Employing computational linguistics techniques to identify limited patient health literacy: Findings from the ECLIPPSE study

ObjectiveTo develop novel, scalable, and valid literacy profiles for identifying limited health literacy patients by harnessing natural language processing.Data SourceWith respect to the linguistic content, we analyzed 283 216 secure messages sent by 6941 diabetes patients to physicians within an integrated system''s electronic portal. Sociodemographic, clinical, and utilization data were obtained via questionnaire and electronic health records.Study DesignRetrospective study used natural language processing and machine learning to generate five unique “Literacy Profiles” by employing various sets of linguistic indices: Flesch‐Kincaid (LP_FK); basic indices of writing complexity, including lexical diversity (LP_LD) and writing quality (LP_WQ); and advanced indices related to syntactic complexity, lexical sophistication, and diversity, modeled from self‐reported (LP_SR), and expert‐rated (LP_Exp) health literacy. We first determined the performance of each literacy profile relative to self‐reported and expert‐rated health literacy to discriminate between high and low health literacy and then assessed Literacy Profiles’ relationships with known correlates of health literacy, such as patient sociodemographics and a range of health‐related outcomes, including ratings of physician communication, medication adherence, diabetes control, comorbidities, and utilization.Principal FindingsLP_SR and LP_Exp performed best in discriminating between high and low self‐reported (C‐statistics: 0.86 and 0.58, respectively) and expert‐rated health literacy (C‐statistics: 0.71 and 0.87, respectively) and were significantly associated with educational attainment, race/ethnicity, Consumer Assessment of Provider and Systems (CAHPS) scores, adherence, glycemia, comorbidities, and emergency department visits.ConclusionsSince health literacy is a potentially remediable explanatory factor in health care disparities, the development of automated health literacy indicators represents a significant accomplishment with broad clinical and population health applications. Health systems could apply literacy profiles to efficiently determine whether quality of care and outcomes vary by patient health literacy; identify at‐risk populations for targeting tailored health communications and self‐management support interventions; and inform clinicians to promote improvements in individual‐level care.     

The teaching of medicine at the University Centre for Health Sciences Yaounde,Cameroon: its concordance with the Edinburgh Declaration on Medical Education

Summary. The University Centre for Health Sciences (UCHS) or as it is referred to in French ‘Centre Universitaire des Sciences de la Santé’ (CUSS), became functional in 1969 with the enrolment of the first group of students. The objective of this training programme was to produce a scientifically sound, multipurpose doctor who would be fully operational in a rural setting with minimal equipment and supplies ( Monekosso 1970, 1972 ). The graduate had to be able to adapt readily to new situations and improvise whenever possible, calling for a high degree of competence and initiative. The training strategies adopted by UCHS in 1969 which met this requirement were later found to be in close concordance with the tenets of the World Conference on Medical Education held in Edinburgh in 1988, the Edinburgh Declaration. While some of the terminology may not have been worked out at the time, the programme developed embraced some new concepts hitherto untried or undeveloped:

• — the problem-solving approach in the first to the sixth year;
• — an integrated teaching approach during the first to sixth year of medical training;
• — an integrated medicine internship in district hospitals in the sixth year;
• — a community-based training approach throughout the training;
• — team training of three different health professionals;
• — competency-based training;
• — health services linked research;
• — health services linked training ( Monekosso & Quenum 1978 ).

The concordance of this programme to the Edinburgh Declaration is of great interest in realizing the World Federation for Medical Education programme and implementing the Edinburgh Declaration. The involvement of the three innovative medical schools in the planning stage of the curriculum explains this concordance.     

“课堂理论教学与临床实践教学相结合”的两步教学法理论与实践

阐述了山东大学医学院医学伦理学课程“课程理论教学与临床实践教学相结合”教学模式改革的设想提出过程,具体实施办法和实施效果。实践证明,这一教学法,对于培养医学生的医德信念和医学伦理决策能力是切实有效的,值得在实践中进一步完善和推广。     

医学高职高专教育英语教学模式研究

目的 :探讨适合医学高职高专教育的英语教学模式。方法 :通过对 10个医疗单位和开封医专往届毕业生调查 ,英语在实际工作中的运用 ,并对其调查结果用卡氏检验法进行统计。结论 :现有的医学高职高专教育的英语教学模式不适合医学高职高专教育的培养目标。结果 :医学高职高专教育英语教学模式应把基础英语和专业英语放到同等重要位置 ,旨在培养学生在实际工作中运用语言的能力     

教考分离的实践与探索

通过对学校三个年级学生使用“基础医学课程国家试题库”后的情况分析,认为教考分离是今后考试工作的一个趋势。但目衣使用的试题库在知识点的构成,个别试题质量以及适应性方面有待改进。因此有必要建立适合我校的,反映最新学科进展的试题库,以利于提高教学质量。     

对我校硕士研究生英语教学的思考

本文通过对我校硕士研究生英语水平的现状及存在问题的分析,从听、说、读、写等方面提出了对硕士研究生英语教学改革的思路。     

组织学实验课教学方法的探讨

目的　 探讨组织学实验课的教学方法 ,提高教学质量。方法　 在组织学实验课上 ,分别采用幻灯讲解、放映电视录像等方法对学生进行辅导 ;要求学生分别做绘镜下实像图、模式图、填图作业 ,在此基础上 ,组织学生进行讨论 ,并列表调查学生对上述 3种作业和 2种辅导的反映。结果　 赞成幻灯讲解辅导的人数 ( 71 % )显著地多于赞成放电视录像辅导的人数 ( 2 9% ) ,具有显著性差异 ( P<0 .0 0 1 )。 61 %的学生认为 ,在节约时间、检查发现学习的薄弱环节、增加复习面、调动学习积极性等方面 ,填图优于绘图。赞成做填图作业的人数 ( 94% )显著地多于赞成做绘图作业的人数 ( 4 % ) ,差异显著 ( P <0 .0 0 1 )。结论　 在目前的条件下 ,作为组织学实验课上的集体辅导 ,电视录像并不能完全代替幻灯讲解 ;让学生做填图作业 ,在节约时间、调动学习积极性、发现学习的薄弱环节、加深学习印象、增加复习的广度等方面明显地优于做绘图作业 ,值得在教学中推广。     

Crossed aphasia. An update

The aim of this article is to present an update of a rare but interesting problem: crossed aphasia. This term indicates the presence of aphasia after unilateral cerebral lesion of the hemisphere ipsilateral to the patient's dominant hand. We report two cases, review the most relevant literature, and analyze clinical, neuroanatomical, and neurophysiological aspects, taking in consideration the various interpretations proposed to explain this unusual language disorder.