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PubMed2006

MedIEQ-Quality labelling of medical web content using multilingual information extraction.

Quality of Internet health information is essential because it has the potential to benefit or harm a large number of people and it is therefore essential to provide consumers with some tools to aid them in assessing the nature of the information they are accessing and how they should use it without jeopardizing their relationship with their doctor. Organizations around the world are working on establishing standards of quality in the accreditation of health-related web content. For the full success of these initiatives, they must be equipped with technologies that enable the automation of the rating process and allow the continuous monitoring of labelled web sites alerting the labelling agency. In this paper we describe the European project MedIEQ (Quality Labelling of Medical Web Content Using Multilingual Information Extraction) that integrates the efforts of relevant organizations on medical quality labelling, multilingual information retrieval and extraction and semantic resources, from six different European countries (Spain, Germany, Greece, Finland, Czech Republic and Switzerland). The main objectives of MedIEQ are: first, to develop a scheme for the quality labelling of medical web content and provide the tools supporting the creation, maintenance and access of labelling data according to this scheme and second, to specify a methodology for the content analysis of medical web sites according to the MedIEQ scheme and develop the tools that will implement it.

Accreditation↗
PubMed1998

Versatility of a multilingual and bi-directional approach for medical language processing.

At the dawn of the 21st century, we are experiencing an exponential growth of online information that is mostly textual, and that benefits from new electronic media, such as the World Wide Web (WWW), to be broadly diffused across borders. However, there is a gap to bridge between holding information and accessing in a relevant way the deep underlying knowledge. Multilingual natural language processing (NLP), once tuned, is certainly the best solution to cope with this era of textual information. This paper focuses on the lesson learned through the joint development of an analyzer and a generator of medical language, within a multilingual context. Concrete examples, derived from the efforts under way in the European GALEN-IN-USE project, illustrate the use of these linguistic tools for the handling of surgical procedures.

Multilingualism↗
PubMed1996

Multilingual translation of the Functional Assessment of Cancer Therapy (FACT) quality of life measurement system.

There is need for multilingual cross-culturally valid quality of life (QOL) instrumentation to assess the QOL endpoint in international oncology clinical trials. We therefore initiated a multilingual translation of the Functional Assessment of Cancer Therapy (FACT) Quality of Life Measurement System (Version 3) into the following languages: Dutch, French, German, Italian, Norwegian and Swedish. Prior to this project, the FACT Measurement System was available in English, Spanish and Canadian French. The FACT is a self-report instrument which measures multidimensional QOL. The FACT (Version 3) evaluation system uses a 29-49 item compilation of a generic core (29 Likert-type items) and numerous subscales (9-20 items each) which reflect symptoms associated with different diseases, symptom complexes and treatments. The FACT-G (general version) and eight of 18 available cancer-related subscales were translated using an iterative forward-backward translation sequence. After subsequent review by 21 bilingual health professionals, all near final language versions underwent pretesting with a total of 95 patients in the native countries. Available results indicate good overall comprehensibility among native language-speakers. Equivalent foreign language versions of the FACT will permit QOL evaluation of people from diverse cultural backgrounds.

Activities of Daily Living↗
PubMed2003

Multilingualism: an fMRI study.

To investigate the hypothesis that in multilingual speakers different languages are represented in distinct brain regions, 12 multilingual right-handed men performed a word fluency task, a picture naming task, a comprehension reading task, and their respective control tasks in three languages (Dutch, French, and English) while whole-head functional magnetic resonance imaging (fMRI) was applied. In general, all language tasks revealed predominantly overlapping regions of activation for the different languages. Cerebral activation during use of the foreign languages showed a tendency toward a more extensive recruitment of the areas activated in the native language and the activation of a greater number of regions. Word generation in the foreign languages elicited additional bilateral inferior frontal activation, including Broca's area and left middle temporal gyrus activation; in the native language, additional postcentral activation was found. Picture naming in the foreign languages recruited additional inferior-lateral and medial frontal regions predominantly on the left, and more posterior right hemispheric activation in the mother tongue. During comprehension reading there was more activation in medial posterior regions in the native language. Our results suggest that the performance of language tasks in different languages engages largely the same cerebral areas but that the brain, to perform at a comparable proficiency level, engages more neural substrates for later acquired languages. Our findings do not support the view that languages learned later in life entail more right hemispheric involvement. Finally, a consequent effect of language exposure was found for reading, where increased familiarity engages more occipital activation whereas decreased familiarity appears to be associated with increased left hemispheric inferior frontal activation.

