Medication Leaflets Research Articles

Insights and perceptions: Investigating pregnant women's attitudes, understanding, and factors influencing knowledge regarding medication usage during pregnancy-A cross-sectional study.

Medication use during pregnancy is a critical concern due to potential risks to both the mother and fetus. To the extent of our knowledge, there has been no prior research to assess medication use and identify the specific factors of pregnant women within the Yemeni community. This study aimed to investigate the knowledge, beliefs, and practices of Yemeni pregnant women regarding medication use and assess the factors associated with the knowledge during pregnancy. A cross-sectional multi-center study was conducted through face-to-face interviews using a validated structured questionnaire. The study was conducted on pregnant women receiving antenatal care at tertiary care hospitals in four governorates in Yemen. Univariable and multivariate logistic regressions were employed to examine the relationship between participant variables and their knowledge. A P-value of less than .05 was considered statistically significant. Out of the 1003 pregnant women, 35.4% (n = 355) were aged 21-25 years, 33.9% (n = 340) had primary education, 73.6% (n = 738) lived in urban areas, 12.2% (n = 122) were smokers, 38.3% (n = 384) reported chewing khat, and the majority (90.2%, n = 905) were unemployed. Also, 65.5% (n = 657) of the participants reported taking folic acid in their current pregnancy. A total of 2,623 medications were utilized during pregnancy, with 17.8% during the first trimester (n = 468). Around 39.3% (n = 1,037) of medications used fell under the blood and blood-forming organs category. Education level (AOR: 4.00, P < .001), insurance status (AOR: 1.71, P = .026), information about medication risks to the fetus (AOR: 1.96, P = .023), the use of folic acid either in a previous pregnancy (AOR: 1.65, P < .008) or in the current pregnancy (AOR: 4.26, P < .001), and checking the medication leaflet (AOR: 5.67, P < .001) were predictors of higher knowledge. The findings underscore the pressing need for educational interventions aimed at pregnant women. By bridging knowledge gaps and promoting informed decision-making, such initiatives can contribute to a safer and healthier pregnancy journey, reducing the inclination towards self-medication.

Knowledge and practices on home medication storage and disposal in Syria: a population-based, cross-sectional study

BackgroundMedications are commonly found in every household. In Syria, where healthcare infrastructure faces significant challenges, improper storage can lead to reduced medication efficacy and increased health risks. Additionally, inappropriate disposal practices pose serious environmental concerns, especially in a region already grappling with environmental degradation. This study aimed to evaluate the knowledge, and practices of Syrian individuals regarding the appropriate storage and disposal of home medications.MethodA cross-sectional study was conducted from September 22 to October 20, 2023, using an online survey distributed via social media apps (WhatsApp, Facebook, and Telegram) in Syria. The questionnaire, adapted from a similar study in Saudi Arabia, was translated to Arabic using the forward–backward translation technique. A convenience sampling technique was used. Inclusion criteria were participants over eighteen with expired or unused medications at home. Descriptive statistics, Chi-square tests, and binary logistic regression analysis were performed using SPSS version 27, with statistical significance defined as p < 0.05.ResultsA total of 2,217 responses were analyzed, with the majority of participants being female (79%) and aged between 21–30 years (56%). The study found that 90.7% of respondents dispose of expired medications in the garbage, while 95% keep medications in their original containers. Additionally, 30% consult pharmacists for storage instructions, and 64% read storage information on medication leaflets. Logistic regression analysis revealed that males were less likely to check expiration dates before use (OR: 0.58, 95% CI: 0.40–0.84) and periodically (OR: 0.68, 95% CI: 0.54–0.85). Participants aged 31–40 years were less likely to check expiration dates periodically (OR: 0.46, 95% CI: 0.31–0.68), while those with children under six years old were more likely to do so (OR: 1.29, 95% CI: 1.01–1.67). Males were also less likely to read storage instructions (OR: 0.61, 95% CI: 0.50–0.76) but more likely to ask pharmacists about them (OR: 1.26, 95% CI: 1.01–1.57). There was no significant difference in these practices between medical professionals and the general population.ConclusionThis study reveals gaps in the practices related to the storage and disposal of medications among the Syrian public. The findings suggest a need for targeted public education and awareness programs to improve these practices and reduce the associated health and environmental risks.

