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Older adults are being asked to play a more active role in the management of their health, however low health literacy is pervasive in this population and is a major impediment to participation in healthcare activities. We sought to identify literacy-related challenges that older adults experience while managing their health. We interviewed 8 nurses who provided direct care to older adult populations. Thematic analysis was conducted exploring barriers, strategies and resources as they relate to health literacy in older adults. Three main themes were identified: literacy barriers, aging process and social resources. Problems associated with health literacy in this population were pervasive. Numeracy, a component of health literacy, was a central factor for a range of medication management problems. However, nurses reported that they were able to fashion solutions that enabled patients to comprehend quantitative information and act on it accordingly, resulting in better health management.

This paper describes a usability evaluation study of an innovative first generation system (Data Dig) designed to retrieve phenotypic data from the large SFARI data set of 2700 families each of which has one child affected with autism spectrum disorder. The usability methods included a cognitive walkthrough and usability testing. Although the subjects were able to learn to use the system, more than 50 usability problems of varying severity were noted. The problems with the greatest frequency resulted from users being unable to understand meanings of variables, filter categories correctly, use the Boolean filter, and correctly interpret the feedback provided by the system. Subjects had difficulty forming a mental model of the organizational system underlying the database. This precluded them from making informed navigation choices while formulating queries. Clinical research informatics is a new and immensely promising discipline. However in its nascent stage, it lacks a stable interaction paradigm to support a range of users on pertinent tasks. This presents great opportunity for researchers to further this science by harnessing the powers of user-centered iterative design.