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Purpose: Bleeding is an important health outcome of interest in epidemiological studies. We aimed to develop and validate rule‐based algorithms to identify (1) major bleeding and (2) all clinically relevant bleeding (CRB) (composite of major and all clinically relevant nonmajor bleeding) within real‐world electronic healthcare data. Methods: We took a random sample (n = 1630) of inpatient admissions to Singapore public healthcare institutions in 2019 and 2020, stratifying by hospital and year. We included patients of all age groups, sex, and ethnicities. Presence of major bleeding and CRB were ascertained by two annotators through chart review. A total of 630 and 1000 records were used for algorithm development and validation, respectively. We formulated two algorithms: sensitivity‐ and positive predictive value (PPV)‐optimized algorithms. A combination of hemoglobin test patterns and diagnosis codes were used in the final algorithms. Results: During validation, diagnosis codes alone yielded low sensitivities for major bleeding (0.16) and CRB (0.24), although specificities and PPV were high (>0.97). For major bleeding, the sensitivity‐optimized algorithm had much higher sensitivity and negative predictive values (NPVs) (sensitivity = 0.94, NPV = 1.00), however false positive rates were also relatively high (specificity = 0.90, PPV = 0.34). PPV‐optimized algorithm had improved specificity and PPV (specificity = 0.96, PPV = 0.52), with little reduction in sensitivity and NPV (sensitivity = 0.88, NPV = 0.99). For CRB events, our algorithms had lower sensitivities (0.50–0.56). Conclusions: The use of diagnosis codes alone misses many genuine major bleeding events. We have developed major bleeding algorithms with high sensitivities, which can ascertain events within populations of interest. [ABSTRACT FROM AUTHOR]

Neil Cohn's book, "Who Understands Comics? Questioning the Universality of Visual Language Comprehension," explores the fluency and comprehension of visual narratives. Cohn argues against the belief in the universality and transparency of sequential images, presenting evidence from diverse populations and cultures. He examines the developmental trajectory of visual narrative comprehension in children and the role of fluency in comprehension. Cohn also challenges assumptions about visual ability compensating for verbal language impairments in clinical populations. Overall, the book provides a comprehensive overview of the complexities of visual language comprehension and highlights the need for further research in this area. [Extracted from the article]

This article proposes a framework for analyzing visual discourses of disability in press photographs: the Visual Discourses of Disability (ViDD) framework. The development of this framework is based on an analysis of 670 news photographs of disability published in a Malaysian English-language mainstream newspaper. Within the ViDD, the authors propose the notion of perspectivization of disability : how elements in a photo are configured to frame the perspective of disability. These configurations can be placed on a cline, from perspectivizing to personizing. In addition, the cumulative attitudinal meanings in a news image can be placed on another cline, from enabling to disabling. The ViDD framework combines both clines to understand and explain how news photographs construe disability. This framework can serve as a tool for making informed choices in selecting and publishing images of people with a disability, and of disability. [ABSTRACT FROM AUTHOR]

Background: Identifying patients with diabetes mellitus (DM) is often performed in epidemiological studies using electronic health records (EHR), but currently available algorithms have features that limit their generalizability. Methods: We developed a rule-based algorithm to determine DM status using the nationally aggregated EHR database. The algorithm was validated on two chart-reviewed samples (n = 2813) of (a) patients with atrial fibrillation (AF, n = 1194) and (b) randomly sampled hospitalized patients (n = 1619). Results: DM diagnosis codes alone resulted in a sensitivity of 77.0% and 83.4% in the AF and random hospitalized samples, respectively. The proposed algorithm combines blood glucose values and DM medication usage with diagnostic codes and exhibits sensitivities between 96.9% and 98.0%, while positive predictive values (PPV) ranged between 61.1% and 75.6%. Performances were comparable across sexes, but a lower specificity was observed in younger patients (below 65 versus 65 and above) in both validation samples (75.8% vs. 90.8% and 60.6% vs. 88.8%). The algorithm was robust for missing laboratory data but not for missing medication data. Conclusions: In this nationwide EHR database analysis, an algorithm for identifying patients with DM has been developed and validated. The algorithm supports quantitative bias analyses in future studies involving EHR-based DM studies. [ABSTRACT FROM AUTHOR]

There has been much debate about the state of sexuality education in Malaysia which is heavily influenced by conservative cultural and religious attitudes. To better understand the scenario, this study examines how sexual and reproductive health and rights (SRHR) education is communicated multimodally to adolescents via printed and digital promotional materials. These materials were produced by the three main responsible agencies: the National Population and Family Development Board, the Ministry of Health Malaysia and the Federation of Reproductive Health Association Malaysia. Adopting Kress and Van Leeuwen's visual grammar framework in Reading Images (1996) with a focus on visual composition, social actor analysis and viewer positioning, the materials were found to predominantly address Malay teenagers and carry fear-based messages about abstinence and the consequences of committing zina (a Malay word for illicit sexual relations). Custom and conformity rather than expert legitimation and trust in the social and health authorities dominate local sexual health education. The authors argue that contraception should be advocated through a discourse of health and social risk mitigation and responsible gender roles while respecting cultural and moral obligations. Adolescents also have a right to be informed about options appropriate to their own circumstances in line with Target 3.7 of the United Nations Sustainable Development Goals. Locally, such recommendations would contribute to Malaysia's Shared Prosperity Vision 2030 and Twelfth Malaysia Plan which seek to improve the well-being of young citizens through targeted education and public services. [ABSTRACT FROM AUTHOR]