

Objectives: To assess the contribution of back-translation and expert committee to the content and psychometric properties of a translated multidimensional questionnaire. Study Design and Setting: Recommendations for questionnaire translation include back-translation and expert committee, but their contribution to measurement properties is unknown. Four English to French translations of the Health Education Impact Questionnaire were generated with and without committee or back-translation. Face validity, acceptability, and structural properties were compared after random assignment to people with rheumatoid arthritis (N = 1,168), chronic renal failure (N = 2,368), and diabetes (N = 538). For face validity, 15 bilingual people compared translations quality with the original. Psychometric properties were examined using confirmatory factor analysis (metric and scalar invariance) and item response theory. Results: Qualitatively, there were five types of translation errors: style, intensity, frequency/time frame, breadth, and meaning. Bilingual assessors ranked best the translations with committee (P = 0.0026). All translations had good structural properties (root mean square error of approximation <0.05; comparative fit index [CFI], ≥0.899; and Tucker--Lewis index, ≥0.889). Full measurement invariance was observed between translations (ΔCFI ≤ 0.01) with metric invariance between translations and original (lowest ΔCFI = 0.022 between fully constrained models and models with free intercepts). Item characteristic curve analyses revealed no significant differences. Conclusion: This is the first experimental evidence that back-translation has moderate impact, whereas expert committee helps to ensure accurate content. [ABSTRACT FROM AUTHOR]

In this paper we discuss the regularity conditions required for the classical Cram?er-Rao lower bound (CRLB) for real-valued (nonrandom unknown) parameters to hold. It is shown that the commonly assumed requirement that the support of the likelihood function (LF) should be independent of the parameter to be estimated can be replaced by the much weaker requirement that the LF is continuous at the end points of its support. Parameter-dependent support of the LF arises when an unknown parameter is observed in the presence of additive measurement noise and the measurement noise probability density function (pdf) has a finite support. It is also pointed out that the commonly cited requirements of absolute integrability of the derivatives of the LF should be replaced by requirements on the log-LF (LLF). Some practical examples of finite-support measurement noises, which lead to parameter-dependent LF support, are discussed in light of the above. For the case where the LF is not continuous at the end points of its support, a new modified CRLB ?designated as the Cram?er-Rao-Leibniz lower bound (CRLLB), since it relies on Leibniz integral rule ? is presented and its use illustrated. The CRLLB is shown to provide valid bounds for a number of long-standing problems for which the CRLB was shown in the literature as not valid, in particular, for a uniformly distributed measurement noise. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: Cognitive impairment occurs in up to 50% of patients with amyotrophic lateral sclerosis (ALS). Simple tools are required to identify such individuals, as cognitive impairment adversely impacts quality of life and survival. Our objective was to determine the potential utility of the Frontal Assessment Battery (FAB) and the Montreal Cognitive Assessment (MoCA) in evaluating frontal lobe and general cognitive impairment, respectively. We also assessed the feasibility of screening for cognitive impairment in those patients with advanced physical disability by modifying selected FAB and MoCA subtasks. Methods: Fifty-four consecutive ALS patients were screened; 44 completed the FAB and 39 completed the MoCA. We administered modified tasks to patients with severe hand weakness or dysarthria. The patients were classified as cognitively impaired on each measure based on published cut-off scores of 14.11 on the FAB and 26 on the MoCA. Results: Twenty-one percent and 53% of patients were impaired on the FAB and the MoCA, respectively. Scores from patients receiving modified instructions did not differ from those completing standard versions. There were statistically significant correlations between the MoCA total scores and forced vital capacity (FVC) and ALSFRS-R scores. There was no correlation between these variables and the FAB. Conclusions: Both the FAB and MoCA detected cognitive impairment in ALS patients. While the MoCA classified more patients as cognitively impaired than the FAB, the latter was more feasible for assessing patients with physical impairment. Simple task modifications proved effective in allowing patients with speech and motor impairments to undergo screening. Future studies are required to validate both measures, establish optimal cut-off scores, and validate modifications. [Copyright &y& Elsevier]

