Literacy has recently emerged as a key item on the research agenda in medicine and public health. Researchers and practitioners are grappling with evidence that the reading ability of the average adult falls well below the reading level of educational materials, directives, forms, and informed-consent documents commonly used in the health field. The threats to effective communication and efficacious care have spurred interest in exploring strategies for more effective communication. In addition, increased attention to literacy may be driven by legal concerns for adequate protection of human subjects and ethical concerns for patient autonomy in informed-consent procedures. Methodological strides made since 1992, particularly in the form of new tools for rapid literacy measurement, have enabled a number of researchers to explore links between the literacy level of patients and health outcomes that will have critical policy implications. These investigations can best be undertaken through collaborative efforts between educators who understand the learning process and health professionals who understand the protocols used in health care and public health education. Findings will serve to enrich policy and practice.

The principles of readability are in every style manual. Readability formulas are in every word processor. What is missing is the research and theory on which they stand.

Virtually all indicators of physical health and mental competence favor persons of higher socioeconomic status (SES). Conventional theories in the social sciences assume that the material disadvantages of lower SES are primarily responsible for these inequalities, either directly or by inducing psychosocial harm. These theories cannot explain, however, why the relation between SES and health outcomes (knowledge, behavior, morbidity, and mortality) is not only remarkably general across time, place, disease, and kind of health system but also so finely graded up the entire SES continuum. Epidemiologists have therefore posited, but not yet identified, a more general “fundamental cause ” of health inequalities. I concatenate various bodies of evidence to demonstrate that differences in general intelligence (g) may be that fundamental cause. Intelligence and Health Inequality 3

Consumer health information written by health care professionals is often inaccessible to the consumers it is written for. Traditional readability formulas examine syntactic features like sentence length and number of syllables, ignoring the target audience’s grasp of the words themselves. The use of specialized vocabulary disrupts the understanding of patients with low reading skills, causing a decrease in comprehension. A naïve Bayes classifier for three levels of increasing medical terminology specificity (consumer/patient, novice health learner, medical professional) was created with a lexicon generated from a representative medical corpus. Ninety-six percent accuracy in classification was attained. The classifier was then applied to existing consumer health web pages. We found that only 4 % of pages were classified at a layperson level, regardless of the Flesch reading ease scores, while the remaining pages were at the level of medical professionals. This indicates that consumer health web pages are not using appropriate language for their target audience.

Abstract. We describe the design and evaluation of a virtual agent that explains health documents to patients. The prevalence and impact of low health literacy is presented as a motivation for such agents, given that face-to-face interaction with health providers is cited as one of the most effective means of communicating with these patients. We analyze the form and distribution of pointing gestures used by experts in explaining health documents, and use this data to develop a computational model of agent-based document explanation. This model is evaluated in a randomized controlled trial. Preliminary results indicate that patients with low health literacy are more satisfied with health document explanation by a virtual agent compared to a human.

Background: A new name for schizophrenia, reflecting a biopsychosocial conceptualization, may have utility in educating patients and the public. If readily translatable, it would be of great value in transcultural psychiatry. It may be clinically beneficial to psychoeducation in evidence-based treatment modalities such as medication management, multifamily group psycho-education and cognitive therapy. Discussion: Neuro-Emotional Integration Disorder (NEID) is proposed as the biopsychosocial candidate term to replace schizophrenia. The following subtypes are proposed: defensive type replacing paranoid, motoric type replacing catatonic, Brief Neuro-Emotional-Integration Breakdown (B-NEIB) replacing brief psychotic episode, NEID-Time Limited replacing schizophreniform disorder. Schizoaffective disorder might be termed NEID-Bipolar type. Anti-psychotic medication would be termed NEI-Enhancing medication. Conclusions: By emphasizing the neuropsychiatric basis of this ‘highly treatable

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While human-computer interaction (HCI) methodologies are designed to be general, they have most often been applied in the context of literate end users in the West. These methodologies may, however, need rethinking for application in HCI for the developing world (HCID) contexts, where many of the basic assumptions that underpin the methods may not always hold true. In this article, we present an overview of one factor that is signiªcantly different in the HCID context—the literacy of the end user—by drawing on the literature of orality, and we offer a framework for HCID methodology that we argue is more appropriate for the HCID context. Based on this framework, we then present guidelines for design and user research methodologies in such contexts, highlighting seminal HCID research that corroborates these guidelines.

Fish consumption advisories for recreationally caught striped bass and bluefish vary among eastern coastal states. Although specific advice varies, polychlorinated biphenyls (PCBs) are consistently cited as a major risk driver leading to these advisories. The advisories vary from state to state due to differences in analytical methods, toxicological basis, risk management approaches, or actual differences in measured PCB levels. The differences in consumption advisories can be confusing for the public who may be receiving conflicting messages, i.e., if two states issue different advisories for the same water body as in Long Island Sound. The Eastern Coastal Striped Bass and Bluefish Consumption Advisory Workgroup was formed to explore the feasibility of developing a consistent advisory for recreationally caught migratory marine striped bass and bluefish. This Workgroup did not address subpopulations of landlocked striped bass, non-migratory populations of striped bass, or of commercially available or farm raised striped bass. The objective of the Workgroup was to analyze the feasibility of a consistent advisory based on PCB contaminants for all of the Atlantic coastal states. Where consistent advisories are not possible, the report provides a rationale for this conclusion. Four sub-workgroups also compiled

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