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PubMed2005

Clinicians and dyslexia--a computer-based assessment of one of the key cognitive skills involved in drug administration.

AIMS: This research investigates the relationship between dyslexia traits and nurse performance on a laboratory task designed to assess one of the key cognitive skills involved in drug administration. The potential moderating role of perceived performance control was also assessed, based on previous work demonstrating the importance of self-belief as a facilitator of vocational success. BACKGROUND: Dyslexia within the health care professions has been the subject of wide and emotionally charged debate but has not yet been scientifically examined. Those who fear clinicians with dyslexia do so because of a presumed or potential risk to patient health and safety posed by dyslexia-induced performance error (e.g. problems with drug administration). DESIGN, SAMPLE AND METHODS: 46 nurses (40 student nurses and 6 qualified nurses) volunteered to complete a battery of computerised tasks assessing for dyslexia traits (using four accuracy tasks measuring different types of literacy skill), a paired association task designed to measure one of the key cognitive skills involved in drug administration) and a self-report questionnaire (Learning Styles Questionnaire, self-reported reading difficulty and a history of educational support, perceived control over performance). The performance criterion measure was constructed after detailed job analysis (involving analysis of official documentation, in-depth interviews and field observation across a variety of clinical settings) and involved matching drug names to patient names and vice versa. RESULTS: The results showed that the dyslexia indicators (objective and self-report) were significantly correlated with performance on the paired association task. Contrary to expectation however, the perceived control variable was not associated with performance. CONCLUSION: The findings provide tentative support for the idea that some tasks might be problematic for the clinician with dyslexia. Taken in isolation however, it would be inappropriate to conclude that this will necessarily translate into true performance errors without taking into consideration the entire performance context. Suggestions are made for replicating and extending the study to provide a more solid and constructive basis for intervention (e.g. support measures, a built-in checking process).

Adaptation, Psychological↗

PubMed1985

Medical telecommunications--fundamental changes in the art and science of medicine.

The availability of easy to use microcomputers and medical information retrieval systems will result in fundamental and important changes in medical practice. The acquisition of information literacy and fluency will be mandatory techniques for the future practice of medicine and should be taught at the institutional level by faculty sophisticated in the use of information retrieval systems. The resulting improvements in the practice of medicine go beyond simple cost savings to fundamentally alter the ways patients and their disorders are looked upon and handled.

Adult↗

PubMed2001

The readability of pediatric patient education materials on the World Wide Web.

BACKGROUND: Literacy is a national and international problem. Studies have shown the readability of adult and pediatric patient education materials to be too high for average adults. Materials should be written at the 8th-grade level or lower. OBJECTIVE: To determine the general readability of pediatric patient education materials designed for adults on the World Wide Web (WWW). MATERIALS AND METHODS: GeneralPediatrics.com (http://www.generalpediatrics.com) is a digital library serving the medical information needs of pediatric health care providers, patients, and families. Documents from 100 different authoritative Web sites designed for laypersons were evaluated using a built-in computer software readability formula (Flesch Reading Ease and Flesch-Kincaid reading levels) and hand calculation methods (Fry Formula and SMOG methods). Analysis of variance and paired t tests determined significance. RESULTS: Eighty-nine documents constituted the final sample; they covered a wide spectrum of pediatric topics. The overall Flesch Reading Ease score was 57.0. The overall mean Fry Formula was 12.0 (12th grade, 0 months of schooling) and SMOG was 12.2. The overall Flesch-Kincaid grade level was significantly lower (P<.0001), at a mean of 7.1, when compared with the other 2 methods. All author and institution groups had an average reading level above 10.6 by the Fry Formula and SMOG methods. CONCLUSIONS: Pediatric patient education materials on the WWW are not written at an appropriate reading level for the average adult. We propose that a practical reading level and how it was determined be included on all patient education materials on the WWW for general guidance in material selection. We discuss suggestions for improved readability of patient education materials.

Adult↗

PubMed2006

The impact of literacy on health-related quality of life measurement and outcomes in cancer outpatients.