Background Carers provide extended and often unrecognized support to people with cancer. The aim of this study is to test the hypothesis that excessive carer burden is modifiable through a telephone outcall intervention that includes supportive care, information and referral to appropriate psycho-social services. Secondary aims include estimation of changes in psychological health and quality of life. The study will determine whether the intervention reduces unmet needs among patient dyads. A formal economic program will also be conducted. Methods/design This study is a single-blind, multi-centre, randomized controlled trial to determine the efficacy and cost-efficacy of a telephone outcall program among carers of newly diagnosed cancer patients. A total of 230 carer/patient dyads will be recruited into the study; following written consent, carers will be randomly allocated to either the outcall intervention program (n = 115) or to a minimal outcall / attention control service (n = 115). Carer assessments will occur at baseline, at one and six months post-intervention. The primary outcome is change in carer burden; the secondary outcomes are change in carer depression, quality of life, health literacy and unmet needs. The trial patients will be assessed at baseline and one month post-intervention to determine depression levels and unmet needs. The economic analysis will include perspectives of both the health care sector and broader society and comprise a cost-consequences analysis where all outcomes will be compared to costs. Discussion This study will contribute to our understanding on the potential impact of a telephone outcall program on carer burden and provide new evidence on an approach for improving the wellbeing of carers. [ABSTRACT FROM AUTHOR]

Combining line-of-sight (LOS) measurements from passive sensors (e.g., satellite-based IR, ground-based cameras, etc.), assumed to be synchronized, into a single composite Cartesian measurement (full position in 3D) via maximum likelihood (ML) estimation, can circumvent the need for nonlinear filtering?which involves, by necessity, approximations. This ML estimate is shown to be statistically efficient, even for small sample sizes (as few as two LOS measurements), and as such, the covariance matrix obtainable from the Cramer-Rao lower bound (CRLB) provides the correct measurement noise covariance matrix for use in a target tracking filter. [ABSTRACT FROM AUTHOR]

Purpose: To carry out a systematic review of program outcomes used in the evaluation of group-based self-management interventions aimed at people with arthritis and other chronic conditions. Methods: The systematic search was performed across databases MEDLINE, EMBASE, CINAHL, and PsycINFO. Both between-group and within-group effect sizes (ES) were calculated. Results were interpreted as small (ES ~ 0.2), medium (ES ~ 0.5), or large (ES ~ 0.8) effects. Results: The majority of 18 included trials investigated the effectiveness of arthritis-specific interventions. Across most outcomes, small effects on course participants were shown. While effects on knowledge were large (between-group ES = 0.78), effects on clinical outcomes such as pain (ES = 0.10) were negligible to small. Conclusions: This paper is consistent with other reviews in this area, suggesting that people with arthritis receive only marginal benefits from participating in chronic disease self-management interventions. When looking at the types of outcomes that trials are based on, however, alternative explanations for these results seem probable. As evaluations heavily rely on patient self-report, current approaches to program evaluation may not be sufficient to assess the intended impact of self-management education. An in-depth investigation of the types of outcomes assessed is provided in a separate paper. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to describe the content of questionnaires used in the assessment of the individual burden of osteoarthritis. Study Design and Setting: A systematic search of computerized databases was conducted to identify self-report measures of osteoarthritis burden. The content of identified measures was assessed against the eight-domain Personal Burden of Osteoarthritis (PBO) model, which covers physical distress, fatigue, physical limitations, psychosocial distress, physical deconditioning, financial hardship, sleep disturbances, and lost productivity. The PBO was derived from extensive consultations with osteoarthritis patients and clinicians. Results: A review of 5,703 publications identified 158 multi-item self-report measures of the individual burden of osteoarthritis. Content analysis showed that the dimensions of physical limitations, physical distress, and psychosocial distress were well represented by the identified questionnaires. The physical deconditioning and financial hardship dimensions were the least represented in the identified measures. The World Health Organization Quality of Life Scale gave the best coverage of PBO elements, with items matching seven of the eight PBO domains. Conclusion: Despite the large number of questionnaires identified, many aspects of the individual burden of osteoarthritis are not well represented by currently available measures. This may result in systematic gaps in how experiences of people with osteoarthritis are represented in research studies. [ABSTRACT FROM AUTHOR]

