Readability Analysis of Otolaryngology Consent Documents on the iMed Consent Platform

ABSTRACT Introduction The American Medical Association (AMA) and National Institutes of Health (NIH) recommend all patient information and consent materials be provided at the fourth- to sixth-grade level. The iMed Consent platform is used nationally by the Veterans Health Administration and private hospitals. We aimed to assess the readability of otolaryngology consents at the West Los Angeles Veterans Affairs (WLA-VA) hospital to determine whether they conform with AMA/NIH guidelines. Materials and Methods A readability analysis of 27 otolaryngology iMed consent documents was performed. The main outcome measure was the Flesch–Kincaid Grade Level (FKGL). The setting of the study was an otolaryngology clinic at a major VA hospital. All consents used in the WLA-VA otolaryngology clinic for the month of October 2018 were analyzed using readability metrics. These included the Flesch Reading Ease (FRE) score, the FKGL, the Gunning Fog Index (GFI), Simple Measure of Gobbledygook (SMOG), and Coleman–Liau Index (CLI). Results The following means of all consents were calculated for each of the readability metrics: FRE 56.3, FKGL 8.3, GFI 14.5, SMOG 11.3, and CLI 11.2. The standardized anesthesia and blood consent were analyzed separately with the following scores: FRE 45.1, FKGL 11.7, GFI 15.5, SMOG 14.6, and CLI 12.6. The average FKGL of the consents was found to be significantly above the sixth-grade level (P: .0013). Conclusion The average grade level of the otolaryngology iMed consents reviewed was at a reading level above the AMA/NIH recommendations. This objective measure should be taken into consideration when revising the iMed system and in the creation of future standardized consents. Readability analysis does not take into consideration the significant variance that exists as part of the verbal consent process that takes place between patient and provider.

Periodontitis, age-related diseases and diabetes in an endocrinological outpatient setting (PARADIES): a cross-sectional analysis on predictive factors for periodontitis in a German outpatient facility

Background Diabetes mellitus (DM) is a risk factor for periodontitis. Data on risk-modifying factors for periodontitis in diabetes patients are limited. Aims We tested whether sex, age, type of diabetes, metabolic state, comorbidities, complications, measures of well-being and quality of life are predicting periodontitis in a German diabetes outpatient cohort. Methods In total, 1180 out of 1293 participating DM patients completed questionnaires on quality of life, dental hygiene and health. All patients also filled out a modified version of the periodontitis risk questionnaire by the American Association for Periodontology, from which the status of “assumed periodontitis” was deducted. In a subset of participants (n = 461), we measured or inquired the most recent Community Parodontal Index (CPI), providing an objective measure for clinically diagnosed periodontitis. For all subjects, DM history and phenotype, major metabolic parameters (HbA1c, BMI, LDL and total cholesterol levels), general health risk factors, comorbidities and medication were collected. Results Clinically diagnosed (CPI > 2) and assumed periodontitis was detected in 60–67% of our patients. Male sex and oral health-related quality of life were associated with clinically diagnosed periodontitis. Male sex, age, smoking, dental hygiene, dental control and diabetes-related quality of life independently predicted assumed periodontitis. Conclusion In DM patients, quality of life and lifestyle factors which systemically alter microvascular and immunological functions seem to predict periodontitis. Further studies are needed for replication and for pathomechanistic clarification.

Subjective Social Status and Objective Health Among Older People in England. A Longitudinal Approach With Biomarkers

Subjective social status has a known association with health, whereby better health outcomes are observed for those with higher perceived status. However, in this article we offer new evidence on the status–health relationship using a rigorous methodological approach that considers both observed and unobserved confounders. We use 14 years of data from the English Longitudinal Study of Aging and derive a measure of allostatic load with biomarkers as an objective measure of health. We apply ‘within–between’ panel regression models which reveal the expected association between subjective status and health when comparing participants (the ‘between’ estimate), but no association when examining temporal variation within participants (the ‘within’ estimate). When controlling for personality traits, optimism, and parental education the ‘between’ association between subjective status and allostatic also load disappears. These results suggest that perceived status is not a pathway to health, in and of itself, among older people.