Integrating AI-Generated Summaries of Medication Leaflets into a Mobile Application for Medication Management.

Effective medication management poses significant challenges, particularly when navigating multiple medications with intricate dosages and schedules. This paper presents a prototype mobile application to streamline information retrieval from dense medication leaflets. By utilizing automated information extraction based on large language models, the application seamlessly retrieves pertinent details from the Austrian medicinal product index upon scanning the medication package. This extracted information is organized and displayed within the app, ensuring clarity and accessibility for users. In addition to this core functionality, the application offers a suite of features tailored to facilitate effective medication management. By integrating comprehensive medication information with practical medication management tools, the application empowers users to navigate complex medication regimes with confidence and ease.

Unveiling the future: precision pharmacovigilance in the era of personalized medicine

In the era of personalized medicine, pharmacovigilance faces new challenges and opportunities, demanding a shift from traditional approaches. This article delves into the evolving landscape of drug safety monitoring in the context of personalized treatments. We aim to provide a succinct reflection on the intersection of tailored therapeutic strategies and vigilant pharmacovigilance practices. We discuss the integration of pharmacogenetics in enhancing drug safety, illustrating how genetic profiling aids in predicting drug responses and adverse reactions. Emphasizing the importance of phase IV—post-marketing surveillance, we explore the limitations of pre-marketing trials and the necessity for a comprehensive approach to drug safety. The article discusses the pivotal role of pharmacogenetics in pre-exposure risk management and the redefinition of pharmacoepidemiological methods for post-exposure surveillance. We highlight the significance of integrating patient-specific genetic profiles in creating personalized medication leaflets and the use of advanced computational methods in data analysis. Additionally, we examine the ethical, privacy, and data security challenges inherent in precision medicine, emphasizing their implications for patient consent and data management.

Development of an App for Symptom Management in Women With Breast Cancer Receiving Maintenance Aromatase Inhibitors: Protocol for a Mixed Methods Feasibility Study.

Patients with postmenopausal nonmetastatic estrogen receptor-positive breast cancer often experience a reduced quality of life after primary treatment. The disease and treatment trajectory consists of surgery followed by chemotherapy or radiation therapy. Upon this, maintenance hormone therapy with an aromatase inhibitor can result in several physical and psychosocial symptoms. Optimal symptom control during maintenance therapy is central to maintaining the patient's quality of life. This study aims to (1) develop an electronic symptom management tool for patients with postmenopausal early breast cancer receiving maintenance aromatase inhibitors with an endocrine aspect and (2) assess the feasibility, acceptability, and usability of the pilot version of the Bone@BC app. Furthermore, longitudinally, symptom prevalence and quality of life for patients with postmenopausal nonmetastatic estrogen receptor-positive breast cancer will be explored. This study follows a multistage research plan. In stage 1, a systematic literature review to establish an overview of aromatase inhibitor-related symptoms reported by postmenopausal women with nonmetastatic estrogen receptor-positive breast cancer will be completed. In stage 2, a comprehensive overview of symptoms related to aromatase inhibitors (letrozole, exemestane, and anastrozole) will be performed (eg, by reviewing medical leaflets and guidelines). In stage 3, an electronic app with a user-friendly Patient Concern Inventory list to comprise symptoms and concerns will be developed. Last, in stage 4, a convergent mixed methods feasibility study of the pilot version of the Bone@BC app will be conducted. A total of 45 patients with postmenopausal nonmetastatic estrogen receptor-positive breast cancer will use the app daily for symptom identification and respond to 6 serial patient-reported outcome measurements for 12 weeks. Finally, semistructured interviews will be performed. The primary outcome includes consent rate, attrition rate, retention rates, technical issues, and adherence, assessed using preestablished criteria on feasibility and a mixed methods approach for exploring acceptability. A patient advisory board consisting of 5 women with breast cancer is recruited to include their perspectives and experiences in the planning, organization, implementation, and dissemination of the research throughout the project. At the time of submitting this paper (January 2024), a total of 23 patients have been included in the stage 2 medical audit over the recruitment period of 3 months (November 2022 to February 2023), and 19 patients have been enrolled in stage 2, the semistructured patient interviews. This protocol describes a study investigating the feasibility, acceptability, and usability of the symptom management tool Bone@BC developed for patients with breast cancer with an endocrine aspect. ClinicalTrails.gov NCT05367830; https://clinicaltrials.gov/ct2/show/NCT05367830. DERR1-10.2196/49549.