Background: Health literacy has become an increasingly important concept in public health. We sought to develop a comprehensive measure of health literacy capable of diagnosing health literacy needs across individuals and organisations by utilizing perspectives from the general population, patients, practitioners and policymakers. Methods: Using a validity-driven approach we undertook grounded consultations (workshops and interviews) to identify broad conceptually distinct domains. Questionnaire items were developed directly from the consultation data following a strict process aiming to capture the full range of experiences of people currently engaged in healthcare through to people in the general population. Psychometric analyses included confirmatory factor analysis (CFA) and item response theory. Cognitive interviews were used to ensure questions were understood as intended. Items were initially tested in a calibration sample from community health, home care and hospital settings (N=634) and then in a replication sample (N=405) comprising recent emergency department attendees. Results: Initially 91 items were generated across 6 scales with agree/disagree response options and 5 scales with difficulty in undertaking tasks response options. Cognitive testing revealed that most items were well understood and only some minor re-wording was required. Psychometric testing of the calibration sample identified 34 poorly performing or conceptually redundant items and they were removed resulting in 10 scales. These were then tested in a replication sample and refined to yield 9 final scales comprising 44 items. A 9-factor CFA model was fitted to these items with no cross-loadings or correlated residuals allowed. Given the very restricted nature of the model, the fit was quite satisfactory: ÷2 WLSMV(866 d.f.) = 2927, p<0.000, CFI = 0.936, TLI = 0.930, RMSEA = 0.076, and WRMR = 1.698. Final scales included: Feeling understood and supported by healthcare providers; Having sufficient information to manage my health; Actively managing my health; Social support for health; Appraisal of health information; Ability to actively engage with healthcare providers; Navigating the healthcare system; Ability to find good health information; and Understand health information well enough to know what to do. Conclusions: The HLQ covers 9 conceptually distinct areas of health literacy to assess the needs and challenges of a wide range of people and organisations. Given the validity-driven approach, the HLQ is likely to be useful in surveys, intervention evaluation, and studies of the needs and capabilities of individuals. [ABSTRACT FROM AUTHOR]

Background: Research involving more representative samples is needed to extend our understanding of the broader impact of obesity in hip or knee joint disease (arthritis and OA) beyond clinical settings. Although population-based research has been conducted in the United States, how these findings translate to other countries is unclear. Using a national approach, this study explored associations between obesity and the burden of hip and knee joint disease in Australia (in terms of prevalence, pain, stiffness, function, Health-Related Quality of Life (HRQoL) and disease severity). Methods: A random sample of 5000 Australians (⩾39 years) from the federal electoral roll was invited to complete a mailed questionnaire to identify doctor-diagnosed hip arthritis, hip OA, knee arthritis and knee OA and evaluate the burden of these conditions. Validated questionnaires included the WOMAC Index, Assessment of Quality of Life instrument and Multi-Attribute Prioritisation Tool. Body Mass Index (BMI) was classified into underweight/normal weight (⩽24.99 kg/m²), overweight (25-29.99) or obese (⩾30). Multiple logistic regression was used to estimate odds of arthritis and OA, with demographic and socioeconomic variables included in the models. Associations between BMI and other variables were investigated using analysis of covariance, with adjustment for age and sex. Results: Data were available from 1,157 participants (23%). Overweight participants had increased odds of knee arthritis (adjusted OR (AOR) 1.87, 95%CI 1.14-3.07) and knee OA (AOR 2.11, 95%CI 1.07-4.15). Obesity was associated with higher prevalence of hip arthritis (AOR 2.18, 95%CI 1.17-4.06), knee arthritis (AOR 5.47, 95%CI 3.35-8.95) and knee OA (AOR 7.35, 95%CI 3.85-14.02). Of those with arthritis or OA, obese individuals reported more pain (for hip arthritis, hip OA and knee OA), greater stiffness (for hip arthritis, knee arthritis and knee OA), worse function (all diagnoses), lower HRQoL (for hip arthritis and hip OA) and greater disease severity (all diagnoses). Conclusions: This national study has demonstrated that the odds of arthritis and OA was up to 7 times higher for obese individuals, compared with those classified as underweight/normal weight. Concurrent obesity and joint disease had a marked impact on several key aspects of wellbeing, highlighting the need for public health interventions. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Clinical trials of new agents to reduce the severity and impact of influenza require accurate assessment of the effect of influenza infection. Because there are limited high-quality adult influenza Patient Reported Outcomes (PRO) measures, the aim was to develop and validate a simple but comprehensive questionnaire for epidemiological research and clinical trials. Methods: Construct and item generation was guided by the literature, concept mapping, focus groups, and interviews with individuals with laboratory-confirmed influenza and expert physicians. Items were administered to 311 people with influenza-like illness (ILI) across 25 US sites. Analyses included classic psychometrics, structural equation modeling (SEM), and Rasch analyses. Results: Concept mapping generated 149 concepts covering the influenza experience and clustered into symptoms and impact on daily activities, emotions, and others. Items were drafted using simplicity and brevity criteria. Eleven symptoms from the literature underwent review by physicians and patients, and two were removed and one added. The symptoms domain factored into systemic and respiratory symptoms, whereas the impact domains were unidimensional. All domains displayed good internal consistency (Cronbach α≥0.8) except the three-item respiratory domain (α = 0.48). A five-factor SEM indicated excellent fit where systemic, respiratory, and daily activities domains differentiated patients with ILI or confirmed influenza. All scales were responsive over time. Conclusions: Patient and clinician consultations resulted in an influenza PRO measure with high validity and good overall evidence of reliability and responsiveness. The Influenza Intensity and Impact Questionnaire (FluiiQ™) will improve the evaluation of existing and future agents designed to prevent or control influenza infection by increasing the breadth and depth of measurement in this field. [Copyright &y& Elsevier]

