The use of Natural Language Processing techniques to support Health Literacy: an evidence-based review

Background and objectives: To conduct a literature search and analysis of the existing research using natural language processing for improving or helping health literacy, as well as to discuss the importance and potentials of addressing both fields in a joint manner. This review targets researchers who are unfamiliar with natural language processing in the field of health literacy, and in general, any researcher, regardless of his or her background, interested in multi-disciplinary research involving technology and health care. Methods: We introduce the concepts of health literacy and natural language processing. Then, a thorough search is performed using relevant databases and well-defined criteria. We review the existing literature addressing these topics, both in an independent and joint manner, and provide an overview of the state of the art using natural language processing in health literacy. We additionally discuss how the different issues in health literacy that are related to the comprehension of specialised health texts can be improved using natural language processing techniques, and the challenges involved in these processes. Results: The search process yielded 235 potential relevant references, 49 of which fully fulfilled the established search criteria, and therefore they were later analysed in more detail. These articles were clustered into groups with respect to their purpose, and most of them were focused on the development of specific natural language processing modules, such as question answering, information retrieval, text simplification or natural language generation in order to facilitate the understanding of health information.This research work has been partially funded by the University of Alicante, Generalitat Valenciana, Spanish Government and the European Commission through the projects, "Tratamiento inteligente de la informacion para la ayuda a la toma de decisiones" (GRE12-44), "Explotacion y tratamiento de la informacion disponible en Internet para la anotacion y generacion de textos adaptados al usuario" (GRE13-15), DIIM2.0 (PROMETEOII/2014/001), ATTOS (TIN2012-38536-C03-03), LEGOLANG-UAGE (TIN2012-31224), SAM (FP7-611312), and FIRST (FP7-287607)

The status of Xhosa and communicative competence in Cape Education Department schools

Bibliography: leaves 196-201.The empirical survey of Xhosa amongst Standard 10 pupils in Cape Education Department Schools (CED) sought to verify or negate two central concerns which surf aced in a pilot study of five Western Cape schools. This thesis contends that little has changed throughout South Africa's colonial and apartheid history with regard to the status of African languages within South Africa and particularly in CED schools. The second contention is that various factors, including the lack of second language expertise and contact with mother tongue speakers, continue to undermine the potential development of pupils' communicative competence in Xhosa. Separate questionnaires which included categorical and open ended questions were posted to Xhosa-teachers, Standard 10 non-mother tongue Xhosa pupils and their parents. The Xhosa teachers administered the questionnaires. There was an 80% response from the total population of CED schools offering Xhosa. The number of subjects included 169 Xhosa pupils, 154 parents and 26 Xhosa teachers. STATGRAPHICS and BMDP were the statistical packages used in the analysis. Chi-Squared tests with the Yates correction for continuity were used to compare frequencies between categorical variables. ANOVA and t-tests were used with continuous variables. Findings indicated the deteriorating status of Xhosa in schools. The low number of CED schools ( 13. 0%) offering Xhosa and a 0. 5% growth rate in Standard 10 pupils doing Xhosa between 1988 and 1991 are an indication of this. The lack of encouragement and support for Xhosa from schools and the CED, coupled with problematic subject choice options, the Xhosa syllabus and the examination system, has affected the status of Xhosa and the motivation of pupils adversely. In the survey, pupils had low communicative competence in Xhosa levels of perceived due to the lack of informal, natural acquisition environments and the over- emphasis of grammatical aspects in the classroom and in examinations. Furthermore, the lack of quality primary and secondary education based on negatively affected pupils' second language theory has attitudes, motivation and communicative competence levels in Xhosa. The recognition of the importance of African languages in a future non-racial South Africa in the current language debate has highlighted the contradiction that exists today. This contradiction necessitates the urgent re-assessment of language and education policies, strategies and teaching methodologies in order to uplift the status of African languages and improve the levels of competence in the target language amongst school pupils

