A Visual Approach to Improving the Experience of Health Information for Vulnerable Individuals

Many individuals with low health literacy (LHL) and limited English proficiency (LEP) have poor experiences consuming health information: they find it unengaging, unappealing, difficult to understand, and un-motivating. These negative experiences may blunt, or even sabotage, the desired effect of communicating health information: to increase engagement and ability to manage health. It is imperative to find solutions to improve poor experiences of health information, because such experiences heighten vulnerability to poor health outcomes. We aimed to address a gap in the health literacy literature by studying the patient experience of health information and how visualization might be able to help. Our four studies involved patients presented with health information in various settings to improve understanding and management of their care. We used semi-structured interviews and observations to understand patient experiences of receiving personal health information in the hospital. We learned that the return of results is desired and has the potential to promote patient engagement with care. We developed a novel method to analyze LHL, LEP caregiver experience and information needs in the community setting. The novel method increased our understanding and ability to detect differences in experiences within the same ethnic group, based on language preference. Next, we interrogated the literature for a solution to easily communicate complicated health information to disinterested, LHL, LEP individuals. We found that visualizations can help increase interest, comprehension, support faster communication, and even help broach difficult topics. Finally, our findings were used to develop a novel prototype to improve experiences of consuming genetic risk information for those having LHL and LEP. Unlike traditional approaches that focus on communicating risk numbers and probabilities, the novelty of our approach was that we focused on communicating risk as a feeling. We achieved this by leveraging vicarious learning via real patient experience materials (e.g., quotes, videos) and empathy with an emotive relational agent. We evaluated and compared the prototype to standard methods of communicating genetic risk information via a mixed methods approach that included surveys, questionnaires, interviews, observations, image analysis, and facial analysis. Main outcome variables were perceived ease of understanding, comprehension, emotional response, and motivation. We employed t-tests, ANOVAs, directed content analysis, correlation, regression, hierarchical clustering, and Chernoff faces to answer the research questions. All variables were significantly different for the prototype compared to the standard method, except for motivation as rated by 32 LHL, LEP community members. Findings revealed that LHL, LEP individuals have difficulty appropriately processing standard methods of communicating risk information, such as risk numbers supported by visual aids. Further, appealing visuals may inappropriately increase confidence in understanding of information. Visualizations affected emotions, which influenced perceived ease of understanding and motivation to take action on the information. Comprehension scores did not correlate with perceived ease of understanding, emotional response, or motivation. Findings suggest that providing access to comprehensible health information may not be enough to motivate patients to engage with their care; providing a good experience (taking into account the aesthetics and emotional response) of health information may be essential to optimize outcomes

Forgone opportunities of large-scale agricultural investment: A comparison of three models of soya production in Central Mozambique

Agriculture is one of the main engines for prosperity and economic growth in Africa but effective agricultural strategies to support rural development and poverty alleviation are not yet identified. While state investment in the small-scale farming sector is minimal, and the medium-scale “emergent” household farm sector remains underrepresented, large-scale land investments are advocated as means to bring capital to rural areas and stimulate development. Yet, little empirical research has been done to contrast agricultural development strategies and to understand their strengths and weaknesses. We present an analysis of different soya production models - small-scale farmers, medium-scale mechanised emergent farmers, and large-scale commercial operations - and their socio-economic aspects in Central Mozambique. Based on purposefully collected data in 10 villages in Gurué district, our findings suggest that large-scale plantations create localized land scarcity and that the benefits from wage labour and local investments do not compensate rural populations for lost access to land. Small- and medium-scale soya farming also leads to decreasing land availability, but provides greater socio-economic benefits such as on-farm employment and work opportunities along the local value chain. Small- and medium-scale soya production increases on- and off-farm income and leads to spill-over effects to the local economy. Negative effects of these models of soya production on food production could not be detected; instead the cultivation of soya significantly increases maize yields grown in rotation. These findings suggest that small- and medium-scale commercial farming can compete with large-scale operations in key socio-economic parameters and that a concentration on large-scale investments can result in forgone opportunities regarding rural development and poverty reduction