A Cross-Sectional Evaluation of Knowledge of Medicine Safety and Frequency of Reading Medication Leaflets and Its Predictors-Insights from Saudi Adults in Riyadh, Saudi Arabia [Letter

A Cross-Sectional Evaluation of Knowledge of Medicine Safety and Frequency of Reading Medication Leaflets and Its Predictors-Insights from Saudi Adults in Riyadh, Saudi Arabia [Letter

A Cross-Sectional Evaluation of Knowledge of Medicine Safety and Frequency of Reading Medication Leaflets and Its Predictors - Insights from Saudi Adults in Riyadh, Saudi Arabia.

On the other hand, patient safety, is of the utmost importance, in addition to health care providers' counseling and advice, patient information leaflets (PILs) also have a significant impact on health outcomes. This study aimed to assess the Knowledge of medicine safety and Frequency of reading medication Leaflets and their predictors among the Saudi population in Riyadh Saudi Arabia. This cross-sectional study was conducted over three months in 2023 using online structured self-administered questionnaires, on the adults of Saudi Arabia, admitted to provide informed consent, aged ≥18 years, able to complete the questionnaires, being Saudi nationals, and currently living in the country. The data analysis was performed using the Statistical Package for Social Science (SPSS) version 27. In this study, 23.6% (n=123) of respondents always read the PILs, while 14.6% (n=76) of them never read the PILs. In addition, 22.6% (n=118) of them find it difficult to understand the PILs. In this study, 53.9% of them revealed that ADRs are unexpected reactions after taking the normal dose and 15.4% of them do not know what ADRs are. The respondents gender (B= 0.164; SE=0.075; 95CI = 0.017-0.310; p = 0.029), Social status (B = 0.251; SE = 0.079; 95CI = 0.096-0.406; p = 0.002) and monthly income (B= 0.136; SE = 0.021; 95CI = 0.095-0.178; p < 0.001) was the predictor of reading PILs. In this study, two-thirds of participants took medication and knew why they were taking it. However, only a few of them took the medicine after seeing a doctor, suggesting self-medication practice. In addition, 22.1% of them find it difficult to understand the PILS, and a small number of them would rather read it. Highlighting the significance of seeking medical advice from healthcare professionals before using a medication.

Multimodal Analysis of Selected Health Awareness Materials: A Visual Grammar Approach

The Visual Grammar approach is effective in examining the communicative value of healthcare posters. As semiotic resources, these posters comprise both images and text for persuasive and informative ends. Previous studies have looked at multilingual health care texts and medical information leaflets using different approaches, but the focus here was monolingual healthcare posters written in English. Hence, this study analyzed five purposefully selected online healthcare posters meant for a Nigerian audience. It looks at the ways image and text cohere as syntagm within narrative and conceptual representations to form persuasive and informative messages, and the multimodal constraints on the healthcare posters as they serve communicative ends. A descriptive research design was adopted to analyse corpus from five online health care materials. Features of the materials were identified and classified according to manifested multimodal features before they were subjected to narrative and conceptual analyses. The way image and text cohere; their functions and communicative values were also discussed to highlight attendant constraints. Findings show that as a multimodal text the healthcare posters employ semiotic resources to project messages as either contextualized or decontextualized. Major and minor semiotic processes, achieved by image and text coherence, form both narrative and conceptual meaning-making units. Added to this informative value are colour variations and font size which are also employed as enhancers of detail, mood and contrast as well as attention drawing devices. Logos of sponsors give the health messages varying credibility values as rhetorical questions and advice-clauses serve persuasive ends. Thus, the study concluded that the communicative potential of a healthcare poster are hinged on semiotic resources that constrain readers’ or viewers’ perceptions on health matters.