Observed Mass-Scale Call-Response Dynamics Between Public Health Officials and the American Public in the Surging COVID-19 Pandemic Summer 2020

By any objective measure, the United States has mishandled its response to the SARS-CoV-2 and COVID-19 outbreak, with 177,394 deaths and 5,745,721 cases. In the world, there have been some 796,330 deaths and 22,848,030 validated coronavirus cases (with 15,500,447 recovered). The real rates are thought to be 3x – 10x higher given the low access to tests. In this moment, there are multiple epidemics ongoing in the U.S., resulting in massive government and private industry expenditures, disrupted markets, and social roiling. In journalistic coverage and social image sets, the interactive call-response between public health officials and the general American public may be seen in the Summer of 2020 (in a time of phased shutdowns and re-openings and re-closings). This work offers an original content analysis of over 2,431 journalistic articles and 2,224 social images captured July 3, 2020 to understand where the call-response communications broke down and the message got lost at enormous social and personal cost. A sidebar offers an analysis of COVID-19 social memes.

Picture-wise just noticeable difference prediction model for JPEG image quality assessment

Introduction/purpose: The paper presents interesting research related to the performance analysis of the picture-wise just noticeable difference (JND) prediction model and its application in the quality assessment of images with JPEG compression. Methods: The performance analysis of the JND model was conducted in an indirect way by using the publicly available results of subject-rated image datasets with the separation of images into two classes (above and below the threshold of visible differences). In the performance analysis of the JND prediction model and image quality assessment, five image datasets were used, four of which come from the visible wavelength range, and one dataset is intended for remote sensing and surveillance with images from the infrared part of the electromagnetic spectrum. Results: The pap 86 er shows that using a picture-wise JND model, subjective image quality assessment scores can be estimated with better accuracy, leading to significant performance improvements of the traditional peak signal-to-noise ratio (PSNR). The gain achieved by introducing the picture-wise JND model in the objective assessment depends on the chosen dataset and the results of the initial simple to compute PSNR measure, and it was obtained on all five datasets. The mean linear correlation coefficient (for five datasets) between subjective and PSNR objective quality estimates increased from 74% (traditional PSNR) to 90% (picture-wise JND PSNR). Conclusion: Further improvement of the JND-based objective measure can be obtained by improving the picture-wise model of JND prediction.

From Speech Acoustics to Communicative Participation in Dysarthria: Toward a Causal Framework

Purpose: We proposed and tested a causal instantiation of the World Health Organization's International Classification of Functioning, Disability and Health (ICF) framework, linking acoustics, intelligibility, and communicative participation in the context of dysarthria. Method: Speech samples and communicative participation scores were collected from individuals with dysarthria ( n = 32). Speech was analyzed for two acoustic metrics (i.e., articulatory precision and speech rate), and an objective measure of intelligibility was generated from listener transcripts. Mediation analysis was used to evaluate pathways of effect between acoustics, intelligibility, and communicative participation. Results: We observed a strong relationship between articulatory precision and intelligibility and a moderate relationship between intelligibility and communicative participation. Collectively, data supported a significant relationship between articulatory precision and communicative participation, which was almost entirely mediated through intelligibility. These relationships were not significant when speech rate was specified as the acoustic variable of interest. Conclusion: The statistical corroboration of our causal instantiation of the ICF framework with articulatory acoustics affords important support toward the development of a comprehensive causal framework to understand and, ultimately, address restricted communicative participation in dysarthria.

Pilot Study to Assess Changes in the Blink Reflex Across Age

ObjectiveThe objective was to conduct a preliminary study to access blink reflex parameters across age using the Eyestat.BackgroundThe blink reflex is a primitive brainstem response to an external stimulus is affected by multiple neurologic disorders, including those that affect the dopaminergic circuit that controls the eyelid. Our laboratory has utilized a potential objective measure to identify concussions within a college aged sport population called Eyestat, which measures changes in blink reflex parameters. Prior research cited significant differences in various blink reflex parameters between active play, concussion, and baseline. However, data with older, non-athlete populations has not defined.Design/MethodsOne hundred forty three subjects between the ages of 8–80 participated in this study. Once the subject was seated, the test sequence was initiated, in which the subject placed their face into the mask and 5 random air puffs were applied to the corner of the left or right eyes over a course of 20 seconds. High-speed videography (280 frames/sec.) captured the response of the subject's eyes before and after each stimuli.ResultsDescription statistics of the data indicated differences across age with the following parameters: Latency (ms): 46.02 (ages 8–21); 47.12 (ages 22–30); 48.96 (ages 31–40); 47.44 (ages 41–50); 55.20 (ages 51–60); and 55.39 (ages 61–80). Oscillations (qty): 14.10 (ages 8–21); 14.25 (ages 22–30); 12.19 (ages 31–40); 12.75 (ages 41–50); 9.98 (ages 51–60); and 9.78 (ages 61–80). Excursions (px): 127.57 (ages 8–21); 137.46 (ages 22–30); 135.34 (ages 31–40); 144.88 (ages 41–50); 147.72 (ages 51–60); and 148.85 (ages 61–80).ConclusionsAlthough more research is warranted to determine if these differences occur with a larger subject pool, this data substantiates the need for longitudinal assessments of the blink reflex as a potential biomarker, providing a non-invasive assessment of brain health in various populations.