The Vehicle, Spring 2001

Vol. 42, No. 2 Table of Contents To Dream Without CeasingElizabeth Dedmanpage 4-5 Honoring Commandos at Spean BridgeKat Stevenspage 6 The Girl I NamelyKevin Manuspage 7 AbsolutionMike Mauritzenpage 8 Summertime SuperheroesChris Ptasnikpage 9 Flower at GlencoeKat Stevenspage 10 AddictionAdam Funkpage 11 Cornfield in JanuaryRobert Prattepage 12 MelancholyOona Margaret Burkepage 13 In PicturesAmanda McKaypage 14 Words to a Silent FilmBrianne Bolinpage 15 ManagerRobert Prattepage 16 The WellJanet Windegathpage 17 A Meal at the Personal Growth CafeAshley Kieferpage 18 Castlegate Evening at AberdeenKat Stevenspage 19 What We AreKevin Manuspage 20 Ode to My Gin-Soaked OlivesBrianne Bolinpage 21 The Six String PlayerRyan Guimondpage 22 MaxineJay Edwardspage 23 BarefootKrista Bodenpage 24 JulyAdam Funkpage 25 HopeOona Margaret Burkepage 26 UntitledLevy Wooln Dannerpage 27 The One and Only Picture I Have of YouKevin Manuspage 28 Death of a Fat ManBrianne Bolinpage 29-32https://thekeep.eiu.edu/vehicle/1075/thumbnail.jp

The Vehicle, Spring 2003

Table of Contents Knowledge of SelfGreg Baptistepage 4 Coleman 3371Amanda Beardpage 5 Mixed Messages (after Stephen Dunn)Colette Beausoleilpage6 Returning to RhythmAubrey Bonannopage 6 Pecan GroveNatalie Espositopage 7 Childhood\u27s EndRachael Harzinskipage 15 Unknown InfantAmanda Beard and Andy Kochpage 16 NeverRachael Harzinskipage 16 alone she sitsKrystal Heringpage 18 A Sketch of GrandmaKrystal Heringpage 19 Two HeadstonesAmanda Beard and Andy Kochpage 19 Shattuc, Summer 1995Andy Kochpage 20 Sky PoemAndy Kochpage 21 Wild Years (For: Tom)Scott E. Lutzpage 21 All Air, No Net!Lora Ann Neihartpage 22 The Evil ApostleJanet McGrathpage 23 DifferentRachel Seftonpage 27 Dear Insurance ExecutivePatti Smithpage 27 Dancing MusicJosh Sopiarzpage 28 The Picnic For LisaJosh Sopiarzpage 29 Today (an unusually warm and sunny winter day)Josh Sopiarzpage 30 Silver and NeonStanley (Buck) Weisspage 30 About the sacredness of dandruff, of peoples\u27 essences; or why I feared cleaning my father\u27s roomLevi Woollen-Dannerpage 32 In Boulder on a blustery day that reminded me I wasn\u27t running away from anythingLevi Woollen-Dannerpage 33 Biographiespage 35https://thekeep.eiu.edu/vehicle/1079/thumbnail.jp

Charcoal production in the Mopane woodlands of Mozambique: what are the trade-offs with other ecosystem services?

African woodlands form a major part of the tropical grassy biome and support the livelihoods of millions of rural and urban people. Charcoal production in particular is a major economic activity, but its impact on other ecosystem services is little studied. To address this, our study collected biophysical and social datasets, which were combined in ecological production functions, to assess ecosystem service provision and its change under different charcoal production scenarios in Gaza Province, southern Mozambique. We found that villages with longer histories of charcoal production had experienced declines in wood suitable for charcoal, firewood and construction, and tended to have lower perceived availabilities of these services. Scenarios of future charcoal impacts indicated that firewood and woody construction services were likely to trade-off with charcoal production. However, even under the most extreme charcoal scenario, these services were not completely lost. Other provisioning services, such as wild food, medicinal plants and grass, were largely unaffected by charcoal production. To reduce the future impacts of charcoal production, producers must avoid increased intensification of charcoal extraction by avoiding the expansion of species and sizes of trees used for charcoal production. This is a major challenge to land managers and policymakers in the area. This article is part of the themed issue ‘Tropical grassy biomes: linking ecology, human use and conservation’

Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome