Browsing by Subject "Comprehension"
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Item Open Access Age-related differences in resolving semantic and phonological competition during receptive language tasks.(Neuropsychologia, 2016-12) Zhuang, Jie; Johnson, Micah A; Madden, David J; Burke, Deborah M; Diaz, Michele TReceptive language (e.g., reading) is largely preserved in the aging brain, and semantic processes in particular may continue to develop throughout the lifespan. We investigated the neural underpinnings of phonological and semantic retrieval in older and younger adults during receptive language tasks (rhyme and semantic similarity judgments). In particular, we were interested in the role of competition on language retrieval and varied the similarities between a cue, target, and distractor that were hypothesized to affect the mental process of competition. Behaviorally, all participants responded faster and more accurately during the rhyme task compared to the semantic task. Moreover, older adults demonstrated higher response accuracy than younger adults during the semantic task. Although there were no overall age-related differences in the neuroimaging results, an Age×Task interaction was found in left inferior frontal gyrus (IFG), with older adults producing greater activation than younger adults during the semantic condition. These results suggest that at lower levels of task difficulty, older and younger adults engaged similar neural networks that benefited behavioral performance. As task difficulty increased during the semantic task, older adults relied more heavily on largely left hemisphere language regions, as well as regions involved in perception and internal monitoring. Our results are consistent with the stability of language comprehension across the adult lifespan and illustrate how the preservation of semantic representations with aging may influence performance under conditions of increased task difficulty.Item Open Access At 6-9 months, human infants know the meanings of many common nouns.(Proc Natl Acad Sci U S A, 2012-02-28) Bergelson, Elika; Swingley, DanielIt is widely accepted that infants begin learning their native language not by learning words, but by discovering features of the speech signal: consonants, vowels, and combinations of these sounds. Learning to understand words, as opposed to just perceiving their sounds, is said to come later, between 9 and 15 mo of age, when infants develop a capacity for interpreting others' goals and intentions. Here, we demonstrate that this consensus about the developmental sequence of human language learning is flawed: in fact, infants already know the meanings of several common words from the age of 6 mo onward. We presented 6- to 9-mo-old infants with sets of pictures to view while their parent named a picture in each set. Over this entire age range, infants directed their gaze to the named pictures, indicating their understanding of spoken words. Because the words were not trained in the laboratory, the results show that even young infants learn ordinary words through daily experience with language. This surprising accomplishment indicates that, contrary to prevailing beliefs, either infants can already grasp the referential intentions of adults at 6 mo or infants can learn words before this ability emerges. The precocious discovery of word meanings suggests a perspective in which learning vocabulary and learning the sound structure of spoken language go hand in hand as language acquisition begins.Item Open Access Evaluation High-Quality of Information from ChatGPT (Artificial Intelligence-Large Language Model) Artificial Intelligence on Shoulder Stabilization Surgery.(Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association, 2024-03) Hurley, Eoghan T; Crook, Bryan S; Lorentz, Samuel G; Danilkowicz, Richard M; Lau, Brian C; Taylor, Dean C; Dickens, Jonathan F; Anakwenze, Oke; Klifto, Christopher SPurpose
To analyze the quality and readability of information regarding shoulder stabilization surgery available using an online AI software (ChatGPT), using standardized scoring systems, as well as to report on the given answers by the AI.Methods
An open AI model (ChatGPT) was used to answer 23 commonly asked questions from patients on shoulder stabilization surgery. These answers were evaluated for medical accuracy, quality, and readability using The JAMA Benchmark criteria, DISCERN score, Flesch-Kincaid Reading Ease Score (FRES) & Grade Level (FKGL).Results
The JAMA Benchmark criteria score was 0, which is the lowest score, indicating no reliable resources cited. The DISCERN score was 60, which is considered a good score. The areas that open AI model did not achieve full marks were also related to the lack of available source material used to compile the answers, and finally some shortcomings with information not fully supported by the literature. The FRES was 26.2, and the FKGL was considered to be that of a college graduate.Conclusions