Abstract: Objective: Health literacy refers to an individual''s ability to seek, understand, and use health information. A range of indices exist that purport to measure health literacy across individuals and populations. This study aimed to review the development and content of existing indices and to critically appraise their properties. Study Design and Setting: Using standardized search terms, published generic health literacy indices (1990–2008) were identified. Using a methodological framework, each was evaluated for purpose, validity (face, content, construct), reliability, responsiveness, feasibility, and generalizability. Results: Nineteen instruments were evaluated. Three measurement approaches were identified: direct testing of individual abilities, self-report of abilities, and population-based proxy measures. Composition of underlying constructs and content varied widely across instruments, and none appeared to fully measure a person''s ability to seek, understand, and use health information. The content was focused primarily on reading comprehension and numeracy; scoring categories were poorly defined and may not be mutually exclusive, and few indices had been assessed for reliability. Conclusion: Health literacy is not consistently measured, making it difficult to interpret and compare health literacy at individual and population levels. Empirical evidence demonstrating validity and reliability of existing indices is required, and more comprehensive health literacy instruments need to be developed. [Copyright &y& Elsevier]

A response by David F. Kallmes, Patrick J. Heagerty and Jeffrey G. Jarvik to a letter to the editor about their article "A Randomized Trial of Vertebroplasty for Osteoporotic Spinal Fractures" in the August 6, 2009 issue is presented.

Background: Vertebroplasty has become a common treatment for painful osteoporotic vertebral fractures, but there is limited evidence to support its use. Methods: We performed a multicenter, randomized, double-blind, placebo-controlled trial in which participants with one or two painful osteoporotic vertebral fractures that were of less than 12 months' duration and unhealed, as confirmed by magnetic resonance imaging, were randomly assigned to undergo vertebroplasty or a sham procedure. Participants were stratified according to treatment center, sex, and duration of symptoms (<6 weeks or ≥6 weeks). Outcomes were assessed at 1 week and at 1, 3, and 6 months. The primary outcome was overall pain (on a scale of 0 to 10, with 10 being the maximum imaginable pain) at 3 months. Results: A total of 78 participants were enrolled, and 71 (35 of 38 in the vertebroplasty group and 36 of 40 in the placebo group) completed the 6-month follow-up (91%). Vertebroplasty did not result in a significant advantage in any measured outcome at any time point. There were significant reductions in overall pain in both study groups at each follow-up assessment. At 3 months, the mean (±SD) reductions in the score for pain in the vertebroplasty and control groups were 2.6±2.9 and 1.9±3.3, respectively (adjusted between-group difference, 0.6; 95% confidence interval, −0.7 to 1.8). Similar improvements were seen in both groups with respect to pain at night and at rest, physical functioning, quality of life, and perceived improvement. Seven incident vertebral fractures (three in the vertebroplasty group and four in the placebo group) occurred during the 6-month follow-up period. Conclusions: We found no beneficial effect of vertebroplasty as compared with a sham procedure in patients with painful osteoporotic vertebral fractures, at 1 week or at 1, 3, or 6 months after treatment. (Australian New Zealand Clinical Trials Registry number, ACTRN012605000079640.) N Engl J Med 2009;361:557-68. [ABSTRACT FROM AUTHOR]