Public knowledge of antibiotics, self-medication, and household disposal practices in Jordan

ABSTRACT Background This study aimed to assess public understanding of antibiotics, self-medication, and drug disposal practices. Methods A cross-sectional self-administered online survey was undertaken in Jordan. Results The study was completed by 1,105 participants. When asked about their knowledge of antibiotics, rational antibiotic use, and disposal practices, 16% percent believed they should discontinue antibiotics once they felt better, and 12% agreed to take the same antibiotics prescribed to others for the same illness. Self-medication with antibiotics was practiced by 44% of the participants. Prior experience, healthcare costs, and pharmacy location were all major determinants of self-medication. Only 6.4% of unneeded antibiotics were returned to the pharmacy, 60% were kept at home, and 26.6% were disposed of at home. Almost half of those who kept the antibiotics said they would use them again, and one-third said they would give them to friends and family. Respondents who had used antibiotics within the previous 6 months (p = 0.052) and relied on medication leaflets (p = 0.031) and physician recommendations (p = 0.001) were less likely to self-medicate with antibiotics. Conclusions The study highlighted areas of inappropriate use of antibiotics, self-medication and the improper antibiotic disposal that can inform antimicrobial stewardship.

Investigating Translation Challenges of English Affixations in Medical Leaflets into Arabic

This paper sheds light on the challenges faced by the student translators when they translate certain affixations in medical texts. It is difficult to understand the medical words without knowing the meaning of affixations attached to them because they have their own meanings and give a scientific reference to the words attach to. The study hypothesizes that student translators have limited knowledge and awareness of such affixations in the medical context especially the leaflets which are widely used in medicines. This paper also investigates the challenges those translators face when they manage the translation of the affixations into Arabic. The data are taken from different medical leaflets and translated into Arabic due to certain strategies used by the translators from English into Arabic. This paper shows to what extent the translation is clear for the TT readers and convey the meaning adequately. In this paper, Vinay and Darbelnet strategies have been adopted in this study to see how the meaning of affixations in the ST is conveyed in TT.

Emergency card, emergency medication, and information leaflet for the prevention and treatment of adrenal crisis (Addison crisis): an Austrian consensus document

Ein wichtiges Ziel bei der Behandlung der Nebenniereninsuffizienz ist die Prävention der Nebennierenkrise (auch akute Nebenniereninsuffizienz oder Addison-Krise genannt). Um in Österreich eine bessere Implementierung sowie Harmonisierung der Maßnahmen zur Prävention und Therapie der Nebennierenkrise zu erreichen, wurde dieses Konsensusdokument erarbeitet. Folgende Maßnahmen werden grundsätzlich für alle Patient*innen mit Nebenniereninsuffizienz empfohlen und in diesem Manuskript ausführlich erörtert: 1. Versorgung mit einer Notfallkarte („steroid emergency card“) sowie evtl. auch mit einem Armband oder einer Halskette (oder Ähnlichem) mit medizinischem Alarmhinweis „Nebenniereninsuffizienz, benötigt Glukokortikoide“. 2. Versorgung mit einem Hydrocortison-Notfallkit zur Injektion (alternativ auch Suppositorien/Zäpfchen zur Notfallapplikation) sowie ausreichenden oralen Glukokortikoiddosen für Stresssituationen/Erkrankungen. 3. Schulung von Patient*innen und Angehörigen zur Steigerung der Glukokortikoidtherapie in Stresssituationen bzw. bei Erkrankungen („sick day rules“) und zur Selbstinjektion von Hydrocortison. 4. Versorgung mit einer Behandlungsleitlinie (Informationszettel) zur Prävention und Therapie der Nebennierenkrise, welche bei Bedarf auch dem Gesundheitspersonal gezeigt werden soll. 5. Versorgung mit einer Notfall-Telefonnummer des behandelnden endokrinologischen Teams und/oder medizinisch geschulter Betreuungspersonen bzw. Angehöriger. 6. Regelmäßige (vorzugsweise jährliche) Wiederholung der Schulungsmaßnahmen. Dieses Konsensusdokument beinhaltet auch ausführliche Empfehlungen für die perioperative Glukokortikoidtherapie sowie für diverse andere Stresssituationen.

