25,797 research outputs found

    A method to quantify residents\u27 jargon use during counseling of standardized patients about cancer screening

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    Background Jargon is a barrier to effective patient-physician communication, especially when health literacy is low or the topic is complicated. Jargon is addressed by medical schools and residency programs, but reducing jargon usage by the many physicians already in practice may require the population-scale methods used in Quality Improvement. Objective To assess the amount of jargon used and explained during discussions about prostate or breast cancer screening. Effective communication is recommended before screening for prostate or breast cancer because of the large number of false-positive results and the possible complications from evaluation or treatment. Participants Primary care internal medicine residents. Measurements Transcripts of 86 conversations between residents and standardized patients were abstracted using an explicit-criteria data dictionary. Time lag from jargon words to explanations was measured using “statements,” each of which contains one subject and one predicate. Results Duplicate abstraction revealed reliability κ = 0.92. The average number of unique jargon words per transcript was 19.6 (SD = 6.1); the total jargon count was 53.6 (SD = 27.2). There was an average of 4.5 jargon-explanations per transcript (SD = 2.3). The ratio of explained to total jargon was 0.15. When jargon was explained, the average time lag from the first usage to the explanation was 8.4 statements (SD = 13.4). Conclusions The large number of jargon words and low number of explanations suggest that many patients may not understand counseling about cancer screening tests. Educational programs and faculty development courses should continue to discourage jargon usage. The methods presented here may be useful for feedback and quality improvement efforts

    The role of word frequency and morpho-orthography in agreement processing

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    Agreement attraction in comprehension (when an ungrammatical verb is read quickly if preceded by a feature-matching local noun) is well described by a cue-based retrieval framework. This suggests a role for lexical retrieval in attraction. To examine this, we manipulated two probabilistic factors known to affect lexical retrieval: local noun word frequency and morpho-orthography (agreement morphology realised with or without –s endings) in a self-paced reading study. Noun number and word frequency affected noun and verb region reading times, with higher-frequency words not eliciting attraction. Morpho-orthography impacted verb processing but not attraction: atypical plurals led to slower verb reading times regardless of verb number. Exploratory individual difference analyses further underscore the importance of lexical retrieval dynamics in sentence processing. This provides evidence that agreement operates via a cue-based retrieval mechanism over lexical representations that vary in their strength and association to number features

    Measuring Justice

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    The research imperative of refining ways to measure justice is important and necessary. Our work as lawyers improves the more we know about our effectiveness and the more our choices are evidence based. Nevertheless, quantifying the work of a lawyer is not easy. How do we ensure that any measure of justice captures outcomes for both trial-based advocacy and non-trial-based advocacy on behalf of clients, including negotiated outcomes? How do we quantify the role lawyers play in listening to our clients, explaining the systems in which they operate, and supporting them through often very difficult times in their lives? How do we ensure that any measure of justice includes a client’s sense of the process as well as the outcome? How do we make sure that what we measure does not suggest the limits of what is possible or desired

    Spoken word recognition in adolescents with autism spectrum disorders and specific language impairment

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    Spoken word recognition, during gating, appears intact in specific language impairment (SLI). This study used gating to investigate the process in adolescents with autism spectrum disorders plus language impairment (ALI). Adolescents with ALI, SLI, and typical language development (TLD), matched on nonverbal IQ listened to gated words that varied in frequency (low/high) and number of phonological onset neighbors (low/high density). Adolescents with ALI required more speech input to initially identify low-frequency words with low competitor density than those with SLI and those with TLD, who did not differ. These differences may be due to less well specified word form representations in ALI