Adult↗
PubMed1987

Respiratory questionnaires in occupational studies: their use in multilingual workforces on the Witwatersrand.

The mother tongue of the majority of black workers in the industrial workforces of the Witwatersrand is either Zulu or S Sotho/Tswana, and these are also the main languages spoken in the area. However a substantial minority cite one of several other languages as their mother tongue. In consequence, in occupational surveys using a respiratory questionnaire, the accepted practice has been to use multilingual interviewers who administer the questionnaire in whichever of the two main languages the interviewee requests, but work from an English language version. To test the reproducibility of the information so gathered, a standardized questionnaire was administered to 56 subjects on two occasions approximately three weeks apart by each of two interviewers, one of whose mother tongue was Zulu and the other S Sotho. Reproducibility was little affected by whether the interviewer used her mother tongue or not, pointing to the multilingual competence of both interviewers. Reproducibility was, however, less in subjects not interviewed in their mother tongue compared to those who were. In general, reproducibility was also less for symptom than for history questions, though the phlegm question performed comparably to that reported for more homogeneous language/ethnic groups. Thus, even if internally valid, respiratory symptom information obtained by this method may have limited generalizability. However respiratory history information appears more reliable and may prove of value in the investigation of the natural history of chronic lung disease in this and similar communities.

Adult↗
PubMedDate not supplied

A multicultural and multilingual outreach program for cervical and breast cancer screening.

Partners in Health: The Breast and Cervical Health Cooperative is a New Orleans-based community health intervention program designed to increase the access of underserved multicultural, multiethnic, and multilingual women to cervical and breast cancer health education and screening. This article describes innovative approaches used over the past 4 years to successfully link the services of a university cancer center to women in the community through a culturally sensitive outreach program. In addition to cancer screening, health referrals were made for many other diverse medical/social complications such as hypertension, obesity, and violence. The program initially targeted African American women but during the past year has successfully integrated Latinas. Key to the program's success was the collaboration of community lay health educators, community churches, advanced practice nurses, and public health programs. This article provides an overview of program strategies and outcomes and discusses multicultural and multilingual issues.

Black or African American↗
PubMed2001

HONselect: multilingual assistant search engine operated by a concept-based interface system to decentralized heterogeneous sources.

Any new user to the Internet will think that to retrieve the relevant document is an easy task especially with the wealth of sources available on this medium, but this is not the case. Even experienced users have difficulty formulating the right query for making the most of a search tool in order to efficiently obtain an accurate result. The goal of this work is to reduce the time and the energy necessary in searching and locating medical and health information. To reach this goal we have developed HONselect [1]. The aim of HONselect is not only to improve efficiency in retrieving documents but to respond to an increased need for obtaining a selection of relevant and accurate documents from a breadth of various knowledge databases including scientific bibliographical references, clinical trials, daily news, multimedia illustrations, conferences, forum, Web sites, clinical cases, and others. The authors based their approach on the knowledge representation using the National Library of Medicine's Medical Subject Headings (NLM, MeSH) vocabulary and classification [2,3]. The innovation is to propose a multilingual "one-stop searching" (one Web interface to databases currently in English, French and German) with full navigational and connectivity capabilities. The user may choose from a given selection of related terms the one that best suit his search, navigate in the term's hierarchical tree, and access directly to a selection of documents from high quality knowledge suppliers such as the MEDLINE database, the NLM's ClinicalTrials.gov server, the NewsPage's daily news, the HON's media gallery, conference listings and MedHunt's Web sites [4, 5, 6, 7, 8, 9]. HONselect, developed by HON, a non-profit organisation [10], is a free online available multilingual tool based on the MeSH thesaurus to index, select, retrieve and display accurate, up to date, high-level and quality documents.