Fish-eating killer whales Orcinus orca in the northeastern Pacific live in highly stable matrifocal social groups called pods. Each pod produces a repertoire of seven or more stereotyped call types. We compared the relative production of call types of free-ranging killer whale pods over time and between social contexts. The relative production of call types by each pod during directional travel was distinct over a 27-yr period; however, both temporal stability and pod distinctiveness were strongly influenced by a subset of dominant call types within the repertoire of each pod. Some call types within the repertoires contain biphonation (two overlapping independently modulated tones) and have a higher estimated active space than call types containing just one tone. In multi-pod aggregations the relative production of the dominant call types of each pod decreased and the relative production of a subset of call types that are rarely recorded from single-pod groupings increased. The majority of these contained biphonation. The data suggest a distinction between a subset of dominant call types that may function to identify the pod and a subset of less common call types including several call types containing biphonation that are more commonly produced during inter-pod affiliations. [ABSTRACT FROM AUTHOR]

Background: The Medical Outcomes General Health Survey (SF-36) is a widely used health status measure; however, limited evidence is available for its performance in orthopedic settings. The aim of this study was to examine the magnitude and meaningfulness of change and sensitivity of SF-36 subscales following orthopedic surgery. Methods: Longitudinal data on outcomes of total hip replacement (THR, n = 255), total knee replacement (TKR, n = 103), arthroscopic partial meniscectomy (APM, n = 74) and anterior cruciate ligament reconstruction (ACL, n = 62) were used to estimate the effect sizes (ES, magnitude of change) and minimal detectable change (sensitivity) at the group and individual level. To provide context for interpreting the magnitude of changes in SF-36 scores, we also compared patients' scores with age and sex-matched population norms. The studies were conducted in Sweden. Follow-up was five years in THR and TKR studies, two years in ACL, and three months in APM. Results: On average, large effect sizes (ES≥0.80) were found after orthopedic surgery in SF-36 subscales measuring physical aspects (physical functioning, role physical, and bodily pain). Small (0.20-0.49) to moderate (0.50-0.79) effect sizes were found in subscales measuring mental and social aspects (role emotional, vitality, social functioning, and mental health). General health scores remained relatively unchanged during the follow-up. Despite improvements, post-surgery mean scores of patients were still below the age and sex matched population norms on physical subscales. Patients' scores on mental and social subscales approached population norms following the surgery. At the individual level, scores of a large proportion of patients were affected by floor or ceiling effects on several subscales and the sensitivity to individual change was very low. Conclusion: Large to moderate meaningful changes in group scores were observed in all SF-36 subscales except General Health across the intervention groups. Therefore, in orthopedic settings, the SF-36 can be used to show changes for groups in physical, mental, and social dimensions and in comparison with population norms. However, SF-36 subscales have low sensitivity to individual change and so we caution against using SF-36 to monitor the health status of individual patients undergoing orthopedic surgery. [ABSTRACT FROM AUTHOR]

The paper record label, invented by Eldridge Johnson in the early 1900s, affected the fortunes and status of the analogue disc. On the one hand, it transformed it into a marketable product. On the other, using Walter Benjamin's term, it helped to restore 'aura' to this mass-produced good. The clearest outcome of labelling lies in the fact that the term 'record label' soon became a synonym for 'record company'. The label helped to brand both record and company but in so doing it altered the nature of their relationship. This article traces the manufacturing company's domination over all other contributors listed on the paper label. It also outlines the consequences and compromises that have resulted from making such bold claims over the contents of the disc. Beyond its merely informative tasks, the record label was first used to develop associations between the manufacturing company and its recorded output, a process that soon grew complicated. Later it was employed to highlight the difference between classical and popular music. It was then used to create further sub-divisions, such as those which arose in the US market between 'popular', 'race', and 'hillbilly' musics. Such divisions were crucial in fostering the practice of record collecting. The generic label was an essential guide to, and indicator of, the record collector's hobby. Nevertheless, collectors soon went further than record companies had planned. In order to establish the authenticity of their discs, record collectors explored each aspect and alteration of the record label. A practice that helped to individualize each duplicated disc. [ABSTRACT FROM AUTHOR]