BACKGROUND: Limited evidence exists regarding the relationship between literacy and health-related quality of life (HRQL). Research is needed to develop measurement techniques for low literacy populations and to evaluate potential literacy-related measurement bias. METHODS: A Talking Touchscreen (TT) was developed for an HRQL study. Low (n = 214) and high literacy (n = 201) adult cancer outpatients participated, 70% of whom were from racial/ethnic minorities. Patients completed three questionnaires by TT: FACT-G (cancer-specific), SF-36 (generic health status), and a standard gamble utility questionnaire. Measurement bias was evaluated using item response theory (IRT). Effects of literacy on HRQL were evaluated using regression models. RESULTS: Most (97%) patients rated the TT easy to use. In IRT analysis, 6/27 FACT-G and 12/31 SF-36 items demonstrated literacy bias; this was relatively balanced (10 items 'biased against' low literacy; 8 'biased against' high literacy). Mean literacy group differences were statistically and clinically non-significant for 9/14 HRQL outcomes. Adjustment for bias and/or covariates eliminated most remaining differences. CONCLUSIONS: The TT is valid and useful for HRQL assessment in low literacy populations. There appears to be no systematic literacy bias in reporting HRQL, and low literacy is not an independent risk factor for poorer HRQL.

Cancer Care Facilities↗

PubMedDate not supplied

A program to educate woman who test positive for the hepatitis B virus during the perinatal period.

This computerized patient education program targeted the woman's self-identified learning needs and educated her about etiology, prognosis, and risk of transmission to the infant and other contacts. The educational program is an 18-page color slide presentation intended to be viewed jointly by the nurse and patient during a home visit. It uses strategies known to be effective for women with low literacy skills; the nurse uses this as an adjunct teaching tool to traditional one-on-one verbal instruction. Because many women who test positive for hepatitis B surface antigen during the perinatal period lack basic knowledge regarding the hepatitis B virus, it is essential that nurses teach this important information to at-risk populations.

Adult↗

PubMedDate not supplied

Research collaboratories: their potential for health behavior researchers.

OBJECTIVE: To discuss how online collaboratories can improve the effectiveness and efficiency of research conducted in multiple sites. METHODS: We describe how online collaboratories offer a flexible infrastructure for health behavior researchers, and describe the strengths and weaknesses of such tools and the lessons learned from several systems. RESULTS: Although virtual collaboration requires a technology infrastructure achieved at some cost, including access, connectedness, bandwidth, and technology literacy, the potential benefits to health behavior researchers are extensive. CONCLUSIONS: The range of technical skills and level of comfort with technology are variable in most groups. However, technology tools are just one aspect of the fully realized collaboratory. Ultimately it is the human skills for collaboration rather than the technical excellence of the infrastructure that signals the potential for success.

Computer Communication Networks↗

PubMed2002

Artificial neural networks for infant mortality modelling.

This work aims to investigate a simple to use and easy to interpret methodology for assessing the relative importance of input variables in artificial neural networks (ANNs) applied to epidemiological modelling. The independent variables were 43 variables of the social, economic, environmental and health sector of 59 Brazilian municipalities, and the outcomes were infant mortality rates from these municipalities. Two assays were developed for the ANN modelling. On the first, all 43 variables were taken as input; and on the second, input variables were chosen with the help of factor analysis (FA). The relative importance of the input variables was investigated by means of bootstrap replications of the ANN model on the second assay. Further, multiple linear regression models (LRMs) were developed with the same data set and compared to the ANN models. The FA analysis allowed the selection of eight variables for the second assay. The percent of explained variance R(2) on the ANNs was in the range 0.74-0.80, while linear models had R(2)=0.4-0.5. These findings were validated by the bootstrap replications, in which the ANN models remained with higher R(2) and lower mean square error than the LRMs. The analysis of the best (second) ANN model indicated the highest ranking of importance for the variables literacy, agricultural and livestock sector jobs, number of commercial establishments and telephones. The approach presented here successfully integrated a data-oriented model with expert knowledge, indicating the potentiality of ANN modelling in the prediction, planning and assessment of public health actions.

Brazil↗

PubMedDate not supplied

Systematic identification and intervention for reading difficulty: case studies of children with EAL.

Literacy underpins education. There is now very widespread concern over standards of literacy for children from multi-cultural backgrounds, who are learning English as a second or subsequent language, and who may have special educational needs. Research evidence suggests that the earlier children's difficulties can be identified, the more effective (and cost-effective) intervention will be, provided that the intervention is tailored to the child's abilities and skills. Nicolson and Fawcett have developed systematic procedures for identifying children at risk for reading difficulty, together with systematic teaching strategies to overcome reading difficulty. In this paper we present case studies of children with EAL (English as an additional language) drawn from a controlled study using computer interventions with secondary school children. Our findings indicate that children with EAL may be more resistant to remediation than some children with learning difficulties. The prognosis is more problematic for children with both EAL and dyslexia.

Adolescent↗

PubMed2005

Literacy as a leisure activity: free-time preferences of older children and young adolescents.