KenSwQuAD -- A Question Answering Dataset for Swahili Low Resource Language

The need for Question Answering datasets in low resource languages is the motivation of this research, leading to the development of Kencorpus Swahili Question Answering Dataset, KenSwQuAD. This dataset is annotated from raw story texts of Swahili low resource language, which is a predominantly spoken in Eastern African and in other parts of the world. Question Answering (QA) datasets are important for machine comprehension of natural language for tasks such as internet search and dialog systems. Machine learning systems need training data such as the gold standard Question Answering set developed in this research. The research engaged annotators to formulate QA pairs from Swahili texts collected by the Kencorpus project, a Kenyan languages corpus. The project annotated 1,445 texts from the total 2,585 texts with at least 5 QA pairs each, resulting into a final dataset of 7,526 QA pairs. A quality assurance set of 12.5% of the annotated texts confirmed that the QA pairs were all correctly annotated. A proof of concept on applying the set to the QA task confirmed that the dataset can be usable for such tasks. KenSwQuAD has also contributed to resourcing of the Swahili language.Comment: 17 pages, 1 figure, 10 table

Translations of informed consent documents for clinical trials in South Africa: are they readable?

1. Introduction: Obtaining Informed consent is an ethical prerequisite for enrollment in clinical research. There is a perception that Informed consent documents used in biomedical research are lengthy, overly complex and above the reading capability of typical research participants. In South Africa, ethical committees regulating research on human participants (HRECs) are mandated by the Department of Health’s National Health Research Ethics Council’s (NHREC) guidelines to ensure that researchers have made special considerations for vulnerable groups when conducting research. This includes considerations made for populations with low literacy. For example, the Standard Operating Procedure (SOP) of the University of Cape Town’s Human Research Ethics Committee (UCTHREC), requires that the language used in Informed consent documents should be directed at a reading level of grade 6 to 8 and that common, everyday words should be used rather than complex language syntax. The HREC expects researchers to translate the approved English version documents into local languages such as isiXhosa and Afrikaans. Since ethics committee focus approval on the English language consent documents and only acknowledge translated versions, a potential gap in this process is whether the translated versions meet the same required readability levels. This study aims to investigate whether translated versions of English language informed consent documents used at a single busy clinical research site are readable and meet the readability levels specified by UCTHREC. 2. Methodology: A quantitative descriptive statistical design was used to explore readability levels of informed consent documents used at a single clinical research facility based in a semi-rural community. Informed consent documents approved by UCTHREC over the past thirteen years (2004 to 2017) that met the inclusion criteria were analysed for readability. The LIX readability test tool was used to calculate readability scores and the levels of reading difficulty. These scores were then matched to a grade level conversion chart to determine the equivalent number of education years required to be able to easily understand the information. Readability levels were determined for isiXhosa and Afrikaans translations of the documents and compared to the levels of the English document. 3. Results: The results indicate that informed consent documents used at this single clinical research facility, independent of language type, are difficult to read. A total of 259 sub-sections of informed consent documents from 10 different studies were analysed. The analysis showed that informed consent documents were classified as “very difficult to read” according to the LIX readability tool in a large proportion of English, isiXhosa and Afrikaans languages: 41 (16%), 255 (98%), and 85 (33%) of informed consent sections respectively. Of all the subsections of English, isiXhosa and Afrikaans documents respectively, 98 (38%), 0 (0%) and 126 (49%) were classified as “difficult to read”, while 79 (31%), 3 (1%) and 38 (15%) were found to have an “average” readability level. Twenty eight (11%), 1 (0%) and 10 (4%) were found to be “easy to read” and 13 (5%), 0 (0%) and 0 (0%) had a “very easy” readability level. The mean LIX readability scores across English, isiXhosa, and Afrikaans languages were respectively 42.27 (95% CI 41.20 – 43.34) corresponding to a readability level of “average”, 74.64 (95% CI 73.79-75.49), corresponding to “very difficult to read” and 46.73 (95% CI 45.66-47.8) “difficult to read”. These findings suggest a high level of difficulty in reading of the text in the Informed consent documents. 4. Conclusion: Translations of Informed consent documents used at a single busy clinical research site are difficult to read and are written at high school to tertiary reading level. These reading levels are above the recommended level prescribed by the site’s research ethics committee (UCTHREC). Local ethics committees should employ more stringent guidelines and checks to ensure readability of translated informed consent documents. Researchers and Sponsors should include readability outcomes in the design and with submissions of new protocols

A descriptive analysis of statements taken by police officers from child complainants in sexual offence cases that examines the degree to which the form and content of the statements accord with best practice across a range of variables