Objective: To investigate the utility associated with subcutaneous infusion (deferoxamine) compared with once-daily oral administration (deferasirox) of iron chelation therapy. Methods: Interviews using the time trade-off technique were used to estimate preferences (utility) for health states by finding the point at which respondents were indifferent between a longer but lower quality of life (QoL) and a shorter time in full health. Participants (n = 110) were community-based, 51% women, median age 35 years, from four regions in Sydney, Australia. Respondents rated three health states involving equal outcomes for people with thalassemia but with different treatment modalities for iron chelation; an “anchor state” describing a patient receiving iron chelation without administration mode specified, anchor state plus iron chelation via subcutaneous infusion, and anchor state plus iron chelation through once-daily oral medication. Results: On an interval scale between 0 (death) and 1 (full health), median (interquartile range) utility of 0.80 (0.65–0.95) for the anchor state, 0.66 (0.45–0.87) for subcutaneous infusion, and 0.93 (0.80–0.97) for once-daily oral administration was obtained. The mean (median) difference of 0.23 (0.27) between the two treatments was statistically significant (Wilcoxon-signed rank test, P < 0.001). Subcutaneous infusion was associated with a mean (median) utility 0.13 (0.14) lower than the anchor state ( P < 0.001), and once-daily oral treatment had a utility 0.10 (0.13) higher ( P < 0.001). Conclusion: Community respondents associate oral administration of an iron chelator such as deferasirox with enhanced QoL compared with subcutaneous treatment. Assuming equal safety and efficacy, QoL gains from once-daily oral treatment compared with subcutaneous infusion are significant. [ABSTRACT FROM AUTHOR]

Abstract: Objective: This paper describes the development and validation of the Health Education Impact Questionnaire (heiQ). The aim was to develop a user-friendly, relevant, and psychometrically sound instrument for the comprehensive evaluation of patient education programs, which can be applied across a broad range of chronic conditions. Methods: Item development for the heiQ was guided by a Program Logic Model, Concept Mapping, interviews with stakeholders and psychometric analyses. Construction (N =591) and confirmatory (N =598) samples were drawn from consumers of patient education programs and hospital outpatients. The properties of the heiQ were investigated using item response theory and structural equation modeling. Results: Over 90 candidate items were generated, with 42 items selected for inclusion in the final scale. Eight independent dimensions were derived: Positive and Active Engagement in Life (five items, Cronbach''s alpha (α)=0.86); Health Directed Behavior (four items, α =0.80); Skill and Technique Acquisition (five items, α =0.81); Constructive Attitudes and Approaches (five items, α =0.81); Self-Monitoring and Insight (seven items, α =0.70); Health Service Navigation (five items, α =0.82); Social Integration and Support (five items, α =0.86); and Emotional Wellbeing (six items, α =0.89). Conclusion: The heiQ has high construct validity and is a reliable measure of a broad range of patient education program benefits. Practice Implications: The heiQ will provide valuable information to clinicians, researchers, policymakers and other stakeholders about the value of patient education programs in chronic disease management. [Copyright &y& Elsevier]

The article addresses the elements of blackface minstrelsy that can be witnessed in the popular music practice of sampling. During the late nineteenth century, blackface minstrelsy became the most popular form of entertainment in the U.S. It was a response to a particular historical situation. And this article particularly focused on the work of the dance music artist Moby.

Abstract: The risk to non-human biota from exposure to ionizing radiation is of current international interest. In calculating radiation doses to humans, it is common to multiply the absorbed dose by a factor to account for the relative biological effectiveness (RBE) of the radiation type. However, there is no international consensus on the appropriate value of such a factor for weighting doses to non-human biota. This paper summarizes our review of the literature on experimentally determined RBEs for internally deposited alpha-emitting radionuclides. The relevancy of each experimental result in selecting a radiation weighting factor for doses from alpha particles in biota was judged on the basis of criteria established a priori. We recommend a nominal alpha radiation weighting factor of 5 for population-relevant deterministic and stochastic endpoints, but to reflect the limitations in the experimental data, uncertainty ranges of 1–10 and 1–20 were selected for population-relevant deterministic and stochastic endpoints, respectively. [Copyright &y& Elsevier]