PURPOSE: Literacy plays an important role in the development of language in school-age children and adolescents. For example, by reading a variety of books, magazines, and newspapers, students gain exposure to complex vocabulary, and reading becomes a prime opportunity for learning new words. Despite the importance of reading for lexical development, little is known about the pleasure reading habits of today's youth. The first goal of this investigation was to examine the preferences of older children and young adolescents with respect to reading as a leisure-time activity and its relationship to other free-time options that are likely to compete for their attention. The second goal was to examine the amount of time that young people spend reading for pleasure each day and the types of materials they most enjoy reading. The third goal was to determine if preferences for free-time activities and reading materials would evince age- and gender-related differences during the period of development from late childhood through early adolescence (ages 11-15 years). The findings could serve as a reference point for understanding what is reasonable to expect of students during this age range. METHOD: The participants were 100 sixth graders (mean age = 11;7 [years; months]) and 100 ninth graders (mean age = 14;8) attending public schools in western Oregon. Each group contained an equal number of boys and girls, all of whom spoke English as their primary language and were considered to be typical achievers. All participants completed a survey concerning their preferred free-time activities and reading materials. They also reported the average amount of time they spent reading for pleasure each day. RESULTS: The most popular free-time activities were listening to music/going to concerts, watching television or videos, playing sports, and playing computer or video games. Least preferred activities were cooking, running or walking, writing, and arts and crafts. Reading was moderately popular. The most popular reading materials were magazines, novels, and comics; least popular were plays, technical books, and newspapers. Interest in pleasure reading declined during this age range (11-15 years), and boys were more likely than girls to report that they spent no time reading for pleasure. CLINICAL IMPLICATIONS: Given the importance of reading to lexical development in school-age children and adolescents, reading should be promoted as a leisure activity during these years. School-based speech-language pathologists (SLPs), in their role as language consultants, can benefit from understanding the pleasure-reading patterns of today's youth. It is especially important for SLPs to monitor these patterns in students who have language disorders, as it is common for these young people to experience deficits in reading and in lexical development. Fortunately, much can be done in school settings to encourage strong literacy habits in all students if SLPs work collaboratively with teachers, principals, psychologists, librarians, parents, and students. Suggestions are offered for ways to encourage young people to spend more time reading for pleasure.

Adolescent↗

PubMed2004

Methodology of an ongoing, randomized, controlled trial to improve drug use for elderly patients with chronic heart failure.

BACKGROUND: Medications can improve the functioning and health-related quality of life of patients with chronic heart failure (CHF) and reduce morbidity, mortality, and costs of treatment. However, patients may not adhere to therapy. Patients with complex medication regimens and low health literacy are at risk for nonadherence. OBJECTIVE: The primary goal of this project is to develop and assess a multilevel pharmacy-based program to improve patient medication adherence and health outcomes for elderly CHF patients with low health literacy. METHODS: In this 4-year, controlled trial, patients aged 50 years with a diagnosis of CHF who are being treated at Wishard Health Services (Indianapolis, Indiana) are randomly assigned to pharmacist intervention or usual care. Intervention patients receive 9 months of pharmacist support and 3 months of postintervention follow-up. The intervention involves a pharmacist providing verbal and written education, icon-based labeling of medication containers, and therapeutic monitoring. The pharmacist identifies patients' barriers to appropriate drug use, coaches them on overcoming these barriers, and coordinates medication use issues with their primary care providers. Daily updates of relevant monitoring data are delivered via an electronic medical record system and stored in a personal computer system designed to support pharmacist monitoring and facilitate documentation of interventions. To measure medication adherence objectively, electronic monitoring lids are used on all CHF medications for patients in both study groups. Other assessments include self-reported medication adherence, results of echocardiography (eg, ejection fraction), brain natriuretic peptide concentrations, and health-related quality of life. Health services utilization, refill adherence, and cost data derive from electronic medical records. After completion of this study, the data can be used to assess the effectiveness and cost-effectiveness of our intervention. RESULTS: One hundred twenty-two patients have been assigned to receive the intervention and 192 to receive usual care. CONCLUSIONS: Our study aims to improve patients' knowledge and self-management of their medication and to improve medication monitoring in a multilevel pharmacy-based intervention. By doing so, we intend that the intervention will improve the health outcomes of elderly patients with CHF.

Aged↗

PubMed2006

Using digital videos displayed on personal digital assistants (PDAs) to enhance patient education in clinical settings.

