Search

Cost-effectiveness analysis is increasingly relevant in humanitarian action. The cost of response has increased exponentially in the past decade, alongside concurrent donor budget restrictions. However, there remains limited comprehension and application of these methods in this field. This paper documents methods developed for use within Action Against Hunger, an international humanitarian organisation, in response to a lack of understanding of this topic within the humanitarian community and limited evidence of the cost-effectiveness of humanitarian action. These methods encompass costs to both implementing institutions and participating communities. Activity-based cost analyses are conducted to assess resources per programme activity. Cost-effectiveness is evaluated using successful programme outcomes, and uncertainty is appraised via sensitivity analysis. This paper aims to advance knowledge, stimulate discussion, and promote the adoption of cost-effectiveness methods for building the evidence base for humanitarian action, including consideration of community costs, to enable analytical outputs that are useful for managers and policymakers alike.

Controversy exists concerning the origins of object permanence, with different measures suggesting different conclusions. Looking measures have been interpreted as evidence for early understanding (Baillargeon, 1987, Developmental Psychology, 23:655), while Piaget (The construction of reality in the child, 1954) interpreted perseverative reaching behaviour on his AB search task to be indicative of limited understanding. However, looking measures are often reported to be an unreliable index of infant expectation (Haith, 1998, Infant Behaviour and Development, 21:167) and reaching behaviour has been explained by many alternative processes (e.g. Smith et al., 1999, Psychological Review, 106:235; Topál et al., 2008, Science, 321:1831). We aimed to investigate whether social looking (Dunn & Bremner, 2017, Developmental Science, 20:e12452; Walden et al., 2007, Developmental Science, 10:654) can be used as a valid measure of infant expectation of object location during the Piagetian AB search task. Furthermore, we aimed to test the social accounts of perseverative reaching by investigating how the direction of experimenter gaze would affect infant search and social behaviour. Infant search and social behaviour was compared on B trials across three different conditions, namely experimenter gaze to midline, location A and location B. Search performance significantly improved when the experimenter looked to location B. Infant social looking indicated that infants expect the object to be found in the location in which they search and are actively seeking information about object location from the experimenter. We conclude that social looking is a valid index of infant expectation that has provided support for the importance of the social environment on the AB search task. This casts doubt on the potential for this task to provide information related to the development of object permanence in infancy., In comparison to infant search and social behaviour on a standard version of the A‐not‐B search task, when the experimenter directed their gaze towards the correct location on B trials, infants made fewer search errors. When the experimenter directed their gaze towards the incorrect location, infants made more search errors and initiated more social looks. We conclude that understanding the infant's active social behaviour in this task is integral to understanding the A‐not‐B search error.

Motor experiences and active exploration during early childhood may affect individual differences in a wide range of perceptual and cognitive abilities. In the current study, we suggest that active exploration of objects facilitates the ability to process object forms and magnitudes, which in turn impacts the development of numerosity perception. We tested our hypothesis by conducting a preregistered active exploration intervention with 59 8‐month‐old infants. The minimal intervention consisted of actively playing with and exploring blocks once a day for 8 weeks. In order to control for possible training effects on attention, we used book reading as a control condition. Pre‐ and post‐test assessments using eye‐tracking showed that block play improved visual form perception, where infants became better at detecting a deviant shape. Furthermore, using three control tasks, we showed that the intervention specifically improved infants' ability to process visual forms and the effect could not be explained by a domain general improvement in attention or visual perception. We found that the intervention did not improve numerosity perception and suggest that because of the sequential nature of our hypothesis, a longer time frame might be needed to see improvements in this ability. Our findings indicate that if infants are given more opportunities for play and exploration, it will have positive effects on their visual form perception, which in turn could help their understanding of geometrical concepts., Playing with blocks leads 8‐month‐old infants to develop better visual form perception, conceptualized here as detecting a deviant shape, compared to infants who were assigned to a reading control group.

ObjectiveAccording to the precaution adoption process model, cervical screening nonparticipants represent a heterogeneous group including those who are unaware of, unengaged with, or undecided about screening, as well as intenders and decliners. We aimed to explore beliefs about cervical screening among these different types of nonparticipant.MethodsSemistructured interviews were carried out with women aged 26 to 65 years living in Britain (n = 29). Women were purposively sampled to represent different nonparticipant types. Interviews were transcribed verbatim, and data were analysed thematically using framework analysis.ResultsThe salience of some barriers to screening varied between different types of nonparticipant. Bad experiences were prominent in the discussions of women who had decided not to attend, while practical barriers were more prominent among intenders. There was also some overlap between nonparticipant types. For example, many of the undecided women described not wanting to go for screening, but with less certainty than decliners. Some intenders (particularly those who had not been screened before) described not really wanting to attend but feeling they ought to. Women's views on the invitation/reminder process also varied; intenders and maintainers appreciated written reminders and general practitioner (GP) prompts but decliners sometimes perceived these as “badgering.” Throughout the interviews, women described changing views on screening in the wider context of ageing and motherhood.ConclusionsThe salience of screening barriers varies by nonparticipant type, offering possibilities for tailored interventions. However, the fluidity of women's stage of screening adoption might have implications for this approach to intervention design.

