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Stroke education materials are crucial for the recovery of stroke patients, but their effectiveness depends on their readability. The American Medical Association (AMA) recommends patient education materials be written at a sixth-grade level. Studies show existing paper and online materials exceed patients' reading levels and undermine their health literacy. Low health literacy among stroke patients is associated with worse health outcomes and decreased efficacy of stroke rehabilitation. We reviewed the readability of paper (i.e brochures, factsheets, posters) and online (i.e American Stroke Association, Google, Yahoo!) stroke patient education materials, reading level of stroke patients, accessibility of online health information, patients' perceptions on gaps in stroke information, and provided recommendations for improving readability. A PRISMA-guided systematic literature review was conducted using PUBMED, Google Scholar, and EbscoHost databases and "stroke", "readability of stroke patient education", and "stroke readability" search terms to discover English-language articles. A total of 12 articles were reviewed. SMOG scores for paper and online material ranged from 11.0 - 12.0 grade level and 7.8 - 13.95 grade level respectively. Reading level of stroke patients ranged from 3rd grade to 9th grade level or above. Accessibility of online stroke information was high. Structured patient interviews illustrated gaps in patient education materials and difficulty with comprehension. Paper and online patient education materials exceed the reading level of stroke patients and the AMA recommended 6th grade level. Due to limitations in readability, stroke patients are not being adequately educated about their condition. [ABSTRACT FROM AUTHOR]

Explaining the meaning of the results to the reader is the purpose of the discussion section of a research paper. There are elements of the discussion section that should be included and pitfalls that should be avoided. Always write the discussion section for the reader. Remember that the focus is to help the reader understand the study and that the focus should be on the study data. [ABSTRACT FROM AUTHOR]

This study investigated the readability level of second-grade secondary school scientific stream Chemistry and Physics textbooks in Jordan, determining the effect of gender on the degree of readability, in addition to knowing the order of the textbooks according to the degree of their readability in both books. The current study was conducted to determine the readability level of chemistry and physics textbooks by involving 300 second-grade secondary school students of the public schools affiliated with the Directorate of Education, Jordan. Four Cloze tests were prepared from different topics of both textbooks to measure their readability. The test included four texts with 20 words omitted from each text, and the texts were presented in the same format as in the textbooks, with clear instructions provided for the students. A pilot sample outside the study sample was administered with the test-retest method to confirm the reliability of the four tests for both textbooks. The findings revealed that physics textbooks had a higher level of readability than chemistry textbooks. A significant difference (p≤0.05) was observed based on the type of textbook in the readability of chemistry and physics textbooks. The scientific texts in the chemistry textbook were ordered in light of their readability level. In contrast, the scientific texts in the physics textbook were not ordered in light of their readability level. The study concluded that the readability level of Jordanian Chemistry and Physics textbooks of the second grade of the scientific stream differed significantly (p≤0.05). The study recommends that the Jordan Ministry of Education should appoint a panel of experts to review the textbooks and make the necessary changes to improve their readability level. [ABSTRACT FROM AUTHOR]

Purpose: The Internet is a ubiquitous source of medical information, and natural language processors are gaining popularity as alternatives to traditional search engines. However, suitability of their generated content for patients is not well understood. We aimed to evaluate the appropriateness and readability of natural language processor-generated responses to urology-related medical inquiries. Materials and Methods: Eighteen patient questions were developed based on Google Trends and were used as inputs in ChatGPT. Three categories were assessed: oncologic, benign, and emergency. Questions in each category were either treatment or sign/symptom-related questions. Three native English-speaking Board-Certified urologists independently assessed appropriateness of ChatGPT outputs for patient counseling using accuracy, comprehensiveness, and clarity as proxies for appropriateness. Readability was assessed using the Flesch Reading Ease and Flesh-Kincaid Reading Grade Level formulas. Additional measures were created based on validated tools and assessed by 3 independent reviewers. Results: Fourteen of 18 (77.8%) responses were deemed appropriate, with clarity having the most 4 and 5 scores (P [ .01). There was no significant difference in appropriateness of the responses between treatments and symptoms or between different categories of conditions. The most common reason from urologists for low scores was responses lacking information dsometimes vital information. The mean (SD) Flesch Reading Ease score was 35.5 (SD[10.2) and the mean Flesh-Kincaid Reading Grade Level score was 13.5 (1.74). Additional quality assessment scores showed no significant differences between different categories of conditions. Conclusions: Despite impressive capabilities, natural language processors have limitations as sources of medical information. Refinement is crucial before adoption for this purpose. [ABSTRACT FROM AUTHOR]

The purpose of this study is to develop a socioscientific scenario related to space research. The study consists of four parts: preparation of a draft scenario, obtaining expert opinions, revising and implementing the scenario. The selection of the topic, space research, was based on the following criteria: (i) being current, (ii) being realistic, (iii) including different aspects, (iv) familiarity of students with these topics, and (v) being part of the science curriculum. In developing the scenario content, various sources such as newspaper articles, research findings, scientific publications, popular science materials, teaching resources, websites, blogs, and reports were utilized. The scenario concludes with discussion questions. After developing the draft scenario, experts in science education, special education, and Turkish language education were consulted to evaluate the readability, comprehensibility, suitability for the study, and age level appropriateness. Based on the experts' feedback, the final version of the scenario was prepared and pilot tested with five gifted students. The pilot test results demonstrated that the scenario was effective in stimulating informal reasoning and revealing patterns of informal reasoning through the discussion questions. The research findings were discussed in the context of the literature, and recommendations for future research were provided. [ABSTRACT FROM AUTHOR]

This qualitative study aimed to identify and analyse reading comprehension strategies used by five deaf adults, 22–47 years old, who were close to complete or had already completed their studies at a higher education institution. The method chosen was a partial replication of the one used by Banner and Wang (2011) in their think-aloud study to describe cognitive and metacognitive reading comprehension strategies use among deaf students and adults. The present study included similar interview questions and think-aloud procedures, which were conducted by a deaf teacher, native user of Chilean Sign Language (LSCh). Participants read informational texts and were interrupted three times during the reading task to answer questions about their cognitive and metacognitive processes. Results showed that these deaf adults can use strategies from all the categories identified by Pressley and Afflerbach (1995): constructing meaning, monitoring and improving comprehension, and evaluating comprehension. Some strategies described in the study from Banner and Wang were observed only in individual cases, and some of them were not used at all. The deaf participants of this study also used some strategies that were not included in some previous studies. Since very few deaf adults in Chile have completed higher education, the information provided by this study could be useful in guiding interventions aimed to improve reading comprehension in elementary, high school, and college DHH students. The relevance of early experiences with reading, and motivational factors associated to reading achievement are discussed. [ABSTRACT FROM AUTHOR]