OBJECTIVES: To evaluate the effects of using an audiovisual animation (i.e., digital video) displayed on a personal digital assistant (PDA) for patient education in a clinical setting. METHODS: Quasi-experimental study of a prospective technology intervention conducted in an outpatient infectious diseases clinic at an academic medical center. Subjects responded to questions immediately before, immediately after, and 4-6 weeks after watching a digital video on a PDA. Outcome measures include participant knowledge of disease, knowledge of medications, and knowledge of adherence behaviors; attitudes toward the video and PDA; self-reported adherence; and practicality of the intervention. RESULTS: Fifty-one English-speaking adults who were initiating or taking medications for the treatment of HIV/AIDS participated in the study. At visit one, statistically significant improvements in knowledge of disease (p<0.005; paired t-test), knowledge of medications (p<0.005; paired t-test), and knowledge of adherence behaviors (p<0.05; ANOVA) were measured after participants watched the PDA-based video. At visit two (4-6 weeks later), statistically significant improvements in self-reported adherence to the medication regimens (p<0.005; paired t-test) were reported. Participants liked the PDA-based video and indicated that it was an appropriate medium for learning, regardless of their baseline literacy skills. The video education process was estimated to take 25 min of participant time and was viewed in both private and semi-private locations. CONCLUSIONS: Technology-assisted education using a digital video delivered via PDA is a convenient and potentially powerful way to deliver health messages. The intervention was implemented efficiently with participants of a variety of ages and educational levels, and in a range of locations within clinical environments. Additional study of this methodology is warranted.

Adult↗

PubMed2003

Evolving strategies for the incorporation of bioinformatics within the undergraduate cell biology curriculum.

Recent advances in genomics and structural biology have resulted in an unprecedented increase in biological data available from Internet-accessible databases. In order to help students effectively use this vast repository of information, undergraduate biology students at Drake University were introduced to bioinformatics software and databases in three courses, beginning with an introductory course in cell biology. The exercises and projects that were used to help students develop literacy in bioinformatics are described. In a recently offered course in bioinformatics, students developed their own simple sequence analysis tool using the Perl programming language. These experiences are described from the point of view of the instructor as well as the students. A preliminary assessment has been made of the degree to which students had developed a working knowledge of bioinformatics concepts and methods. Finally, some conclusions have been drawn from these courses that may be helpful to instructors wishing to introduce bioinformatics within the undergraduate biology curriculum.

Biology↗

PubMed1993

Computerized assessment of verbal skill.

This paper describes a computerized diagnostic test for the assessment of basic literacy skills in Dutch. Central in this test is a skill labeled word image, referring to the subject's implicit knowledge of orthographic structure. Test norms were obtained in a group of reference subjects. The most notable trend found in the standardization study was that the development of word image performance showed a nonlinear, U-shaped trend. Two case studies are reported. A supplementary validation study, based on test data collected from standard reference groups of normal and poor readers, demonstrated that word image performance is significantly related to between-group differences.

Child↗

PubMed2006

Distance learning for communicating cancer, culture, and literacy: a model for cancer control advancement.

BACKGROUND: Successful cancer control communications and research must reflect an understanding and appreciation of the importance of cultural, linguistic, and literacy needs of diverse audiences. The Cancer, Culture and Literacy Institute, a National Cancer Institute-funded R25 educational project, blends traditional learning approaches with distance learning methodologies to reach demographically dispersed cancer control researchers with new knowledge and skills on culture and literacy. We report here the distance learning component of the project. METHODS: A Web-based learning management system was developed that consisted of three elements: (1) educational modules, (2) communications, and (3) resources. RESULTS: Results from 64 doctorally prepared participants demonstrated high satisfaction with the content, high usefulness of materials, and very good to excellent stimulation of thinking. CONCLUSIONS: Distance learning offers a promising and appealing vehicle for communicating cancer control skills, interventions, and best practices, and thus has the potential to impact the appropriateness of cancer communications, research, and education.

Computer-Assisted Instruction↗

PubMed2026

AI In Leukemia Diagnostics: Complementing the Pathologist's Role.

Artificial intelligence (AI) is reshaping every stage of leukemia diagnostics, from digital morphology and multiparameter flow cytometry to next-generation sequencing, multi-omics analysis, and emerging computational frontiers such as quantum-inspired feature selection. This review outlines how contemporary AI tools can automate labor-intensive quantitation, flag diagnostically salient patterns, and standardize interpretation, while the pathologist or hematologist retains authority over validation, context-specific integration, and clinical decision-making. We present an illustrative "human-in-the-loop" workflow that embeds AI modules within current laboratory information systems, emphasizing points where expert oversight mitigates algorithmic bias and resolves discordant findings. We further map the validator-integrator role across morphology, flow cytometry, and genomic/multi-omic interpretation and provide practical training competencies and use cases for AI-assisted hematopathology. Beyond technical deployment, the article addresses the educational transformation required for sustainable adoption. Drawing on international competency frameworks, including the Digital Health Competencies in Medical Education Framework and recently proposed AI-specific Entrustable Professional Activities, we map core skills that future hematopathologists must master: data-science literacy, critical appraisal of AI outputs, and ethical governance. We highlight evaluated training models such as the Pathology Informatics Essentials for Residents curriculum, Stanford Artificial Intelligence in Machine and Imaging workshops, and College of American Pathologists bootcamps and propose integration strategies adaptable across resource settings. By pairing rigorous validation with targeted education, AI can elevate rather than eclipse the diagnostic role of the leukemia specialist, enabling more timely, reproducible, and personalized patient care.