Objective: The research compared and contrasted hand-scoring and computerized methods of evaluating the grade level of patient education materials that are distributed at an academic medical center in east Tennessee and sought to determine if these materials adhered to the American Medical Association’s (AMA’s) recommended reading level of sixth grade.Methods: Librarians at an academic medical center located in the heart of Appalachian Tennessee initiated the assessment of 150 of the most used printed patient education materials. Based on the Flesch-Kincaid (F-K) scoring rubric, 2 of the 150 documents were excluded from statistical comparisons due to the absence of text (images only). Researchers assessed the remaining 148 documents using the hand-scored Simple Measure of Gobbledygook (SMOG) method and the computerized F-K grade level method. For SMOG, 3 independent reviewers hand-scored each of the 150 documents. For F-K, documents were analyzed using Microsoft Word. Reading grade levels scores were entered into a database for statistical analysis. Inter-rater reliability was calculated using intra-class correlation coefficients (ICC). Paired t-tests were used to compare readability means.Results: Acceptable inter-rater reliability was found for SMOG (ICC=0.95). For the 148 documents assessed, SMOG produced a significantly higher mean reading grade level (M=9.6, SD=1.3) than F-K (M=6.5, SD=1.3; p

A pilot study assessed an electronic informed consent model within a randomized controlled trial (RCT). Participants who were recruited for the parent RCT project were randomly selected and randomized to either an electronic consent group ( n = 32) or a simplified paper-based consent group ( n = 30). Results from the electronic consent group reported significantly higher understanding of the purpose of the study, alternatives to participation, and who to contact if they had questions or concerns about the study. However, participants in the paper-based control group reported higher mean scores on some survey items. This research suggests that an electronic informed consent presentation may improve participant understanding for some aspects of a research study.

Inconsistencies among testing methods and results in previous research prompted this study that builds upon a systematic usability testing research framework to better understand how interface medium influences users' abilities to detect usability flaws in applications. Interface medium was tested to identify its effects on users' perceptions of usability and abilities to detect usability problems and severe usability problems. Results indicated that medium has no effect on users' abilities to detect usability problems or perceptions of usability. However, results did indicate an interaction between the medium and the tested application in which users were able to identify significantly more usability problems on a higher fidelity medium using a particular application. Results also indicated that as users' perceptions of an application's usability increases, the users are less able to detect usability problems in that application. Usability testing should begin early in the design process, even if low fidelity mediums will be used.

Objective: To study the ability of patients with semantic dementia to understand actions, in order to examine the contribution of semantic memory to action comprehension. Methods: The ability to comprehend symbolic and instrumental actions was assessed in 6 patients with semantic dementia and 10 healthy controls. The patients were also given the imitation test of meaningful and meaningless actions. Results: In all patients with semantic dementia, comprehension of both symbolic and instrumental actions was defective. The comprehension of symbolic actions was more impaired than that of instrumental actions. Their ability to imitate other’s actions was well preserved. Conclusion: This study showed that comprehension of action was impaired in semantic dementia, suggesting that semantic memory has an important role in comprehension of human action.

Objective: To evaluate interictal language functions in patients with medically intractable left and right sided mesial temporal lobe epilepsy (TLE). Methods: Spontaneous speech, language comprehension, confrontation naming, repetition, reading, writing, and word fluency were examined in 12 patients with left sided TLE and 11 patients with right sided TLE. Results: Four patients out of 23 displayed language deficits in more than one language domain. Three further patients exhibited isolated language deficits. Linguistic deficits were observed in both left TLE and right TLE. In quantitative analyses left and right TLE only differed in spontaneous speech (p = 0.02); no difference was found in other language functions, laterality quotient of Wada test, or overall IQ. Qualitative error analysis of object naming, however, showed typical errors associated only with left TLE. Patients with linguistic deficits were older at testing compared to patients without linguistic deficits (p = 0.003), whereas other factors including side of TLE, handedness, educational level, age at epilepsy onset, and duration of epilepsy did not differ between groups. Conclusions: Possible explanations for these findings include neuronal cell loss and deafferentiation in cortical areas, and disruption of the basal temporal language area pathways. Our study suggests that some patients with chronic mesial TLE exhibit linguistic deficits when specifically tested, and underlines the need to routinely investigate linguistic functions in TLE.