This study aims to assess the quality and readability of online resources regarding postoperative pain control for patients having undergone total shoulder arthroplasty (TSA), along with identifying gaps among the types of information. Three search engines were used to conduct internet searches utilizing a combination of TSA and pain management search phrases. The top 20 web pages from each search engine were gathered, reviewed, and scored by five different evaluators. Scoring was performed using 30-point criteria, integrated into an overall quality of resource (QR) score considered significant for patient education about TSA and pain management according to American Pain Society and American Academy of Orthopaedic Surgeons' published recommendations (Table I). Domain scores (route of administration, type of analgesia, opioid-specific, and general guidance) were calculated by summing the total points and dividing by the total possible score for each domain. The reading level of the Flesch-Kinkaid grade level, the Flesch reading ease, and the simple measure of gobbledygook index was also assessed. The overall readability was low, with a mean Flesch-Kincaid grade level score of 10.3 ± 2.0 and Simple Measure of Gobbledygook score of 9.9 ± 1.5. According to this index, only one website (2.3%) was written below the suggested 6th grade reading level. There was a mean QR score of 9.6/30 points, ranging from 2 to 22 (Table II). Most resources (90.9%) did not achieve greater than 50% of the total available points (greater than 15 out of 30). Of the domains, the mean score for route of administration was 31.8%, types of analgesia was 43.6%, opioid-specific was 11.4%, and general guidance was 43.2%. Opioid-specific scores were lower than all three other domain scores (all P <.001). According to our findings, current online resources for pain management following TSA are written above the average literacy level for adults in the United States and lack educational content, especially regarding opioid-specific discussion and recommendations. Resources must target gaps in online patient education to better inform patients of postoperative pain control, convey expectations, and encourage patient-physician conversations and decision-making. [ABSTRACT FROM AUTHOR]

Objective: The Institute for Safe Medication Practices (ISMP) and the United States Food and Drug Administration (FDA) disseminated widely used lists of drug name pairs involved in wrong-drug errors, for which they recommended tall-man lettering (TML). Linguistic similarity is believed responsible for confusion of these drugs. This study aims to quantify linguistic similarity and other linguistic properties of these generic-generic name pairs. Methods: The FDA's Phonetic and Orthographic Computer Analysis (POCA) software was used to generate numerical similarity scores for the generic-generic name pairs on these lists and to identify conflicts between these names and the names of other marketed products. Within each pair, differences in name length and the number of identical prefix (initial) letters and suffix (final) letters were determined. Results: The selected pairs shared a mean of 2.5 (± 1.8) identical prefix letters and 3.2 (± 2.9) identical suffix letters. The mean POCA score 69.5 (± 9.7), indicated moderate-to-high similarity. POCA scores for individual pairs ranged from 90 (most similar) to 46 (least similar). Individual names averaged 11.2 (± 9.1) high-similarity conflicts with names of other marketed drugs. Conclusions: POCA analysis could be a valuable tool in determining whether linguistic similarity contributes to specific wrong-drug errors. The finding of 11.2 (± 9.1) high-similarity conflicts with names of other marketed drugs is more than for candidate names USAN accepts and suggests the names on the FDA and ISMP lists are linguistically problematic. [ABSTRACT FROM AUTHOR]

Text Summarization models facilitate biomedical clinicians and researchers in acquiring informative data from enormous domain-specific literature within less time and effort. Evaluating and selecting the most informative sentences from biomedical articles is always challenging. This study aims to develop a dual-mode biomedical text summarization model to achieve enhanced coverage and information. The research also includes checking the fitment of appropriate graph ranking techniques for improved performance of the summarization model. The input biomedical text is mapped as a graph where meaningful sentences are evaluated as the central node and the critical associations between them. The proposed framework utilizes the top k similarity technique in a combination of UMLS and a sampled probability-based clustering method which aids in unearthing relevant meanings of the biomedical domain-specific word vectors and finding the best possible associations between crucial sentences. The quality of the framework is assessed via different parameters like information retention, coverage, readability, cohesion, and ROUGE scores in clustering and non-clustering modes. The significant benefits of the suggested technique are capturing crucial biomedical information with increased coverage and reasonable memory consumption. The configurable settings of combined parameters reduce execution time, enhance memory utilization, and extract relevant information outperforming other biomedical baseline models. An improvement of 17% is achieved when the proposed model is checked against similar biomedical text summarizers. [ABSTRACT FROM AUTHOR]

Online reviews significantly influence decision-making in many aspects of society. The integrity of internet evaluations is crucial for both consumers and vendors. This concern necessitates the development of effective fake review detection techniques. The goal of this study is to identify fraudulent text reviews. A comparison is made on shill reviews vs. genuine reviews over sentiment and readability features using semi-supervised language processing methods with a labeled and balanced Deceptive Opinion dataset. We analyze textual features accessible in internet reviews by merging sentiment mining approaches with readability. Overall, the research improves fake review screening by using various transformer models such as Bidirectional Encoder Representation from Transformers (BERT), Robustly Optimized BERT (Roberta), XLNET (Transformer-XL) and XLM-Roberta (Cross-lingual Language model-Roberta). This proposed research extracts and classifies features from product reviews to increase the effectiveness of review filtering. As evidenced by the investigation, the application of transformer models improves the performance of spam review filtering when related to existing machine learning and deep learning models. [ABSTRACT FROM AUTHOR]

Importance: Handwriting legibility is the main criterion for determining whether a child has handwriting difficulties. A comprehensive assessment of handwriting legibility with sound psychometrics is essential to timely identification of handwriting difficulties and outcome measurement after handwriting interventions. Objective: To evaluate the psychometrics of the Computer-Aided Measure of Chinese Handwriting Legibility (CAM-CHL) and to investigate Chinese handwriting legibility in school-age children using the CAM-CHL. Design: Cross-sectional, repeated observation, test–retest. Setting: Elementary schools in Taiwan. Participants: We recruited 25 lower-grade children for the examination of test–retest reliability, 75 children from all grade levels, and 10 senior schoolteachers for the examination of the CAM-CHL's convergent validity and the investigation of handwriting legibility. Outcomes and Measures: Children were asked to copy a set of Chinese characters as legibly as possible. We used the CAM-CHL to assess handwriting legibility in four domains: Size, Orientation, Position, and Deformation. The schoolteachers were asked to subjectively assess the handwriting legibility using a 3-point Likert-type scale. Results: The CAM-CHL demonstrated good to excellent test–retest reliability and acceptable random measurement error in all legibility domains. The CAM-CHL had fair to moderate convergent validity with schoolteachers' perceptions. Additionally, upper-grade children had better handwriting legibility in the Size and Position domains than lower-grade children. Conclusions and Relevance: The CAM-CHL, a comprehensive and objective method of assessing Chinese handwriting legibility, has sound reliability and acceptable validity, suggesting its potential as an outcome measure for school-age children. What This Article Adds: The CAM-CHL can be used in comprehensive evaluations of Chinese handwriting legibility in school-age children. The CAM-CHL has acceptable psychometrics for use as an outcome measure. This study supports the use of the Computer-Aided Measure of Chinese Handwriting Legibility (CAM-CHL) as an outcome measure with acceptable psychometrics for the comprehensive evaluation of the handwriting legibility of school-age children. [ABSTRACT FROM AUTHOR]