Knowledge and practices concerning the storage and disposal of home medications among people in the eastern region of Saudi Arabia: A cross-sectional study

BackgroundMedications are widely used and stored in people’s homes throughout the year. Inappropriate storage of home medications is a worldwide problem and may affect the effectiveness and stability of medications, which impacts the activity and capability of these medications to treat diseases. This study aimed to assess the awareness of the public in the eastern region of Saudi Arabia concerning the appropriate storage of used medications and the proper disposal of unwanted medications. MethodA cross-sectional survey was conducted in the eastern region of Saudi Arabia between February and June 2018. The study questionnaire tool was constructed based on several previous studies regarding medication storage, recycling, and the correct and safe disposal of expired, unwanted, or unused medication. ResultsA total of 820 responses was collected. The results showed that 91.0% of the respondents keep their medications in the original container, and only 4.5% of them write the expiry date on the new containers. While 47.1% of the respondents read the storage instructions written in the medication leaflet, only 16.2% of the respondents ask the pharmacist about the storage instructions. A majority of the respondents (84.4%) check the expiry date of medications before use, and 70.1% of them periodically check the expiry date of stored medications. Age, gender, and education level were important factors that affected medication storage practices. ConclusionThis work underpinned the lack of awareness among the public regarding the appropriate way to store home medications and the proper way to dispose of unwanted and expired medications.

Reading minds: A study of deictic shifts in translated written interaction between mental-health professionals and their readers

The practice of knowledge mediation in written texts relating to the health sciences has hitherto received limited attention within Translation Studies. The overall aim of this study is to explore writer-reader interaction in a bilingual corpus of medical leaflets published on the website of the Royal College of Psychiatrists (UK). In order to do this, a comparative analysis of English source texts and Spanish target texts was conducted to identify shifts in personal reference, which served to contrast patterns in knowledge transfer processes between mental health experts and their target audiences. The study is underpinned by Thompson and Thetela’s (1995) tenet that interactive and interactional features have to be considered in conjunction. It seeks to make a contribution to the relatively understudied field of how interaction patterns differ across cultural and linguistic settings. The corpus is of special interest due to the sensitivity of its subject matter, the varied constituency it addresses and the fact that the translated texts were produced and revised by mental health professionals.

The Use of Over-The-Counter (OTC) Medications by University Students During Examinations in Saudi Arabia: A Cross-Sectional Study.

PurposeDuring examinations, many students use various over-the-counter (OTC) drugs to improve their concentration or treat exam-related medical symptoms. The purpose of this study was to scrutinize the use of OTC drugs during examinations in Saudi Arabia.Materials and MethodsA cross-sectional study was designed, consisting of online, self-administered questionnaires comprising 27 items, including the awareness, knowledge, and attitude of students toward OTC drug use during examinations. A logistic regression model was fitted to determine factors that predict OTC drug use. The data were analyzed using Statistical Package for Social Science (SPSS).ResultsA total of 463 (92.6%) completed questionnaires were received from 500 recruited participants. Among participants, 58.5% were women, 47.9% were 22 years or older and completing their final year of study, and 44.1% of students preferred not to disclose their monthly income. The most common cause (35.6%) for OTC drug use during the examination period was headache, followed by pain (21%), fever (16.6%), and cough (8.2%). The most commonly used medication were painkillers, antipyretics, cough and cold medications, and vitamins (57.2%, 16.4%, 11%, and 7.3%, respectively). Male students showed a significant lack of awareness and knowledge regarding the safety and reasons for OTC drug use compared with their female counterparts and were less likely to read the medication leaflet before use (p < 0.001, odds ratio [OR]: 0.36, confidence interval [CI]: 0.23–0.57) and did not know which drugs require prescriptions (p < 0.001, OR: 0.41, CI: 0.27–0.63). Other significant factors that predicted OTC drug use included age, university level, and drug income.ConclusionThe most common reported cause for OTC drug use during examinations among students was headache. Sex, age, university level, and monthly income were significant factors affecting OTC drug use during examinations.

Barriers to Accessing Medicines among Syrian Asylum Seekers and Refugees in a German Federal State.