Background: Patient education and self-management programs are offered in many countries to people with chronic conditions such as osteoarthritis (OA). The most well-known is the disease-specific Stanford Arthritis Self-Management Program (ASMP). While Australian and international clinical guidelines promote the concept of self-management for OA, there is currently little evidence to support the use of the ASMP. Several meta-analyses have reported that arthritis self-management programs had minimal or no effect on reducing pain and disability. However, previous studies have had methodological shortcomings including the use of outcome measures which do not accurately reflect program goals. Additionally, limited costeffectiveness analyses have been undertaken and the cost-utility of the program has not been explored. Methods/design: This study is a randomised controlled trial to determine the efficacy (in terms of Health-Related Quality of Life and self-management skills) and cost-utility of a 6-week group-based Stanford ASMP for people with hip or knee OA. Six hundred participants referred to an orthopaedic surgeon or rheumatologist for hip or knee OA will be recruited from outpatient clinics at 2 public hospitals and community-based private practices within 2 private hospital settings in Victoria, Australia. Participants must be 18 years or over, fluent in English and able to attend ASMP sessions. Exclusion criteria include cognitive dysfunction, previous participation in self-management programs and placement on a waiting list for joint replacement surgery or scheduled joint replacement. Eligible, consenting participants will be randomised to an intervention group (who receive the ASMP and an arthritis self-management book) or a control group (who receive the book only). Follow-up will be at 6 weeks, 3 months and 12 months using standardised self-report measures. The primary outcome is Health-Related Quality of Life at 12 months, measured using the Assessment of Quality of Life instrument. Secondary outcome measures include the Health Education Impact Questionnaire, Western Ontario and McMaster Universities Osteoarthritis Index (pain subscale and total scores), Kessler Psychological Distress Scale and the Hip and Knee Multi-Attribute Priority Tool. Cost-utility analyses will be undertaken using administrative records and self-report data. A subgroup of 100 participants will undergo qualitative interviews to explore the broader potential impacts of the ASMP. Discussion: Using an innovative design combining both quantitative and qualitative components, this project will provide high quality data to facilitate evidence-based recommendations regarding the ASMP. [ABSTRACT FROM AUTHOR]

The integration of routine clinical administrative activities into ongoing rigorous clinical research poses challenges for both clinicians and researchers. This case study describes the development of a responsive database system used to facilitate comprehensive longitudinal research into the outcomes of patients waiting for hip and knee replacement surgery in a large public teaching hospital. The initial research procedure was paper-based, with manual patient matching and data entry. This process was time-consuming and associated with substantial risk of error and omissions, necessitating the design of a better system. An integrated database system was designed to receive daily electronic updates of the orthopaedic waiting-list and scheduled clinic and surgery dates. Using readily available software (Microsoft Access), new patients were identified through specifying inclusion and exclusion criteria which allowed rapid and complete recruitment at time of entry to the waiting-list. The integrated system specified the appropriate timing of multiple follow-up assessments, provided prompt information on recruitment for reporting purposes and integrated multiple linked research projects within one database. Seamless exporting of data to statistical programs for analysis was also enabled. This simple integrated approach facilitated efficient execution of a longitudinal study from recruitment to statistical analysis while maximising confidentiality and minimising resources required. This case study describes the development and design of a simple system which could be easily adapted for database management in hospital or clinic-based settings according to local requirements. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the role of immune status and psychosocial factors in survival from early breast cancer (N=61). Baseline assessments included lymphocyte number and function, natural killer cell activity (NKA), plasma cortisol and prolactin level. Psychosocial measures included anxiety, depression and mental adjustment to cancer and social support. Length of follow-up was 6.1–7.9 years with 14 (23%) breast cancer deaths. In Cox proportional hazards models adjusting for lymph node status two parameters predicted longer survival, low NKA (HR 29 per LLU, p=0.003) and minimizing the illness adjustment (HR 0.64 per scale point, p=0.012). These data provide little evidence for a psychoneuroimmunological mechanism in the survival from breast cancer. While this study is limited due to small sample size, and therefore the possibility of inflated estimates, longer survival in those minimizing the illness is a finding consistent with recent studies; however, the counter-intuitive finding that high NKA predicts shorter survival may be a marker for current disease or response to treatments. Copyright © 2003 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Measurement of Health-Related Quality of Life (HRQoL) of the elderly requires instruments with demonstrated sensitivity, reliability, and validity, particularly with the increasing proportion of older people entering the health care system. This article reports the psychometric properties of the 12-item Assessment of Quality of Life (AQoL) instrument in chronically ill community-dwelling elderly people with an 18-month follow-up. Comparator instruments included the SF-36 and the OARS. Construct validity of the AQoL was strong when examined via factor analysis and convergent and divergent validity against other scales. Receiver Operator Characteristic (ROC) curve analyses and relative efficiency estimates indicated the AQoL is sensitive, responsive, and had the strongest predicative validity for nursing home entry. It was also sensitive to economic prediction over the follow-up. Given these robust psychometric properties and the brevity of the scale, AQoL appears to be a suitable instrument for epidemiologic studies where HRQoL and utility data are required from elderly populations. [Copyright &y& Elsevier]