Background: It is well-known, but perhaps not well documented, that after the first democratic elections in 1994, South African education was declared standard. However, poverty is widespread in rural-based schools, which negatively impacts the development of quality education for learners. This is attributed to the unique challenges that learners in rural-based schools face that affect their quality of education. Apart from inadequate state funding, insufficient resources, and underqualified teachers, learners are faced with poor reading and writing in foreign languages such as English. Furthermore, teaching language incorporating music as a supportive tool has been neglected. Music can be a powerful tool for language teaching for several reasons. This has become a significant contributor and barrier to effective education. Objective: Therefore, from this background, this article aims to discuss the effectiveness of music education in developing and fostering reading and writing in rural-based schools. Method: A qualitative research method was used embedded within content analysis of existing scholarly writings. Results: Framed within music learning theory, the findings of this article reveal that music education plays an essential role in improving the readability of learners, especially in ruralbased schools. Conclusion: This article concludes by affirming that music education is essential in developing and fostering the reading and writing of languages such as English in rural-based schools. However, this calls for the Department of Basic Education (DBE) to provide a proper music infrastructure in rural-based schools. Contribution: This article provides new insight about the role of music education in improving reading and writing for learners. [ABSTRACT FROM AUTHOR]

Language processing requires the integration of diverse sources of information across multiple levels of processing. A range of psycholinguistic properties have been documented in previous studies as having influence on brain activation during language processing. However, most of those studies have used factorial designs to probe the effect of one or two individual properties using highly controlled stimuli and experimental paradigms. Little is known about the neural correlates of psycholinguistic properties in more naturalistic discourse, especially during language production. The aim of our study is to explore the above issues in a rich fMRI dataset in which participants both listened to recorded passages of discourse and produced their own narrative discourse in response to prompts. Specifically, we measured 13 psycholinguistic properties of the discourse comprehended or produced by the participants, and we used principal components analysis (PCA) to address covariation in these properties and extract a smaller set of latent language characteristics. These latent components indexed vocabulary complexity, sensory-motor and emotional language content, discourse coherence and speech quantity. A parametric approach was adopted to study the effects of these psycholinguistic variables on brain activation during comprehension and production. We found that the pattern of effects across the cortex was somewhat convergent across comprehension and production. However, the degree of convergence varied across language properties, being strongest for the component indexing sensory-motor language content. We report the full, unthresholded effect maps for each psycholinguistic variable, as well as mapping how these effects change along a large-scale cortical gradient of brain function. We believe that our findings provide a valuable starting point for future, confirmatory studies of discourse processing. [ABSTRACT FROM AUTHOR]

Background: Language differences and health literacy limit former refugees' access to health education messages and thus their success in achieving improvements in health behaviours. Method: A suite of simple oral health education resources consisting of dual Arabic/English language pamphlets suited to the needs of Syrian former refugees were co-developed, and feedback was provided by nine focus groups of former refugees. Results: Thirty-nine former refugees resettled in Dunedin, New Zealand provided their feedback. The majority of participants thought these were useful, easy to read, and worthwhile. Major themes included novelty and usefulness, clarity (language/readability) and cultural appropriateness, layout, graphics and format, alternative methods, and venues for distribution. The research confirmed the value of tailoring information to be targeted to specific populations. When treating resettled former refugees, health care providers should deliver information in a way that considers culture, language, education, and background of their clients. Conclusion: Although the participants considered the resources developed in this study to be appropriate and helpful, further research must investigate whether a change in behaviour will result from their utilisation. [ABSTRACT FROM AUTHOR]

Word-predictability measures, such as surprisal, have been used to show that linguistic prediction is an essential neural mechanism for successful comprehension. However, the neural dynamic of this mechanism may differ across individuals listening to the same narrative, revealing possible idiosyncrasies. Therefore, in this study, we investigated the ability of the surprisal measure to address the linguistic prediction in terms of the intersubject phase synchronization (ISPS) among healthy volunteers listening to a narrative during continuous functional Magnetic Resonance Imaging (fMRI) scanning. The data of twenty-seven participants, acquired in a previous study, were re-analyzed to estimate the ISPS associated with an audiobook listening, played forward and backward. Mean ISPS differences between playing conditions were first analyzed across the whole brain. ISPS time-series during the forward condition was explained with both a lexical-only and a semantics-weighted lexical surprisal model of the narrative word series to detect correlations between ISPS and word surprisal values. Compared to the backward condition, mean ISPS was significantly higher during forward condition in a broad network encompassing frontal, temporal, and parietal areas. The lexical-only model disclosed significant negative ISPS-surprisal correlations in the angular gyrus bilaterally, precuneus, left inferior parietal lobule, left middle frontal gyrus, left cerebellum, and left inferior frontal gyrus. The semantics-weighted surprisal model disclosed significant negative ISPS-surprisal correlations in the right angular gyrus, right precuneus, and left inferior frontal gyrus. Besides engaging language-related areas, narrative processing induces significant ISPS levels beyond the language network. The negative ISPS-surprisal correlations observed would signal divergent neural dynamics among individuals, leading to lower group synchronization, when the words to be integrated are characterized by higher surprisal levels. These results provide further support to the use of language models, such as the surprisal, to explain the neural processes of narrative comprehension and additional information into how the human brain exploits predictions during language comprehension. [ABSTRACT FROM AUTHOR]

Although proponents of extensive reading (ER) have recommended easy reading material, book difficulty has been poorly defined and operationalized in previous studies. The present study argues for the use of perceived text difficulty for operationalizing book difficulty based on empirical findings (Holster et al., 2017), reading purposes in ER, and the importance of readers' perspectives. A total of 162 Japanese English-as-a-foreign-language university students rated the difficulty of 15 texts excerpted from graded readers (GRs). The data were analyzed by conducting a many-facet Rasch analysis (Linacre, 1989; Rasch, 1960/1980), where a rating scale model (Andrich, 1978) was tested with persons, texts, and graded readers' levels as the facets of measurement. The results revealed that perceived text difficulty could not replicate the stated difficulty level provided by the GR publisher, reinforcing the necessity of examining perceived text difficulty in ER research and practice in the second and foreign language classroom. [ABSTRACT FROM AUTHOR]