Humans↗

PubMed2006

Development, validation, and use of English and Spanish versions of the telemedicine satisfaction and usefulness questionnaire.

OBJECTIVES: To describe the development and validation of low literacy English and Spanish versions of the 26-item Telemedicine Satisfaction and Usefulness Questionnaire (TSUQ), report telemedicine satisfaction and usefulness ratings of urban and rural participants in the Informatics for Diabetes Education and Telemedicine (IDEATel) project, and explore relationships between utilization and perceptions of satisfaction and usefulness. METHODS: Data sources included TSUQ, utilization data from IDEATel log files, and sociodemographic data from the annual IDEATel interview. Psychometric analyses were conducted to examine the reliability and validity of TSUQ. Data were analyzed using descriptive, correlational techniques. RESULTS: The principal components factor analysis extracted two factors (Video Visits, alpha=.96, and Use and Impact, alpha=.92) that explained 63.6% of the variance in TSUQ satisfaction scores. All satisfaction and usefulness items had mean scores of greater than 4 on a 5-point scale. Those from urban areas reported significantly higher ratings on both factors than rural participants as did those who did not know how to use a computer at baseline. Mean frequency of utilization of IDEATel components was highest for blood sugar testing followed by web site for reviewing results, blood pressure testing, video visits, and ADA educational Web pages. Associations between utilization and perceptions of satisfaction and usefulness varied among IDEATel components. CONCLUSION: Psychometric analyses support the construct validity and internal consistency reliability of TSUQ, which is available in both English and Spanish at a readability level of 8th grade. Both rural and urban participants reported high levels of satisfaction and found all IDEATel components useful. Further work is needed to examine the relationships between utilization and perceptions of satisfaction and usefulness and to explore the effects of location (urban versus rural) and ethnicity on satisfaction with telemedicine services.

Diabetes Mellitus↗

PubMedDate not supplied

Telecommunications and multimedia systems in education: what developments for radiology?

What are the new perspectives for the radiologist with the development of new technologies of telecommunications? At present, when digitization of most biomedical images has become a reality, problems of remote transmission are simplified. However, telematic literacy is necessary to the radiologist. It is already possible through multimedia supports, as CD-ROM and Internet "navigation". Which are the modalities to access "the network of networks"? Through Internet, hypertexs can be consulted, databases can be accessed, programs and printings can be retrieved, electronic mail can be exchanged. The CD-ROM is a further source of knowledge, especially effective in education due to multimedia and hypertext technology. In this context in the education of the radiologist, the hypertext version of a radiology text, finds its place. It is conceived to offer to each user an individualized approach to learning.

Computer Communication Networks↗

PubMed2005

The information needs of perioperative staff: a preparatory study for a proposed specialist library for theatres (NeLH).

AIMS/OBJECTIVES: To undertake an information-needs analysis of operating theatre staff in order to inform the development of a specialist library of the National Electronic Library of Health (NeLH). SETTING: Three hospitals in an NHS Trust in a rural county in the north of England. METHODS: In-depth interviews, during which staff were questioned in regard to their job roles and information needs, information-seeking behaviour, access to computers, use and perceptions of the NeLH, and what they would like from a specialist library. RESULTS: Information needs were found to concern direct care, professional and academic development, medical devices knowledge and administration. Currency and speed of delivery were the key information requirements. Poor communication appeared to be a major problem for many staff and inhibited efficient information exchange. When using the Web, both clinical and non-clinical staff searched in a similar fashion to health consumers generally, despite their need for highly specialist information. Most respondents reacted warmly to the idea of the proposed National Electronic Library for Theatre Staff (NeLTS) and made several practical suggestions for suitable material. However, access was problematic for nurses and might prove to be an obstacle to take-up of the Specialist Library. CONCLUSIONS: Communication difficulties, the fragmentation of data in the field and the consequent difficulties of finding information point to the need for an NeLTS. However, for this library to embrace and succeed with all the various groups that constitute the operating theatre staff, issues of access and digital literacy need to be addressed.

England↗