Objective To use meta-analytic techniques to assess average effect sizes in studies of: (1) the correlation between patient health literacy and both medication and non-medication adherence, and (2) the efficacy of health literacy interventions on improving health literacy and treatment adherence. Methods PsychINFO and PubMed databases were searched (1948–2012). A total of 220 published articles met the criteria for inclusion; effect sizes were extracted and articles were coded for moderators. Results Health literacy was positively associated with adherence (r= .14), and this association was significantly higher among non-medication regimens and in samples with cardiovascular disease. Health literacy interventions increased both health literacy (r = .22) and adherence outcomes (r= .16). Moderator analyses revealed greater intervention efficacy when health literacy and adherence were assessed using subjective measures compared to objective measures. Health literacy interventions had a greater effect on adherence in samples of lower income and of racial-ethnic minority patients than in non-minority and higher income samples. Conclusion This is the first study to synthesize both correlational and intervention studies examining the relationship between health literacy and adherence to both medication and non-medication regimens. Implications These findings demonstrate the importance of health literacy and the efficacy of health literacy interventions especially among more vulnerable patient groups.

Soaring birds migrate in massive numbers worldwide. These migrations are complex and dynamic phenomena, strongly influenced by meteorological conditions that produce thermal and orographic uplift as the birds traverse the landscape. Herein we report on how methods were developed to estimate the strength of thermal and orographic uplift using publicly available digital weather and topography datasets at continental scale. We apply these methods to contrast flight strategies of two morphologically similar but behaviourally different species: golden eagle, Aquila chrysaetos, and turkey vulture, Cathartes aura, during autumn migration across eastern North America tracked using GPS tags. We show that turkey vultures nearly exclusively used thermal lift, whereas golden eagles primarily use orographic lift during migration. It has not been shown previously that migration tracks are affected by species-specific specialisation to a particular uplift mode. The methods introduced herein to estimate uplift components and test for differences in weather use can be applied to study movement of any soaring species.

Diabetes mellitus affects 24 million individuals in the US. In order to manage their diabetes successfully, patients must adhere to treatment regimens that include dietary restrictions, physical activity goals, and self-monitoring of glucose levels. Numerous factors affect patients’ ability to adhere properly, eg, self-efficacy, treatment expectations, health beliefs, and lack of social support. Consequently, diabetes management can be quite complex, requiring lifelong commitment and drastic changes to the patient’s lifestyle. Empirical studies have shown positive and significant relationships between social support and treatment adherence among patients with diabetes. Social support from family provides patients with practical help and can buffer the stresses of living with illness. However, the exact mechanism by which social support affects patient adherence is not yet completely understood. Further research is needed to address how the differences in types of support, such as functional or emotional support, are linked to outcomes for patients. The purpose of this review is to summarize what is known of the impact of social and family support on treatment adherence in patients with diabetes and to explore the current methods and interventions used to facilitate family support for diabetic patients.

Summary 1.Wind power is a fast-growing industry with broad potential to impact volant wildlife. Flight altitude is a key determinant of the risk to wildlife from modern horizontal-axis wind turbines, which typically have a rotor-swept zone of 50-150 m above the ground. 2. We used altitudinal GPS data collected from golden eagles Aquila chrysaetos tracked using satellite telemetry to evaluate the potential impacts of wind turbines on eagles and other raptors along migratory routes. Eagle movements during migration were classified as local (1-5 km h À1 ) or migratory (>10 km h À1 ) and were characterized based on the type of terrain over which each bird was flying, and the bird's distance from wind resources preferred for energy development.3. Birds engaged in local movements turned more frequently and flew at lower altitude than during active migration. This flight behaviour potentially exposes them to greater risk of collision with turbines than when engaged in longer-distance movements. 4. Eagles flew at relatively lower altitude over steep slopes and cliffs (sites where orographic lift can develop) than over flats and gentle slopes (sites where thermal lift is more likely). 5. Eagles predominantly flew near to wind resources preferred by energy developers, and locally moving eagles flew closer to those wind resources with greater frequency than eagles in active migration. 6. Synthesis and applications. Our research outlines the general effects of topography on raptor flight altitude and demonstrates how topography can interact with raptor migration behaviour to drive a potential human-wildlife conflict resulting from wind energy development. Management of risk to migratory species from industrial-scale wind turbines should consider the behavioural differences between both locally moving and actively migrating individuals. Additionally, risk assessment for wind energy-wildlife interactions should incorporate the consequences of topography on the flight altitude of potentially impacted wildlife.

To maximize fitness, flying animals should maximize flight speed while minimizing energetic expenditure. Soaring speeds of large-bodied birds are determined by flight routes and tradeoffs between minimizing time and energetic costs. Large raptors migrating in eastern North America predominantly glide between thermals that provide lift or soar along slopes or ridgelines using orographic lift (slope soaring). It is usually assumed that slope soaring is faster than thermal gliding because forward progress is constant compared to interrupted progress when birds pause to regain altitude in thermals. We tested this slope-soaring hypothesis using high-frequency GPS-GSM telemetry devices to track golden eagles during northbound migration. In contrast to expectations, flight speed was slower when slope soaring and eagles also were diverted from their migratory path, incurring possible energetic costs and reducing speed of progress towards a migratory endpoint. When gliding between thermals, eagles stayed on track and fast gliding speeds compensated for lack of progress during thermal soaring. When thermals were not available, eagles minimized migration time, not energy, by choosing energetically expensive slope soaring instead of waiting for thermals to develop. Sites suited to slope soaring include ridges preferred for wind-energy generation, thus avian risk of collision with wind turbines is associated with evolutionary trade-offs required to maximize fitness of time-minimizing migratory raptors.