This study modified the educational content of an evidence-based fall prevention intervention to make it visually accessible for older adults with low vision. We piloted the intervention on 9 older adults receiving low vision rehabilitation services. Following the intervention, participants demonstrated increased comprehension of the content, perceived a greater understanding of fall prevention strategies, and reported high satisfaction with the intervention's accessibility. Individuals with low vision may have difficulty reading and comprehending printed educational materials. Modifying print materials to improve readability may result in greater understanding of the educational content. [ABSTRACT FROM AUTHOR]

Objectives: Auditory processing disorder (APD) is due to the deficits in perceptual processing of acoustic information in the auditory system, characterized by poor speech perception of noise, regardless of normal hearing. The variability in speech function of APD children can be partly explained by changes in the encoding of spectro-temporal modulations (STMs) which have been overlooked, despite their significance. Given that enhancing STM sensitivity and its processing can be an appropriate way to improve the listener's ability to retrieve and integrate speech segments covered by noise, we decided to evaluate the effects of STM-based auditory training on speech perception in noise and the reliability of this training in children with APD. Methods: Thirty-five children with APD (8-12 years old) were randomly divided into the training (n=17) and control groups (n=18) to evaluate the effectiveness and reliability of STM training on speech in noise perception. The intervention group was trained to detect STM by 120 trials every day for ten days. The STM detection thresholds and speech perception in noise were evaluated before and immediately after the finalization of formal training sessions in both groups. To address the training reliability, the tests were repeated one month after practice in the training group. Results: Following the completion of STM auditory training, the trained APD children improved notably in STM detection tasks and speech in noise tests (P<0.05). The posttraining progress of STM detection thresholds and consonant-vowel in the noise test was preserved for one month after training (P>0.05), but the word in the noise test, especially in the right ear, was not retained (P<0.05). Discussion: Auditory spectro-temporal modulation training can lead to better processing of STM modulation. Its effects can be generalized to higher-order processing, such as speech perception in noise. Auditory training based on STM processing enhancement can play an essential role in improving speech comprehension in the noise abilities of children with APD. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine the readability level of information on 100 unique websites with information on preeclampsia. Five different readability measures were used to measure each website's readability via an online readability calculator. All five readability measures determined that a vast majority of the sites sampled were written at unacceptable levels (89%+). Independent one-tailed t-tests (α = 0.05) determined that there was no statistical difference in the readability scores of.com vs the other websites on any of the 5 readability assessments. We recommend that efforts be made to simplify language in accordance with plain language recommendations for health information in the United States. [ABSTRACT FROM AUTHOR]

While most students who seek academic support succeed in their courses, some still fail or withdraw. What can we learn about them? In this study, 6,299 undergraduates were enrolled in courses supported with Supplemental Instruction (SI), a form of peer-facilitated academic support open to students in challenging courses. Mean final course grades and success rates of students who attended SI with different levels of frequency were examined to determine the impact of SI by session attendance frequency. Mean final course grades and success rates of students with potential barriers to success defined in previous literature (underrepresented minority, first-generation, and remedial enrollment) were also examined to assess the influence of such potential barriers. One-way ANOVAs and chi-square analyses reveal that the more often students attended SI and the lower their barrier level, the higher their mean final course grades and likelihood of success in the course. A deeper analysis of the demographics of the 75 students who failed or withdrew despite attendance at 5 or more SI sessions is also conducted and confirms the significance of the barriers that traditionally interfere with student success. Implications are discussed along with suggestions pertaining to how to best support the students left behind. [ABSTRACT FROM AUTHOR]

To evaluate the readability, understandability, and actionability of online patient education materials (OPEM) related to breast cancer risk assessment. We queried seven English-language search terms related to breast cancer risk assessment: breast cancer high-risk, breast cancer risk factors, breast cancer family history, BRCA, breast cancer risk assessment, Tyrer-Cuzick, and Gail model. Websites were categorized as: academic/hospital-based, commercial, government, non-profit or academic based on the organization hosting the site. Grade-level readability of qualifying websites and categories was determined using readability metrics and generalized estimating equations based on written content only. Readability scores were compared to the recommended parameters set by the American Medical Association (AMA). Understandability and actionability of OPEM related to breast cancer high-risk were evaluated using the Patient Education Materials Assessment Tool (PEMAT) and compared to criteria set at ≥70%. Descriptive statistics and inter-rater reliability analysis were utilized. 343 websites were identified, of which 162 met study inclusion criteria. The average grade readability score was 12.1 across all websites (range 10.8–13.4). No website met the AMA recommendation. Commercial websites demonstrated the highest overall average readability of 13.1. Of the 26 websites related to the search term breast cancer high-risk, the average understandability and actionability scores were 62% and 34% respectively, both below criteria. OPEM on breast cancer risk assessment available to the general public do not meet criteria for readability, understandability, or actionability. To ensure patient comprehension of medical information online, future information should be published in simpler, more appropriate terms. • The average grade readability score of breast cancer risk assessment online education materials was 12.1 • No website met the AMA recommendation of a sixth-grade reading level. • To ensure patient comprehension, future information should be published in simpler, more appropriate terms. [ABSTRACT FROM AUTHOR]

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Childhood otitis media with effusion (OME) is a frequent disease often misunderstood by parents. Information on the Internet is of variable quality and readability. The aim of this study was to measure the quality and readability of French websites related to OME. An advanced Google search was conducted using the terms "Otite séro-muqueuse OR Otite séreuse". Quality was assessed on DISCERN criteria. Readability was assessed using Flesch Reading Ease Scoring (FRES), Flesch-Kincaid Grade Level (FKGL), the Simple Measure of Gobbledygook (SMOG) and a Fry graph. Medians and standard deviations were calculated. Correlation between quality and readability was assessed on Spearman r coefficient. The first ten websites meeting inclusion and exclusion criteria were evaluated. One had been updated during the last 12 months. Median DISCERN score was 49 ± 13.7/80. Median FRES score was 46 ± 9.5/100. Median USA grade-level estimated by FKGL and SMOG respectively was 11 ± 1.7 and 12 ± 1.5. Six websites had Fry score > 12. One website showed high quality. One had a readability score in the target range (below 9th grade reading level (age 14–15)) according to FRES and FKGL. A suggestive correlation was found between lower SMOG readability and higher quality: r = 0.72 (P = 0.024). Three websites followed the most recent scientific guidelines. Online information about OME was of variable quality and readability. Good quality information tended to be less easily understandable by parents. [ABSTRACT FROM AUTHOR]