With over twenty thousand complaints reported annually to police of child sexual abuse in South Africa, specialist police nvestigators are practised at taking statements from child complainants. This thesis analyses the fit between actualpolice practice and that recommended by international best practice. Children are a special class of witness because of their inherent social, emotional, and cognitive immaturity, and they are universally acknowledged to be very difficult witnesses to interview without the interviewer lending a bias to the process and thereby contaminating the outcome. The first half of the thesis therefore provides a detailed account of the research basis of current international best practice and of the hallmarks of that best practice which result in reliable interview outcomes. The second half of the thesis presents a descriptive analysis of 100 police statements taken from children in the Eastern Cape who had been raped in the period between 2010 and 2012. The findings of the analysis are presented in detail and then compared to the best practice summarised from the international research

Giving voice to Mandela: an analysis of accent acquisition intervention for the role of Nelson Mandela in the film Mandela: Long walk to freedom : a case study

Framed by the experiences of the dialogue coaching process for the accent acquisition of the IsiXhosa accent for the role of Nelson Mandela, this study aims to test the methodology I have devised. My tutelage has been rooted in, but not confined to, Western pedagogy, and is present and reflected in the embodied knowledge that I bring to the research. I investigate the use of Received Pronunciation to facilitate this process of accent acquisition and the role a medial point of articulation plays in aiding sound shifts for an accent. From a socio-linguistic perspective the study investigates the elements that constitute and contribute to an authentic accent and examines placement as one of these as action research. I am testing the methodology and as an active participant in the research, while at the same time conducting the research, I am investigating my praxis and process. Favouring a post-structuralist position, I deconstruct and identify good vocal production and question whether this influences the ability to acquire an accent and facilitates this process. The study analyses vocal coaching as a series of modified interventions, which require continual re-modification through the course of action. Language subsists and reflects the cultural paradigm within which it exists. Through an analysis of the characteristics and content of that paradigm I suggest how this knowledge can develop the process of accent acquisition. The study demonstrates the use of Received Pronunciation as a tool coupled with a technical precision and cultural accuracy as valuable and necessary in authentic accent acquisition

Assessing the culture fairness of an intelligence test by adjusting the test times and pictorial examples : a pilot study with grade 2 learners in four Johannesburg schools

Abstract : The HPCSA’s Policy on the Classification of psychometric measuring devices, instruments, methods and techniques, warns that it would be “unwise” (p.1) for the assessment profession to not pursue the adaption of existing and development of new, culturally fair tests. Even so, very few culturally relevant tests have been developed in South Africa (Foxcroft, Paterson, Le Roux, & Herbest, 2004). This is despite practitioners becoming more cognisant of the importance of using sound assessments, which maintain their validity across cultural groups (Paterson & Uys, 2005). There is an urgent need for the development and adaption of psychometric assessments in order to assure their validity in a multicultural South Africa. A test is deemed culturally fair if the test is void of test items that are a source of potential bias. A culture fair intelligence test should therefore accurately test an individual’s intelligence level regardless of their cultural or socio-economic background. Many psychologists believe that the idea that a test “can be completely absent of cultural bias” (Benson, 2003, p.1), that is culture free, is not possible. That being said, a culture fair, as opposed to culture free, test is a necessary and vital goal to strive towards should the assessment profession want to confirm to the regulations as outlined by the HPCSA and the employment Equity Act. In this pilot research project, I argue that the presence of a time limit as well as a formal testing situation could increase test anxiety, and therefore hamper the learner’s ability to supply answers that accurately reflect his/her intellectual ability. An adapted CFT1- R was administered to the sample. In order to establish the optimum time limit for each subtest, the following intervention was implemented during Adaptation of an intelligence test to assess its cultural fairness vii administration. Once the official time for the subtest had lapsed, the administrators marked each child’s progress at 30 second intervals. This continued until the child had finished the subtest, at which point the administrator made a note of the total time needed to complete the test. The results of the data analysis indicated that South African learners may require more time, when completing the CFT1-R, than their German counterparts. Findings also indicated that mother tongue tuition versus second language tuition could possibly influence the child’s ability to perform on a cognitive assessment. A further assumption that could be drawn from the findings is the effect of preschool education, both in terms of the child’s access to a preschool education as well as the quality of education that was received. These assumptions require further research. Adaptation of an intelligence test to assess its cultural fairness.M.Ed. (Childhood Education