    Quantifying the Return on Investment of After School Programming

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    Each fiscal year, there is a battle on Capitol Hill as lawmakers wrestle with reconciling political promises to financial reality. This process is completed with the goal of efficiently allocating scarce resources, in this case tax dollars and other government revenue, across the needs of the over 325 million diverse residents of the United States. Some budget items garner almost universal support, such as defense funding, infrastructure and education. While individuals may differ on how much funding each of these causes should receive, almost all agree that they should be funded by the federal government. Other budget items, such as universal healthcare, food stamps and the National Endowment for the Arts are partisan issues, with some believing they are key government services and others believing they are a waste of their hard-earned money. Daily, many households across the country play out this same battle. Families decide a wide range of financial issues: whether they wish to go on a vacation, send their children to private school, buy a bigger home or donate to causes they care about. Individuals also decide how to spend their time. Should they volunteer more, or use their free hours to learn a new skill or take up a new hobby? Even more specifically, families and individuals must decide where to spend their time and money. Though in the private sector companies typically make decisions based on financial metrics, often times government and non-profit programs are either fiercely opposed or supported based solely on anecdotal evidence or moral concepts. The introduction of these opinions in the budget making process may limit both the government’s and individual’s ability to truly allocate resources efficiently and effectively. Lately, an easy target of federal spending cuts has been the Department of Education. Although most agree the government is obligated to fund public education to some extent, the many other programs funded by the Department of Education have come under fire. According to a Washington Post article from March of 2017, one example is the $1.2 billion dollars in federal grants that are the backbone of funding for many of America’s after school programs. These grants, known as 21CCLC grants, enable over 1.6 million children across the country, to access after school programming (Brown). While these cuts did not become reality in the budget passed in late March of 2018, the threat to these programs is real. If the government cuts funding, individuals may take it as a sign that these programs do not work and reduce their own donations of time and money to the cause. The most efficient way for the government and households to reduce bias and effectively allocate resources is likely to borrow a page from the private sector and perform a numbers-based analysis of all potential options. While anecdotal evidence and moral leanings are still an important part of final decision making, beginning the process with a study of Return on Investment (ROI) improves the cost efficiency of budgets. This study will explore the potential calculation and application of ROI to after-school programming with the goal of showing these programs to be a net positive investment for the government, individuals and society at large

    Islands in the grammar? Standards of evidence

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    When considering how a complex system operates, the observable behavior depends upon both architectural properties of the system and the principles governing its operation. As a simple example, the behavior of computer chess programs depends upon both the processing speed and resources of the computer and the programmed rules that determine how the computer selects its next move. Despite having very similar search techniques, a computer from the 1990s might make a move that its 1970s forerunner would overlook simply because it had more raw computational power. From the naïve observer’s perspective, however, it is not superficially evident if a particular move is dispreferred or overlooked because of computational limitations or the search strategy and decision algorithm. In the case of computers, evidence for the source of any particular behavior can ultimately be found by inspecting the code and tracking the decision process of the computer. But with the human mind, such options are not yet available. The preference for certain behaviors and the dispreference for others may theoretically follow from cognitive limitations or from task-related principles that preclude certain kinds of cognitive operations, or from some combination of the two. This uncertainty gives rise to the fundamental problem of finding evidence for one explanation over the other. Such a problem arises in the analysis of syntactic island effects – the focu

    Shedding New Light on Kaon-Nucleon/Nuclei Interaction and Its Astrophysical Implications with the AMADEUS Experiment at DAFNE

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    The AMADEUS experiment deals with the investigation of the low-energy kaon-nuclei hadronic interaction at the DA{\Phi}NE collider at LNF-INFN, which is fundamental to respond longstanding questions in the non-perturbative QCD strangeness sector. The antikaon-nucleon potential is investigated searching for signals from possible bound kaonic clusters, which would open the possibility for the formation of cold dense baryonic matter. The confirmation of this scenario may imply a fundamental role of strangeness in astrophysics. AMADEUS step 0 consisted in the reanalysis of 2004/2005 KLOE dataset, exploiting K- absorptions in H, 4He, 9Be and 12C in the setup materials. In this paper, together with a review on the multi-nucleon K- absorption and the particle identification procedure, the first results on the {\Sigma}0-p channel will be presented including a statistical analysis on the possible accomodation of a deeply bound stateComment: 6 pages, 2 figure, 1 table, HADRON 2015 conferenc
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