“I did my own research”: Overconfidence, (dis)trust in science and conspiracy theories endorsement

<p>Epistemically suspect beliefs, such as endorsement of conspiracy theories or pseudoscientific claims are widespread even among highly educated individuals. The phenomenon of conspiratorial thinking is not new, yet the COVID-19 pandemic, causing a global health crisis of an unprecedented scale, facilitated the emergence and rapid spread of some rather radical health related pseudoscientific fallacies. Numerous correlates of the tendency to endorse conspiracy theories have already been addressed. However, many of them are not subject to an intervention. Here, we have tested a model that includes predictors ranging across stable characteristics such as demographics (gender, age, education, size of the place of residence), less stable general traits such as conservatism and overconfidence in one’s own reasoning abilities, to relatively changeable worldviews such as trust in science. A hierarchical regression analysis (<i>N</i>=859 participants) showed that included predictors explained a total of 46% of the variance of believing in COVID-19 conspiracy theories, with only gender, overconfidence and trust in science yielding significance. Trust in science was the strongest predictor, implying that campaigns aimed at enhancing public trust in both science as a process, and scientists as individuals conducting it, might contribute to the reduction in susceptibility to pseudoscientific claims. Furthermore, overconfidence in one’s own reasoning abilities was negatively correlated with an objective measure of reasoning (syllogisms test), and positively with the endorsement of conspiracy theories, indicating that so-called Dunning-Kruger effect plays a role in pseudoscientific conspiratorial thinking regarding COVID-19.</p>

“I did my own research”: Overconfidence, (dis)trust in science and conspiracy theories endorsement

<p>Epistemically suspect beliefs, such as endorsement of conspiracy theories or pseudoscientific claims are widespread even among highly educated individuals. The phenomenon of conspiratorial thinking is not new, yet the COVID-19 pandemic, causing a global health crisis of an unprecedented scale, facilitated the emergence and rapid spread of some rather radical health related pseudoscientific fallacies. Numerous correlates of the tendency to endorse conspiracy theories have already been addressed. However, many of them are not subject to an intervention. Here, we have tested a model that includes predictors ranging across stable characteristics such as demographics (gender, age, education, size of the place of residence), less stable general traits such as conservatism and overconfidence in one’s own reasoning abilities, to relatively changeable worldviews such as trust in science. A hierarchical regression analysis (<i>N</i>=859 participants) showed that included predictors explained a total of 46% of the variance of believing in COVID-19 conspiracy theories, with only gender, overconfidence and trust in science yielding significance. Trust in science was the strongest predictor, implying that campaigns aimed at enhancing public trust in both science as a process, and scientists as individuals conducting it, might contribute to the reduction in susceptibility to pseudoscientific claims. Furthermore, overconfidence in one’s own reasoning abilities was negatively correlated with an objective measure of reasoning (syllogisms test), and positively with the endorsement of conspiracy theories, indicating that so-called Dunning-Kruger effect plays a role in pseudoscientific conspiratorial thinking regarding COVID-19.</p>

REM Sleep: An Unknown Indicator of Sleep Quality

Standard polysomnographic analysis of sleep has not provided evidence of an objective measure of sleep quality; however, factors such as sleep duration and sleep efficiency are those more consistently associated with the subjective perception of sleep quality. Sleep reduction as currently occurs in our 24/7 society has had a profound impact on sleep quality; the habitual sleep period should fit within what is a limited nighttime window and may not be sufficient to satisfy the whole sleep process; moreover, the use of artificial light during the evening and early night hours can delay and disturb the circadian rhythms, especially affecting REM sleep. The correct phase relationship of the sleep period with the circadian pacemaker is an important factor to guarantee adequate restorative sleep duration and sleep continuity, thus providing the necessary background for a good night’s sleep. Due to the fact that REM sleep is controlled by the circadian clock, it can provide a window-like mechanism that defines the termination of the sleep period when there is still the necessity to complete the sleep process (not only wake-related homeostasis) and to meet the circadian end of sleep timing. An adequate amount of REM sleep appears necessary to guarantee sleep continuity, while periodically activating the brain and preparing it for the return to consciousness.