There was generally high quality in the answers given on questions relating to shoulder stabilization surgery, but there was a high reading level required to comprehend the information presented. However, it is unclear where the answers came from with no source material cited. It is important to note that the ChatGPT software repeatedly references the need to discuss these questions with an orthopaedic surgeon and the importance of shared discussion making, as well as compliance with surgeon treatment recommendations.Clinical relevance
As shoulder instability is an injury that predominantly affects younger individuals who may use the Internet for information, this study shows what information patients may be getting online.Item Open Access Influence of encoding difficulty, word frequency, and phonological regularity on age differences in word naming.(Experimental aging research, 2011-05) Allen, Philip A; Bucur, Barbara; Grabbe, Jeremy; Work, Tammy; Madden, David JIt is presently unclear as to why older adults take longer than younger adults to recognize visually presented words. To examine this issue in more detail, the authors conducted two word-naming studies (Experiment 1: 20 older adults and 20 younger adults; Experiment 2: 60 older adults and 60 younger adults) to determine the relative effects of orthographic encoding (case type), lexical access (word frequency), and phonological regularity (regular vs. irregular phonology). The hypothesis was that older adults attempt to compensate for sensory and motor slowing by using progressively larger perceptual units (holistic encoding). However, if forced to use smaller perceptual units (e.g., by using mixed-case presentation), it was predicted that older adults would be particularly challenged. Older adults did show larger case-mixing effects than younger adults (suggesting that older adults' performances were especially poor when they were forced to use smaller perceptual units), but there were no age differences in word frequency or phonological regularity even though both age groups showed main effects for these variables. These results suggest that lexical access skill remains stable in the addressed (orthographic/semantic) and assembled (phonological) routes over the life span, but that older adults slow down in recognizing words because it takes them longer to normalize (perceptually "clean up") noisier sensory information.Item Open Access Interactive or static reports to guide clinical interpretation of cancer genomics.(Journal of the American Medical Informatics Association : JAMIA, 2018-05) Gray, Stacy W; Gagan, Jeffrey; Cerami, Ethan; Cronin, Angel M; Uno, Hajime; Oliver, Nelly; Lowenstein, Carol; Lederman, Ruth; Revette, Anna; Suarez, Aaron; Lee, Charlotte; Bryan, Jordan; Sholl, Lynette; Van Allen, Eliezer MObjective
Misinterpretation of complex genomic data presents a major challenge in the implementation of precision oncology. We sought to determine whether interactive genomic reports with embedded clinician education and optimized data visualization improved genomic data interpretation.Materials and methods
We conducted a randomized, vignette-based survey study to determine whether exposure to interactive reports for a somatic gene panel, as compared to static reports, improves physicians' genomic comprehension and report-related satisfaction (overall scores calculated across 3 vignettes, range 0-18 and 1-4, respectively, higher score corresponding with improved endpoints).Results
One hundred and five physicians at a tertiary cancer center participated (29% participation rate): 67% medical, 20% pediatric, 7% radiation, and 7% surgical oncology; 37% female. Prior to viewing the case-based vignettes, 34% of the physicians reported difficulty making treatment recommendations based on the standard static report. After vignette/report exposure, physicians' overall comprehension scores did not differ by report type (mean score: interactive 11.6 vs static 10.5, difference = 1.1, 95% CI, -0.3, 2.5, P = .13). However, physicians exposed to the interactive report were more likely to correctly assess sequencing quality (P < .001) and understand when reports needed to be interpreted with caution (eg, low tumor purity; P = .02). Overall satisfaction scores were higher in the interactive group (mean score 2.5 vs 2.1, difference = 0.4, 95% CI, 0.2-0.7, P = .001).Discussion and conclusion