Context: Patients with primary progressive aphasia have sentence comprehension difficulty, but the longitudinal course of this deficit has not been investigated. Objective: To determine how grammatical, single word meaning, and working memory factors contribute to longitudinal decline of sentence comprehension in primary progressive aphasia. We hypothesised partially distinct patterns of sentence comprehension difficulty in subgroups of patients with progressive non-fluent aphasia (PNFA) and semantic dementia (SD). Design: Cohort. Setting: Institutional out patient referral centre. Patients: PNFA (n = 14), SD (n = 10). Main outcome measure: Sentence comprehension accuracy. Results: PNFA patients were significantly impaired at understanding grammatically complex sentences when first seen, and this was more evident than impairment of their comprehension of grammatically simple sentences (p

Text simplification is a challenging NLP task and it is particularly important in the health domain as most health information requires higher reading skills than an average consumer has. This low readability of health content is largely due to the presence of unfamiliar medical terms/concepts and certain syntactic characteristics, such as excessively complex sentences. In this paper, we discuss a simplification tool that was developed to simplify health information. The tool addresses semantic difficulty by substituting difficult terms with easier synonyms or through the use of hierarchically and/or semantically related terms. The tool also simplifies long sentences by splitting them into shorter grammatical sentences. We used the tool to simplify electronic medical records and journal articles and results show that the tool simplifies both document types though by different degrees. A cloze test on the electronic medical records showed a statistically significant improvement in the cloze score from 35.8% to 43.6%.

Aims: To investigate the dynamic time course of transient global amnesia (TGA)—that is, the process of recovery and the interindividual variability—by testing four patients during the day of TGA itself (on three occasions) and at follow up (on two occasions). Methods: A specially designed protocol focusing on semantic (both conceptual and autobiographical knowledge) and episodic (both anterograde and retrograde components) memory. Results: Every patient showed marked impairment of both anterograde and retrograde episodic memory during the acute phase, with a relative preservation of personal and conceptual semantic knowledge. During the following phase, the authors observed similarities and differences among the patients' patterns of recovery. In general, retrograde amnesia recovered before the anterograde amnesia and anterograde episodic memory was recovered gradually in every case. In contrast, shrinkage of retrograde amnesia was more heterogeneous. In two of the patients, this shrinkage followed a chronological gradient and the most remote events were recovered first. In the two other patients, it depended more on the strength of the trace, and there was no temporal gradient. For the latter, an executive deficit could account for difficulties in accessing both conceptual knowledge and autobiographical memories. Conclusions: This profile of recovery suggests a "neocortical to medial temporal" process in every case, and the possibility of an additional frontal dysfunction in some cases. Hence, the acute phase seems to be characterised by a common episodic impairment. This variability between subjects appears in the recovery phase with two different patterns of impairment.

ContextTo compare family physicians' ability to retain information when reading a review article on paper vs on screen, and in their mother tongue vs in English.MethodsRandomized trial of 114 Scandinavian family physicians who read a review article in October or November 2000 from the Journal of Trauma for 10 minutes either on paper and in English, on screen and in English, on paper in their mother tongue, or on screen in their mother tongue. To assess comprehension, they immediately completed a questionnaire with 6 open questions about 13 key facts from the review article. Sum score was on a scale from 0 (no correct answers) to 13 points (all questions answered correctly).ResultsThere was no significant difference between readers of paper vs screen versions, with a median (interquartile range [IQR]) of 4 (2-6) vs 4 (2-5), respectively (P = .97). Physicians who read in their mother tongue scored significantly higher than those who read in English, with a median (IQR) of 4 (3-6) vs 3 (2-4) (P = .01).ConclusionThe medium (paper vs screen) did not influence the ability of family physicians to retain medical information. They best retained medical information when reading in their mother tongue.

E-readers are fast rivaling print as a dominant method for reading. Because they offer accessibility options that are impossible in print, they are potentially beneficial for those with impairments, such as dyslexia. Yet, little is known about how the use of these devices influences reading in those who struggle. Here, we observe reading comprehension and speed in 103 high school students with dyslexia. Reading on paper was compared with reading on a small handheld e-reader device, formatted to display few words per line. We found that use of the device significantly improved speed and comprehension, when compared with traditional presentations on paper for specific subsets of these individuals: Those who struggled most with phoneme decoding or efficient sight word reading read more rapidly using the device, and those with limited VA Spans gained in comprehension. Prior eye tracking studies demonstrated that short lines facilitate reading in dyslexia, suggesting that it is the use of short lines (and not the device per se) that leads to the observed benefits. We propose that these findings may be understood as a consequence of visual attention deficits, in some with dyslexia, that make it difficult to allocate attention to uncrowded text near fixation, as the gaze advances during reading. Short lines ameliorate this by guiding attention to the uncrowded span.