Online patient education materials (OPEMs) are an increasingly popular resource for women seeking information about breast cancer. The AMA recommends written patient material to be at or below a 6th grade level to meet the general public's health literacy. Metrics such as quality, understandability, and actionability also heavily influence the usability of health information, and thus should be evaluated alongside readability. A systematic review and meta-analysis was conducted to determine: 1) Average readability scores and reporting methodologies of breast cancer readability studies; and 2) Inclusion frequency of additional health literacy-associated metrics. A registered systematic review and meta-analysis was conducted in Ovid MEDLINE, Web of Science, Embase.com , CENTRAL via Ovid, and ClinicalTrials.gov in June 2022 in adherence with the PRISMA 2020 statement. Eligible studies performed readability analyses on English-language breast cancer-related OPEMs. Study characteristics, readability data, and reporting of non-readability health literacy metrics were extracted. Meta-analysis estimates were derived from generalized linear mixed modeling. The meta-analysis included 30 studies yielding 4462 OPEMs. Overall, average readability was 11.81 (95% CI [11.14, 12.49]), with a significant difference (p < 0.001) when grouped by OPEM categories. Commercial organizations had the highest average readability at 12.2 [11.3,13.0]; non-profit organizations had one of the lowest at 11.3 [10.6,12.0]. Readability also varied by index, with New Fog, Lexile, and FORCAST having the lowest average scores (9.4 [8.6, 10.3], 10.4 [10.0, 10.8], and 10.7 [10.2, 11.1], respectively). Only 57% of studies calculated average readability with more than two indices. Only 60% of studies assessed other OPEM metrics associated with health literacy. Average readability of breast cancer OPEMs is nearly double the AMA's recommended 6th grade level. Readability and other health literacy-associated metrics are inconsistently reported in the current literature. Standardization of future readability studies, with a focus on holistic evaluation of patient materials, may aid shared decision-making and be critical to increased screening rates and breast cancer awareness. • Average readability was 11.81, twice the recommended AMA 6th grade reading level. • Readability studies measure and report readability with variable methodologies. • Many readability studies (40%) do not measure additional health literacy metrics. • Standardizing readability studies may improve evaluation and usability of OPEMs. [ABSTRACT FROM AUTHOR]

Background: A medication guide (MG) is a form of FDA-approved labeling that provides patients with information about certain prescribed drugs so that patients can use these drugs safely and effectively. Given ongoing efforts by FDA and industry to continuously improve MG content and format, we hypothesized that more recently approved MGs for new molecular entities (NMEs) would be shorter and more readable compared to NME MGs approved earlier. Methods: We analyzed 53 NME MGs that were either approved in 2011 (n = 16), 2013 (n = 9), 2015 (n = 12), or 2017 (n = 16) to determine whether MG page length, word count, and readability scores differed by year. Readability was estimated by Flesch Reading Ease, Flesch–Kincaid Grade Level (FKGL), Fry graph (FRY), and Gunning's Fog Index (FOG) scores. Results: Mean page length was significantly lower in 2017 than in 2011 and 2013 (ps <.0001). Mean FKGL scores reflected sentences and words found in 8th grade textbooks, but mean FOG and FRY scores were consistent with sentences and words found in 10th and 11th grade textbooks. Conclusions: Although more recent NME MGs were shorter than older NME MGs, additional research is warranted to determine whether shorter MGs lead to improved readability. Developers choosing to estimate MG readability with equations should consider using multiple readability formulas and weigh the strengths and weaknesses of this approach. Using validated tools to more comprehensively assess MG readability should also be considered. [ABSTRACT FROM AUTHOR]

A developmental study was conducted on the reliability of a developed workbook in Basic Drawing. Three experts, and faculty and students of the University of Eastern Philippines rated the workbook. Results of the study showed that the bases for the workbook were determined by the faculty handling drawing in three years in the UEP System who revealed that students have poor performance in drawing subject. From the bases, suggested inputs in the workbook included lettering, oblique drawing, isometric drawing, geometrical figures, polygon construction, ellipse drawing, orthographic drawing, one-point perspective, two-point perspective and section construction. The workbook was subjected to reliability test and the results showed that the workbook did not meet the requirements for a reliable material in all of its aspects considering that all of the values in accuracy, illustrations and presentations, readability, time allotment, and usefulness were below the acceptable value. As such, the workbook still needed further improvement. [ABSTRACT FROM AUTHOR]

Purpose: A discussion forum was hosted by the Association for Applied Human Pharmacology (AGAH e.V.) to critically debate how to interpret and optimise the Investigator's Brochure (IB) for meaningful risk assessment of early clinical trials. Materials and Methods: Four topics were specifically discussed: deficiencies/uncertainties in IBs, guidance for the investigator, reference safety information, and potential risks for human subjects associated with inadequate non-clinical safety assessment in the IB. In each case, 43 participants took part in a real-time online survey with pre-defined questions to capture the audience's opinion. Results: The 'Summary of Data and Guidance for the Investigator' was considered as the section of the IB with the highest need for improvement with emphasis on readability, comprehensibility, timeliness of data, and appropriateness for risk assessment. It was suggested that the IB should at least be signed by the sponsor's scientist responsible for the content on pharmacology and toxicology. It was agreed that sponsors should consider thoroughly whether changes to an IB constitute a substantial amendment, and that the IB should include a section on the change history. Non-clinical pharmacology studies with negative outcomes should be reported in the IB in order to avoid assessment bias. The reference safety information for expectedness assessment of suspected serious adverse reactions should be provided as a stand-alone section of the IB. Conclusion: The overall consensus was that an optimised presentation of data will ensure the best possible understanding of a compound's characteristics and an optimal benefit-risk assessment which will safeguard the participants in clinical trials. [ABSTRACT FROM AUTHOR]

Public health departments recommend that medical terms should be replaced by plain language in order to make health information understandable to the general public. However, as a heuristic cue to assess information credibility, terminology makes an article appear more convincing and objective to its audience. Terminology can also make the information more engaging and persuasive. Using online articles about vaccine as an example, the present study examined whether practitioners should reduce medical terminology to lower the readability level or increase medical terminology to engage more audience. Computer-aided text analysis was used to analyze 541 pro-vaccine articles and 382 anti-vaccine articles. Anti-vaccine online articles contained significantly more medical terminology than pro-vaccine articles. Medical terminology was not significantly associated with readability. The use of medical terminology positively predicted reader engagement in both pro- and anti-vaccine articles, while the reading level of the articles negatively predicted the pro-vaccine articles' reader engagement. Finally, pro-vaccine articles gradually reduced the use of medical terms and lowered readability from 2007 to 2017. Readability and the amount of medical terminology included in anti-vaccine articles did not significantly change over time. Health practitioners are recommended not to simply reduce the use of medical terminology to lower readability levels when creating health education materials. Other recommendations for designing effective health messages and combating misinformation are provided. [ABSTRACT FROM AUTHOR]