In Germany, asylum seekers and refugees (AS&Rs) face challenges when accessing healthcare services including medicines. The aim of this study was to explore the barriers to accessing medicines among Syrian AS&Rs in the state of North Rheine-Westphalia, and to provide an understanding of their perspectives towards taking medicines that contain alcohol or pork products. This study is based on a cross-sectional survey using a combination of sampling methods. We used descriptive statistics to analyze quantitative data. Participants’ answers to an open-ended question yielded qualitative data that were categorized based on the thematic areas they discussed or addressed. Among the 1641 respondents, language barriers had more of an effect on the access to medicines than any other factor studied. The effect of language barriers on access to medicines was more pronounced for female participants, those who were older than 50 years, and participants who had chronic diseases in comparison to the other groups of participants. Male participants and those younger than 50 years of age showed more acceptance towards taking medicines that contain alcohol or pork products. Based on our results, we recommend providing more support for AS&Rs to learn the German language, particularly for female refugees, older refugees, and those with chronic diseases or disabilities. We also recommend providing translated medical leaflets for patients who wish to receive them in their native language. Healthcare providers should try to consider the special conditions of AS&Rs patients and take into account their perspectives about treatments and diseases.

On the Logical Foundation of a Personalized Medical Prescription System

This paper, lays down the logical foundations for a personalized medical prescription system. The proposed system employs detailed pharmaceutical and medical knowledge about a medication and its effects or side effects on the patient, which may go beyond what is available in medication leaflets. The ontology was initially built for the proposed system and employs the description logic system, ALC, for knowledge representation. However, the uncertain nature of medical and medicinal knowledge poses some problems such as drug-drug interactions and drug-disease interactions, which render ALC inadequate to represent and reason within a system such as a personalized medical prescription system. Indeed, there is a need for a more flexible representation that allows reasoning with incomplete knowledge and possibly inconsistent cases. ALC is extended with defeasible rules to obtain defeasible ALC. Defeasible ALC allows the prevention of adverse drug interactions, detection drug-drug interactions and detection of drug-disease interactions. The ultimate purpose of this paper is providing to provide a standard knowledge base system toward a medical prescription capable of dealing with incomplete knowledge, conflicting information (inconsistencies) and exceptions cases, which will enhance individual healthcare and provide an appropriate prescription. This is accomplished by expanding the capabilities of description logic with defeasible rules, to achieve an accurate prescription decision for any patient’s condition(s). Once implemented, a personalized medical prescription system intends to assist, not to replace, the clinician during medical prescription(s) or the pharmacist(s).

Minimizing Drug Adverse Events by Informing About the Nocebo Effect-An Experimental Study.

Relevance: Informing patients about potential adverse events as part of the informed consent may facilitate the development of nocebo-driven drug adverse events (nocebo side effects). Objective: To investigate whether informing about the nocebo effect using a short information sheet can reduce nocebo side effects. Methods: A total of N = 44 participants with weekly headaches for at least 6 months were recruited using the cover story of a clinical trial for a headache medicine. In reality, all participants took a placebo pill and were randomized to the nocebo information group or the standard leaflet group. Participants were instructed to read the bogus medication leaflet entailing side effects information shortly before pill intake. The nocebo group additionally received an explanation about the nocebo effect as part of the leaflet. Questionnaires were completed at baseline, 2 min, and 4 days after the pill intake. We conducted general linear models with bootstrap sampling. Baseline symptoms were included as a covariate. Results: Most participants (70.5%) reported nocebo side effects at 2 min. Participants who received the nocebo information (n = 24) reported less nocebo symptoms than the control group (n = 20) (estimated difference: 3.3, BCa 95% CI [1.14; 5.15], p = 0.01, Cohen’s d = 0.59). Baseline symptoms, perceived sensitivity to medicine, and side effect expectations each moderated the group effect (estimated difference in slope: 0.47, BCa 95% CI [0.19; 0.73], p = 0.001, d = 0.75; 1.07 [0.27; 1.61], p = 0.006, d = 0.73; 1.57 [0.38; 2.76], p = 0.02, d = 0.58). No group differences were found at 4-day follow-up. After revealing the actual aim of the study, 86% of the participants evaluated the nocebo information to be helpful in general. Conclusions: Results provide the first evidence that informing about the nocebo effect can reduce nocebo side effects.

Risk Management in the Ambulatory Care Process in a Mutual Benefit Association Covering Work-Related Accidents and Diseases: Applying Modified Failure Mode and Effect Analysis (FMEA) Methodology.