Interactive genomic reports may improve physicians' ability to accurately assess genomic data and increase report-related satisfaction. Additional research in users' genomic needs and efforts to integrate interactive reports into electronic health records may facilitate the implementation of precision oncology.Item Open Access Mine or yours? Development of sharing in toddlers in relation to ownership understanding.(Child Dev, 2013-05) Brownell, Celia A; Iesue, Stephanie S; Nichols, Sara R; Svetlova, MargaritaTo examine early developments in other-oriented resource sharing, fifty-one 18- and 24-month-old children were administered 6 tasks with toys or food that could be shared with an adult playmate who had none. On each task the playmate communicated her desire for the items in a series of progressively more explicit cues. Twenty-four-month-olds shared frequently and spontaneously. Eighteen-month-olds shared when given multiple opportunities and when the partner provided enough communicative support. Younger children engaged in self-focused and hypothesis-testing behavior in lieu of sharing more often than did older children. Ownership understanding, separately assessed, was positively associated with sharing and negatively associated with non-sharing behavior, independent of age and language ability.Item Open Access Okukkera Ng'omuzungu (lost in translation): understanding the social value of global health research for HIV/AIDS research participants in Uganda.(Global public health, 2010-01) Stewart, K; Sewankambo, NAs major global governance entities begin to re-assess the structure and goals of health research in resource-poor settings, social science can make a vital contribution by expanding the traditional field of research ethics to include new concepts such as the social value of global health research. This essay recasts the definition of social value in health research by shifting away from the official spaces where research occurs and towards the meaning of research as it is produced in the everyday spaces inhabited by the local community. We present three cases that reveal the local view of the social value of health research for Ugandans: autonomy and consent; the concept of risk; and what appears to be a classic case of therapeutic misconception between researcher and informant. Ultimately what we see, we argue, is the fundamental collision of the logic of biomedical research with the logic of local social relationships, that is, researchers perform their role as a transaction, while participants anticipate their involvement in research to be transformative. When we expand the analysis of the impact of research from the research/participant dyad to shifting community networks, we conclude that didactic models, such as the therapeutic misconception, are of limited utility for understanding the social value of global health research in resource-poor settings.Item Open Access Readability of patient education materials in ophthalmology: a single-institution study and systematic review.(BMC Ophthalmol, 2016-08-03) Williams, Andrew M; Muir, Kelly W; Rosdahl, Jullia ABACKGROUND: Patient education materials should be written at a level that is understandable for patients with low health literacy. The aims of this study are (1) to review the literature on readability of ophthalmic patient education materials and (2) to evaluate and revise our institution's patient education materials about glaucoma using evidence-based guidelines on writing for patients with low health literacy. METHODS: A systematic search was conducted on the PubMed/MEDLINE database for studies that have evaluated readability level of ophthalmic patient education materials, and the reported readability scores were assessed. Additionally, we collected evidence-based guidelines for writing easy-to-read patient education materials, and these recommendations were applied to revise 12 patient education handouts on various glaucoma topics at our institution. Readability measures, including Flesch-Kincaid Grade Level (FKGL), and word count were calculated for the original and revised documents. The original and revised versions of the handouts were then scored in random order by two glaucoma specialists using the Suitability Assessment of Materials (SAM) instrument, a grading scale used to evaluate suitability of health information materials for patients. Paired t test was used to analyze changes in readability measures, word count, and SAM score between original and revised handouts. Finally, five glaucoma patients were interviewed to discuss the revised materials, and patient feedback was analyzed qualitatively. RESULTS: Our literature search included 13 studies that evaluated a total of 950 educational materials. Among the mean FKGL readability scores reported in these studies, the median was 11 (representing an eleventh-grade reading level). At our institution, handouts' readability averaged a tenth-grade reading level (FKGL = 10.0 ± 1.6), but revising the handouts improved their readability to a sixth-grade reading level (FKGL = 6.4 ± 1.2) (p < 0.001). Additionally, the mean SAM score of our institution's handouts improved from 60 ± 7 % (adequate) for the original versions to 88 ± 4 % (superior) for the revised handouts (p < 0.001). CONCLUSIONS: Our systematic review of the literature reveals that ophthalmic patient education materials are consistently written at a level that is too high for many patients to understand. Our institution's experience suggests that applying guidelines on writing easy-to-understand material can improve the readability and suitability of educational materials for patients with low health literacy.Item Open Access Striking a balance in communicating pharmacogenetic test results: promoting comprehension and minimizing adverse psychological and behavioral response.(Patient education and counseling, 2014-10) Haga, Susanne B; Mills, Rachel; Bosworth, HaydenObjective