• Only 6% of ED discharge instructions of mTBI complied with national clinical practice guidelines's recommendations. • The mTBI discharge instructions provided at ED were difficult to understand and act upon. • Readability level of mTBI discharge instructions can be optimised without attenuating the important information. • No discharge instructions listed post-concussion symptoms and yet great emphasis given only on emergency symptoms of mTBI. Emergency departments (EDs) routinely provide discharge instructions due to a large number of patients with mild traumatic brain injury (mTBI) being discharged home directly from ED. This study aims to evaluate the quality of available mTBI discharge instructions provided by EDs of Malaysia government hospitals. All 132 EDs were requested for a copy of written discharge instruction given to the patients. The mTBI discharge instructions were evaluated using the Patient Education Materials Assessment-Printable Tool (PEMAT-P) for understandability and actionability. Readability was measured using an online readability tool of Malay text. The content was compared against the discharge instructions recommended by established guidelines. 49 articles were eligible for the study. 26 of the articles met the criteria of understandability, and 3 met the criteria for actionability. The average readability level met the ability of average adult. Most of the discharge instructions focused on emergency symptoms, and none contained post-concussion features. Majority of the discharge instructions provided were appropriate for average people to read but difficult to understand and act upon. Important information was neglected in most discharge instructions. Thus, revision and future development of mTBI discharge instruction should consider health literacy demand and cognitive ability to process such information. [ABSTRACT FROM AUTHOR]

Background: Low literacy skills impact important aspects of communication, including health-related information exchanges. Unsuccessful communication on the part of physician or patient contributes to lower quality of care, is associated with poorer chronic disease control, jeopardizes patient safety and can lead to unfavorable healthcare utilization patterns. To date, very little research has focused on digital communication between physicians and patients, such as secure messages sent via electronic patient portals. Method: The purpose of the current study is to develop an automated readability formula to better understand what elements of physicians' digital messages make them more or less difficult to understand. The formula is developed using advanced natural language processing (NLP) to predict human ratings of physician text difficulty. Results: The results indicate that NLP indices that capture a diverse set of linguistic features predict the difficulty of physician messages better than classic readability tools such as Flesch Kincaid Grade Level. Our results also provide information about the textual features that best explain text readability. Conclusion: Implications for how the readability formula could provide feedback to physicians to improve digital health communication by promoting linguistic concordance between physician and patient are discussed. [ABSTRACT FROM AUTHOR]

Background: Patients are increasingly turning to the internet for health education. Due to the complex pathophysiology, clinic-diagnostic profile, and management spectrum of pituitary tumors, an evaluation of the readability of printed online education materials (POEMs) regarding this entity is warranted. Objective: (1) To apply established readability assessment tools to internet search results on the topic of pituitary tumors. (2) To identify sources of complexity in order to guide the creation POEMs that are in line with the reading level of the target audience. Methodology: After independent, neutral internet search for the phrase "pituitary tumor," the first 100 results were subjected to inclusion criteria matching. Analysis was performed using 5 readability assessment tools including Flesch Reading Ease (FRE), Flesch–Kincaid Grade Level (FKGL), Gunning-Fog Score (GFS), Coleman–Liau Index (CLI), and Simple Measure of Gobbledygook (SMOG). Results: A total of 82 websites met inclusion criteria. All websites were found to be at a higher reading level (P <.01) than the United States Department of Health and Human Services (USDHHS) recommended sixth-grade level. Mean readability scores were as follows: FRE, 38.79; FKGL, 11.27; GFS, 12.83; CLI, 17.31; SMOG, 12.12. Intergroup comparison between FKGL, GFS, CLI, and SMOG yielded that CLI was significantly higher (P <.03). No significant differences in readability were noted between academic and other websites. Conclusion: There is a significant misalignment between the reading level of patients and the readability of pituitary tumor POEMs. This may lead patients to misconceive their diagnoses, management options, and prognosis. [ABSTRACT FROM AUTHOR]

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Background: Informed consent is an important aspect of ethical medical practice. In legal terms, making an intervention without informed consent may mean negligence or malpractice and may lead to legal action, maltreatment, and even attack against the doctor. This study aims to evaluate the readability of informed consent forms (ICFs) used for elective (urology and general surgery) and emergency procedures (emergency medicine and intensive care) by comparing through readability formulas. Method: Elective and emergency ICFs were accessed through the web sites of national health care associations. A total of 387 consent forms were evaluated and the same forms were included only once. A total of 35 consent forms were evaluated for emergency procedures, while a total of 55 consent forms were evaluated for elective procedures. Ateşman and Bezirci-Yılmaz formulas defined for determining the readability level of Turkish texts and Gunning fog and Flesch Kincaid formulas measuring the general readability level were used for calculating the readability level of consent forms. Results: Even though elective ICFs are more readable compared to those of emergency procedures according to Bezirci-Yılmaz formulas, this was statistically insignificant ( P =. 54 \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$P=.54$$\end{document}). The readability of elective consent forms was found to be at a significantly more difficult level to read compared to Ateşman, Gunning fog, and Flesch Kincaid formulas ( P =. 002 \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$P=.002$$\end{document} , P <. 001 \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$P <.001$$\end{document} , P <. 001 \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$P <.001$$\end{document} , respectively). Conclusion: Even though the procedure is emergency or elective, a difficult readability level may cause problems for the doctor in legal phases. Readable and understandable consent forms should be available to be able to explain morbidity and mortality and improve prognosis. Education level of our country should also be considered while preparing these consent forms. [ABSTRACT FROM AUTHOR]

Inpatient discharge education is often suboptimal. Measures of parents' perceived comprehension of discharge instructions are included in national metrics given linkage to morbidity; few studies compare parents' perceived and actual comprehension. We 1) compared parent perceived and actual comprehension of discharge instructions and 2) assessed associations between plan complexity and parent health literacy with overestimation of comprehension (perceive comprehension but lack actual comprehension). Prospective cohort study of English/Spanish-speaking parents (n = 192) of inpatients ≤12 years old and discharged on ≥1 daily medication from an urban public hospital. We used McNemar's tests to compare parent perceived (agree/strongly agree on 5-point Likert scale) and actual comprehension (concordance of parent report with medical record) of instructions (domains: medications, appointments, return precautions, and restrictions). Generalized estimating equations were performed to assess associations between low parent health literacy (Newest Vital Sign score ≤3) and plan complexity with overestimation of comprehension. Medication side effects were the domain with lowest perceived comprehension (80%), while >95% of parents perceived comprehension for other domains. Actual comprehension varied by domain (41%–87%) and was lower than perceived comprehension. Most (84%) parents overestimated comprehension in ≥1 domain. Plan complexity (adjusted odds ratio 3.6; 95% confidence interval 2.9–4.7) and low health literacy (adjusted odds ratio 1.9; 1.3–2.6) were associated with overestimation of comprehension. Parental perceived comprehension of discharge instructions overestimated actual comprehension in most domains. Plan complexity and low health literacy were associated with overestimation of comprehension. Future interventions should incorporate assessment of actual comprehension and standardization of discharge instructions. [ABSTRACT FROM AUTHOR]

The perceived quality of a document is affected by various factors, including grammaticality, readability, stylistics, and expertise depth, making the task of document quality assessment a complex one. In this paper, we explore this task in the context of assessing the quality of Wikipedia articles and academic papers. Observing that the visual rendering of a document can capture implicit quality indicators that are not present in the document text -- such as images, font choices, and visual layout -- we propose a joint model that combines the text content with a visual rendering of the document for document quality assessment. Our joint model achieves state-of-the-art results over five datasets in two domains (Wikipedia and academic papers), which demonstrates the complementarity of textual and visual features, and the general applicability of our model. To examine what kinds of features our model has learned, we further train our model in a multi-task learning setting, where document quality assessment is the primary task and feature learning is an auxiliary task. Experimental results show that visual embeddings are better at learning structural features while textual embeddings are better at learning readability scores, which further verifies the complementarity of visual and textual features. [ABSTRACT FROM AUTHOR]

This study aims to determine the effectiveness of the STEAM (Science, Technology, Engineering, Arts, and Mathematics)-based biotechnology module equipped with flash animation for learning biology in high school. This research was conducted in a high school, involving 32 students of Year XII. The research design was the design model for development of R2D2 with one group pretestposttest design as effectiveness tests. This study utilized a learning design, biotechnology modules equipped with flash animation, instrument testing, validation sheet and questionnaire as research instruments. Data validation and the questionnaire results were then converted into qualitative data into a category. The effectiveness test data were analyzed using the N gain. The results of the validation material, media and users indicated that the module was valid with the final score of 89.85. Students' responses to the module in terms of readability, clarity of presentation, the attractiveness and usefulness of the results were in very good category (81.2%). The effectiveness test showed that result of post-test greater than pre-test and the value of N gain were in the high category (0.72). [ABSTRACT FROM AUTHOR]

In this pilot study, we developed and assessed acceptability of a brochure for women with dense breasts. We measured Flesch-Kincaid Readability of 22 existing breast density educational materials. We then developed a brochure and tested it in two populations of women: 44 safety net hospital patients and 13 Breast Cancer Surveillance Consortium stakeholders. Average grade score of existing materials was 10.0 (range: 5.5–12.7). Our brochure had a grade score of 5.9, and patients reported it was easy to understand. Our plain language brochure could improve patient understanding following mandatory dense breast notification. • Readability of 22 existing breast density educational materials was assessed. • Guided by patient advocates, we developed a print breast density educational brochure. • Brochure acceptability was assessed in focus groups and an online discussion group. • Existing educational materials had low readability. • Our brochure had high readability and can be used to support women with dense breasts. [ABSTRACT FROM AUTHOR]

Background: Patients are increasingly using the Internet to access health information. Patient awareness and education are crucial to advancing the field of PM&R, but many U.S. adults have insufficient health literacy skills to read and understand patient education materials (PEM), frequently written at the 10th-15th-grade level. Reading ability is key for health literacy, but no previous research has assessed the readability of PEM provided by professional PM&R societies.Objectives: Evaluate whether the readability of PM&R PEM meets the NIH-recommended eighth-grade reading level; compare readability of PM&R PEM to two commonly accessed patient resources for sports and rehabilitation medicine topics, handouts from the American Academy of Orthopaedic Surgeons (AAOS) and American Academy of Family Physicians (AAFP), whose readability has been previously analyzed.Design: Cross-sectional study.Methods: Publicly accessible entries within the patient education section of websites sanctioned by professional PM&R societies, as well as the AAOS and AAFP, were analyzed for readability using two validated and widely used tools, the Flesch-Kincaid Grade Level (FKGL) and Simplified Measure of Gobbledygook (SMOG) formulas. Comparative statistics were performed between the three surveyed specialties.Main Outcome Measures: FKGL and SMOG readability scores, which estimate U.S. grade level, or years of education, needed to comprehend text.Results: A total of 167 online PM&R resources were identified and compared to 94 articles from AAOS and 65 from AAFP. Mean SMOG and FKGL levels exceeded the eighth-grade level for both PM&R (SMOG-9.71, 95% CI 9.42-10.0; FKGL-10.35, 95% CI 9.99-10.7) and AAOS (SMOG-9.15, 95% CI 8.96-9.35; FKGL-9.51, 95% CI 9.29-9.74), whereas AAFP met readability guidelines for both measures (SMOG-7.00, 95% CI 6.74-7.27; FKGL-6.76, 95% CI 6.45-7.07). SMOG and FKGL scores suggested significantly higher reading difficulty for PM&R compared to AAOS (SMOG P = .017; FKGL P = .0001) and AAFP (SMOG P < .0001; FKGL P < .0001). Results indicated that 17% of PM&R resources complied with NIH guidelines, vs 8% for AAOS and 83% for AAFP.Conclusions: The average readability of PM&R PEM exceeds the NIH-recommended and average U.S. adult eighth-grade reading level. The physiatry community can make its patient materials more comprehensible and accessible for patients by providing resources at a more appropriate reading level. [ABSTRACT FROM AUTHOR]

Background: More patients are now taking high-risk medicines such as non–vitamin K oral anticoagulants (NOACs). Hence, patient education materials need to be in an understandable format so that they can be empowered to act on their knowledge. Factors such as health literacy and the design of the medicine information material may influence the patient's ability to understand and act on key information. Method: The PRISMA checklist was used to inform the study design. A structured search was conducted to obtain all freely accessible online educational resources designed for patients about the non–vitamin K antagonists (NOACs) during August 2018. Three search engines were used: Google, Yahoo! and Bing, using the search terms "NOAC" and "anticoagulant" combined with "patient/consumer information and patient/consumer resources."We applied the Patient Education Materials Assessment Tool (PEMAT) to evaluate web-based patient education materials in terms of understandability and actionability for patients taking NOACs. Results: Of the 35 materials included, the majority of the materials (n = 32, 91%) were rated as highly understandable (PEMAT score ≥ \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\ge $$\end{document} 70%), and more than three-quarters of all the materials (n = 29, 83%) were rated as poorly actionable (PEMAT score <70%). For understandability, the majority of materials neither provided a summary of the key points nor used visual aids for several items such as simple tables, illustrations, and photographs. For actionability, few materials provided a tangible tool, such as a checklist, to prompt the user into action (n = 4). Few used visual aids such as nonverbal cues to the written instructions (n = 4). Conclusion: To improve the understandability and actionability of most of the NOAC patient education materials, there is a need to include more summaries of information, visual aids, and tangible tools such as checklists. Further research is warranted where patients are involved in providing feedback on the design of medicine information materials for NOACs. [ABSTRACT FROM AUTHOR]

Background: The volunteers approached for participation in a clinical trial should be given detailed and understandable information about the study through an informed consent form (ICF) before enrollment. In this study, we evaluated clinical trial files submitted to the Turkish Medicines and Medical Devices Agency (TITCK) to investigate the compliance to legal legislation and readability of ICFs as well as the factors affecting them. Methods: This is a descriptive, cross-sectional study. We evaluated 160 ICFs in the phase II-IV clinical trial files submitted to TITCK in 2016 to determine their compliance to legislation (n = 160) and to assess their readability (n = 152) using Atesman formula. Overall compliance score was calculated. ICFs were also evaluated in terms of written format (font size, line spacing, section headings) and page count. Statistical analysis was performed with chi-square, Student's t test, analysis of variance, Mann-Whitney U, and Kruskal Wallis analysis. Results: Compliance to legislation and suitability of written format of international trial ICFs were significantly higher than those of national trial ICFs. Most of the national trials were investigator initiated. Readability was low in both national and international trial ICFs where the text was longer in the latter. Conclusion: Results showed that researchers need easy-to-read ICF writing training that fits legal regulations. [ABSTRACT FROM AUTHOR]

Background: Regardless of credentials or expertise, anyone can disseminate nutrition information online, putting the public at risk of receiving unreliable and harmful advice. Registered Dietitians (RD) are nutrition professionals; however, it is unknown how nutrition information or advice online differs between RDs and non-RDs. The objective of this study was to compare nutrition advice communicated on blogs by RD and non-RD bloggers. Methods: A blog-ranking platform, based on search and social media metrics, was used to identify the top-ranked, English-language nutrition blogs written by RDs (n = 10) and non-RDs (n = 10) available through public domain. From each blog, the 20 most recent nutrition-related posts were selected, resulting in a final sample size of 400 blog posts (RD = 200 blog posts; non-RD = 200 blog posts) for qualitative document analysis. Results: Although two themes were found for both RD and non-RD blogs: nutrition recommendations and service promotion/sponsorship, several themes were unique to RD or non-RD blogs. For example, RD blogs were primarily lifestyle blogs that promoted healthy lifestyles. Whereas, non-RD blogs focused on challenging conventional medicine while promoting alternative medicine, establishing their credibility, and had conflicting messages. Conclusions: The internet is an effective tool for communicating nutrition information to a wide audience. RD bloggers can optimize their impact by providing evidence-based nutrition education, addressing current health trends, and making advice achievable for low resource populations. [ABSTRACT FROM AUTHOR]

Reflection involves taking the time to deeply consider a past situation and examine areas of weakness or confusion. It allows identification of learning needs and the development of an action plan to improve future experiences. The aim of this study was to assess second-year dental students' ability to reflect in writing on a clinical rotation when prompted with a guided reflection template. The 76 second-year dental students enrolled in a periodontics clinical rotation course at one U.S. dental school in 2016-17 completed two reflective writing exercises during the semester. A total of 144 journals (after excluding incomplete journals) were analyzed individually by two evaluators following a rubric developed by Kember. This rubric combined Mezirow's seven levels of reflection into four categories: Habitual Action (HA), Understanding (U), Reflection (R), and Critical Reflection (CR). The first two categories are examples of non-reflective thoughts, and the latter two are reflective. The two sets of journals were also compared. On average, the journals contained 0.2% HA, 15.9% U, 73.8% R, and 10.1% CR, averaging 16.1% non-reflective thoughts and 83.9% reflective thoughts. Comparison of the students' first journal submissions to their second showed that the first journals averaged a higher percentage of reflective thought than the second journals: 85.2% vs. 82.7%, respectively. However, the first journals showed a lower average percentage of critical reflection than the second journals: 9.3% vs. 11.3%, respectively. Overall, a high degree of reflection was found in these students' journals after rotation in periodontics clinic, suggesting that reflective journaling can serve as a useful learning exercise to promote continual improvement during clinical training. [ABSTRACT FROM AUTHOR]

The study focused on the impact of scheduling configurations on schools' middle-level social studies test performance levels and barriers affecting time allocated for social studies. Results of South Carolina's accountability assessment system's social studies seventh-grade performance levels in 117 schools, as well as a survey completed by the principals of those schools, were analyzed. No statistically significant difference was found between scheduling configurations used and schools' social studies accountability test performance levels. However, findings did show a statistically significant difference between scheduling configurations used and principals' perceptions of students' preparedness for the next grade level in social studies. Additionally, results showed no clear consensus among principals regarding barriers affecting time allocated for social studies. [ABSTRACT FROM AUTHOR]

The aim and objective of this study was to evaluate the quality and readability of leaflet and online Oral and Maxillofacial Surgery patient information leaflets (PILs). The quality, readability and grade level of each PIL was assessed using the DISCERN, Flesch Reading Ease and Flesh-Kincaid Grade Level instruments respectively. In total, 140 patient information leaflets were assessed. For both leaflet and online PILs, many items of the DISCERN instrument were deemed of low quality and poorly reported. The median overall quality score was 30.2. Variation in the quality and readability scores between leaflet and online PILs and those produced by various societies was evident. Overall, PILs were deemed to be of moderate quality. Online PILs were of lower quality, more difficult to read and aimed at a higher reading age level. [ABSTRACT FROM AUTHOR]

The article offers insights on writing clinical trial summaries in plain language. Topics discussed include the presentation of clinical research through the patients' view, the employment of simple writing and more words to translate medical terms into everyday language, and patient education communication which has a different set of techniques. Also noted are samples of medical jargon and their suggested plain-language translation.

Background: Patients often experience anxiety and feel overwhelmed by the prospect of undergoing open-heart surgery. Randomized controlled trials have found preoperative education materials and counseling to reduce levels of patient anxiety, depression, and perioperative complications following coronary artery bypass grafting (CABG)/valve surgery. Objective: The purposes of this performance improvement project were to develop preoperative teaching materials for cardiac surgery inpatients and evaluate their usability. Methods: Existing CABG/valve teaching materials were evaluated. A new booklet was developed through an iterative process. An expert panel reviewed the final draft using the patient education materials assessment tool for printable materials (PEMAT-P). Patients were surveyed for usability and usefulness. Results: Expert reviewer results for using the PEMAT-P tool for understandability and actionability were 99% and 100%. Of 62 teaching booklets and patient preparedness questionnaires distributed, N = 11 (17.7%) were returned. Nearly all respondents (90.9%) agreed or strongly agreed for questions related to how well the booklet prepared them for surgery. Likewise, 90.9% of respondents agreed or strongly agreed with statements about design and content of the booklet. The hospital consumer assessment of healthcare providers and systems performance reports from October 1, 2016 to December 31, 2016 showed improvement for discharge information (96.2% from 92.2%), symptom to look for (100% from 94.9%), and care transitions (66.2% from 54.3%). Conclusions: The development and implementation of evidence-based preoperative teaching materials help patients and families prepare for open-heart surgery and self-care after discharge. Implications for Nursing: Nurses' utilization of preoperative teaching materials improves patient satisfaction, preparedness, and usefulness. [ABSTRACT FROM AUTHOR]