To assess the impact of different forms of use of failure mode and effect analysis methodology for risk prioritization in the ambulatory care process in a mutual benefit association covering work-related accidents and diseases. The study is based on a previously drafted and individually prioritized risk map by a multidisciplinary team made up of patient safety committee members from health care centers and clinics in a mutual benefit association covering work-related accidents and diseases. The professionals mainly carry out their work in the field of management (individual manager group (IMG)). A group formed by clinicians subsequently completed 2 prioritizations: one based on the individual opinions of each of the members (individual clinical group (ICG)) and another in a consensual way (consensual clinical group (CCG)) as recommended by failure mode and effect analysis methodology. The risk prioritization was compared in the 3 groups (IMG, ICG, and CCG). The risk prioritization by the IMG defines 7 extreme risks (risk prioritization ≥ 275). When the clinical group prioritizes them in an individual way (ICG), there is no extreme risk, whereas when it does so in a consensual way (CCG), there are 21 extreme risks. With respect to the coincidences of existing causes between the 3 groups, it is noted that the "risk of falls" is rated by both the clinical and the manager group but prioritized differently. On the other hand, the ICG and CCG coincide in that pressure on health care services can contribute to carrying out incomplete anamnesis. They also both consider that internal and external waiting lists and holiday periods can cause a delay in the starting of rehabilitation. The IMG and the CCG show similarity in the risk assessment of overprescribing medication and that multiple computer sessions are initiated. Finally, the IMG and the ICG coincide in the "lack of delivery of the medication leaflet". The point of view of the clinicians is important in the risk prioritization of the ambulatory health care process. The difference in the risk prioritization between the clinical group at individual level and after consensus is remarkable.

Assessing the Understanding of Pediatric-Oriented Medication Education Materials Versus Standard Available Education Materials.

The objective of this study was to determine if education material targeting children would improve understanding of medication indication, administration, and common side effects in pediatric subjects. This cross-sectional pilot study included students 7 to 11 years old from a suburban elementary school. Study participants were read either the US Food and Drug Administration-approved adult medication leaflet or a pediatric medication leaflet created at a first-grade reading level for levetiracetam (Keppra, UCB, Inc, Atlanta, GA). Students were asked a set of standardized survey questions to evaluate comprehension of side effects, medication indication, dosing frequency, administration, and overall impression of the leaflet. Fifty-eight children were included. Fifty percent of the children were male, 79% were Caucasian, and the average age was 9 years. There was no statistical difference for demographics in the adult leaflet versus the pediatric leaflet group. Children correctly stated the indication for the medication in 30% of participants (9/30) in the adult leaflet group and 79% of participants (22/28) in the pediatric leaflet group, p = 0.002. The administration frequency question was answered correctly in 93% of the pediatric leaflet group (26/28) as compared to 73% in the adult leaflet group (22/30), p = 0.05. For questions about side effects and how to administer the medication, there was no difference between the groups. The responses regarding readability and understanding of the leaflets were significantly different in the pediatric leaflet group compared to the adult leaflet group, p = 0.001 and p = 0.001, respectively. Leaflets designed for pediatric patients resulted in an improvement in the understanding of the indication for levetiracetam.

Multimodality in medicine: How university medical students approach informative leaflets

This study aims to analyse multimodality in medical leaflets to see how images and other semiotic modes combine with text-flow, adding meaning to the message and broadening the communicative spectrum. Traditionally, in the educational sphere, more importance has been given to text rather than to other semiotic modes but, in fact, writing is also a multimodal practice. In medicine, the visual becomes vital, whether accompanied by meaningful written text or not. The present study analyses 50 medical leaflets designed by first year medical students enrolled in their English for Health Sciences module. The leaflets are a very useful activity integrated as part of their spoken project presentations and include a variety of medical topics, i.e. diabetes, Female Genital Mutilation (FGM), Alzheimer's or Huntington's disease, among others. Images were considered in terms of type, structural organisation, and size. How images combine with text-flow was also observed. The study is an example of how we can apply multimodality to the teaching and learning of languages in the higher education curriculum, proving that multimodality is not only a theory, but also a field of application.