To evaluate health literacy learning modules designed specifically for physiotherapists in private practice. Mixed-method design was used, evaluating pre-post physiotherapist health literacy knowledge and competencies using questionnaires and semi-structured interviews. One rural and one metropolitan private physiotherapy practice were recruited. Clients, physiotherapists, and other clinic staff. The OPHELIA (Optimizing Health Literacy and Access) process was applied to identify the health literacy needs of clients; co-design interventions; and implement and evaluate the interventions. The health literacy learning modules were co-designed with the physiotherapists and included one 3-h face-to-face workshop, followed by two 1-h videoconference workshops. Health literacy knowledge (rated 1–5 for 10 items, max score 50) and skills (rated 1–5 for 5 items, max score 25) were assessed before and after the workshops. Data were analyzed by paired t-test. Interviews were recorded, transcribed, and thematically analyzed. Health literacy knowledge of 19 health professionals improved after the workshop by 63% (pre 26.0 (7.5), post 41.0 (2.7), p <.001). Health literacy skills improved by 65% (pre 4.2 (3.3), post 21.8 (2.3), p <.001). We identified three themes from interview data: 1) 'the multi-faceted nature of health literacy requires multiple strategies'; 2) 'changing practice to promote understanding'; and 3) 'reflection on roles of multidisciplinary private practice.' Improvements in health literacy knowledge and skills are possible through post-graduate professional development. Workshops changed physiotherapists' understanding of their role in promoting health literacy. [ABSTRACT FROM AUTHOR]

To compare the effect of motivational interviewing (MI) and tailored health literacy (HL) follow-up with usual care on hospitalization, costs, HL, self-management, Quality of life (QOL), and psychological stress in people with chronic obstructive pulmonary disease (COPD). A RCT was undertaken in Norway between March 2018-December 2020 (n = 127). The control group (CG, n = 63) received usual care. The intervention group (IG, n = 64) received tailored HL follow-up from MI-trained COPD nurses with home visits for eight weeks and phone calls for four months after hospitalization. Primary outcomes were hospitalization at eight weeks, six months, and one year from baseline. The trial was registered with ClinicalTrials.gov (NCT03216603) and analysed per protocol. Compared with the IG, the CG had 2.8 higher odds (95% CI [1.3 to 5.8]) of hospitalization and higher hospital health costs (MD=€ −6230, 95% CI [−6510 to −5951]) and lower QALYs (MD=0.1, 95% CI [0.10 to 0.11]) that gives an ICER = − 62,300. The IG reported higher QOL, self-management, and HL (p = 0.02- to <0.01). MI-trained COPD nurses using tailored HL follow-up is cost-effective, reduces hospitalization, and increases QOL, HL, and self-care in COPD. Tailored HL follow-up is beneficial for individuals with COPD and the healthcare system. • People with COPD have higher rates of hospitalizations and health literacy (HL) challenges. • They need follow-up in HL, understanding, accessing, using and remembering health information. • The specialists- and community healthcare should collaborate, and HL be tailored to the individual. • Healthcare professionals need strategies such as motivational interviewing to use in follow-up to improve HL. • Tailored HL follow-up affects hospitalization rate, cost, HL, self-management, and quality of life. [ABSTRACT FROM AUTHOR]

In Australia, surveillance data establish that there are higher rates of late HIV diagnoses among heterosexual migrants from Sub-Saharan Africa and new HIV diagnoses among gay and bisexual men (GBM) from Southeast and Northeast Asia and Latin America. Together, these groups are identified as priority migrant communities in current efforts to eliminate HIV transmissions. HIV health literacy is recognised as a key means of improving access to services and health outcomes. This qualitative paper explores critical HIV health literacy among priority migrant communities in Queensland, Australia. To foreground community voices, peer researchers from priority migrant communities participated in the project design, data collection and analysis, with 20 interviews completed. The findings demonstrate how participants' engagement with HIV health information and services is highly relational and situated within the framework of sexual health and wellbeing. Participants strategically selected where to seek information and who they trusted to help them appraise this information. They further demonstrated reflective capacities in identifying the contextual barriers that inhibit the development of their HIV health literacy. The findings highlight the need for HIV health promotion strategies that embrace a sex positive approach, promote cultural change, and involve collaboration with general practitioners (GPs). [ABSTRACT FROM AUTHOR]