Pharmacogenetic (PGx) testing can provide information about a patient's likelihood to respond to a medication or experience an adverse event, and be used to inform medication selection and/or dosing. Promoting patient comprehension of PGx test results will be important to improving engagement and understanding of treatment decisions.Methods
The discussion in this paper is based on our experiences and the literature on communication of genetic test results for disease risk and broad risk communication strategies.Results
Clinical laboratory reports often describe PGx test results using standard terminology such as 'poor metabolizer' or 'ultra-rapid metabolizer.' While this type of terminology may promote patient recall with its simple, yet descriptive nature, it may be difficult for some patients to comprehend and/or cause adverse psychological or behavioral responses.Conclusion
The language used to communicate results and their significance to patients will be important to consider in order to minimize confusion and potential psychological consequences such as increased anxiety that can adversely impact medication-taking behaviors.Practice implications
Due to patients' unfamiliarity with PGx testing and the potential for confusion, adverse psychological effects, and decreased medication adherence, health providers need to be cognizant of the language used in discussing PGx test results with patients.Item Open Access The Child as Econometrician: A Rational Model of Preference Understanding in Children(PLoS ONE, 2014-03) Lucas, Christopher G; Griffiths, Thomas L; Xu, Fei; Fawcett, Christine; Gopnik, Alison; Kushnir, Tamar; Markson, Lori; Hu, JaneRecent work has shown that young children can learn about preferences by observing the choices and emotional reactions of other people, but there is no unified account of how this learning occurs. We show that a rational model, built on ideas from economics and computer science, explains the behavior of children in several experiments, and offers new predictions as well. First, we demonstrate that when children use statistical information to learn about preferences, their inferences match the predictions of a simple econometric model. Next, we show that this same model can explain children's ability to learn that other people have preferences similar to or different from their own and use that knowledge to reason about the desirability of hidden objects. Finally, we use the model to explain a developmental shift in preference understanding.Item Open Access The coherence of memories for trauma: evidence from posttraumatic stress disorder.(Conscious Cogn, 2011-09) Rubin, David CParticipants with posttraumatic stress disorder (PTSD) and participants with a trauma but without PTSD wrote narratives of their trauma and, for comparison, of the most-important and the happiest events that occurred within a year of their trauma. They then rated these three events on coherence. Based on participants' self-ratings and on naïve-observer scorings of the participants' narratives, memories of traumas were not more incoherent than the comparison memories in participants in general or in participants with PTSD. This study comprehensively assesses narrative coherence using a full two (PTSD or not) by two (traumatic event or not) design. The results are counter to most prevalent theoretical views of memory for trauma.Item Open Access Young toddlers' word comprehension is flexible and efficient.(PLoS One, 2013) Bergelson, Elika; Swingley, DanielMuch of what is known about word recognition in toddlers comes from eyetracking studies. Here we show that the speed and facility with which children recognize words, as revealed in such studies, cannot be attributed to a task-specific, closed-set strategy; rather, children's gaze to referents of spoken nouns reflects successful search of the lexicon. Toddlers' spoken word comprehension was examined in the context of pictures that had two possible names (such as a cup of juice which could be called "cup" or "juice") and pictures that had only one likely name for toddlers (such as "apple"), using a visual world eye-tracking task and a picture-labeling task (n = 77, mean age, 21 months). Toddlers were just as fast and accurate in fixating named pictures with two likely names as pictures with one. If toddlers do name pictures to themselves, the name provides no apparent benefit in word recognition, because there is no cost to understanding an alternative lexical construal of the picture. In toddlers, as in adults, spoken words rapidly evoke their referents.