Databases, Bibliographic↗
PubMed1995

Multilingual natural language generation as part of a medical terminology server.

Re-usable and sharable, and therefore language-independent concept models are of increasing importance in the medical domain. The GALEN project (Generalized Architecture for Languages Encyclopedias and Nomenclatures in Medicine) aims at developing language-independent concept representation systems as the foundations for the next generation of multilingual coding systems. For use within clinical applications, the content of the model has to be mapped to natural language. A so-called Multilingual Information Module (MM) establishes the link between the language-independent concept model and different natural languages. This text generation software must be versatile enough to cope at the same time with different languages and with different parts of a compositional model. It has to meet, on the one hand, the properties of the language as used in the medical domain and, on the other hand, the specific characteristics of the underlying model and its representation formalism. We propose a semantic-oriented approach to natural language generation that is based on linguistic annotations to a concept model. This approach is realized as an integral part of a Terminology Server, built around the concept model and offering different terminological services for clinical applications.

Language↗
PubMed2005

Speech disruption under delayed auditory feedback in multilingual speakers.

UNLABELLED: The present study investigated the language familiarity hypothesis formulated by Mackay [(1970). How does language familiarity influence stuttering under delayed auditory feedback? Perceptual and Motor Skills, 30, 655-669] that bilinguals speak faster and stutter less under delayed auditory feedback (DAF) when speaking their more familiar language than a less familiar language. Thirty normally fluent native speakers of Dutch (17 males and 13 females, aged between 18;1 and 26;4 years) who were also proficient in French and English read meaningful and nonsense text under DAF in their mother tongue and in the two later acquired languages. The existence of a language familiarity effect was confirmed. The participants required significantly more time and showed significantly more speech disruptions under DAF in the later acquired languages than in the mother tongue, and reading time and number of speech disruptions was significantly higher for the nonsense texts than for the meaningful text for each of the three languages. An additional question addressed was whether or not there were any gender differences in the susceptibility to DAF. Results did not reveal a clear gender difference. EDUCATIONAL OBJECTIVES: The reader will be able to: (1) summarize the importance of language familiarity for the degree of speech disruption experienced by normally fluent multilingual speakers under delayed auditory feedback; and (2) describe gender differences in the susceptibility to delayed auditory feedback.

Adolescent↗
PubMed1999

Evaluating problem-based learning in a multilingual student population.

OBJECTIVES: The University of Natal Medical School in South Africa provides training for a student body composed of two groups: one with English as a first language and the other with an African language as a first language and English as the second. A new methodology was developed to evaluate an innovative course using modified problem-based learning techniques in this heterogeneous environment. DESIGN: The learning model proposed required achieving a balance of three components: content, enquiry/learning process and social interaction/group process. A multidimensional system, felt to be consistent with this educational philosophy, was developed using seven different quantitative and qualitative techniques. SETTING: The University of Natal Medical School. SUBJECTS: First-year multilingual medical students. RESULTS: The results revealed that social interaction was highly successful in reducing barriers between the student groups and between students and facilitators. However, the emphasis on group participation may have overshadowed the enquiry process, leading to superficial discussions of problems and feelings of repetitiveness. During the course students and facilitators expressed concern that the innovative assessments used did not assess the course content adequately. While the group presentations and projects were useful exercises for consolidation and group interaction, they did not enable facilitators to identify struggling students. CONCLUSIONS: The outcome of the evaluation stressed the need of achieving an appropriate balance both in the curriculum and assessments of the three components of the learning model, particularly in a setting where student backgrounds and language ability differ. Multidimensional methodology is needed for effective evaluation that promotes critical reflection.

Attitude of Health Personnel↗
PubMed2002

The color of two alphabets for a multilingual synesthete.

Interviews with a multilingual synesthete (MLS), who experiences colored letters for Roman and Cyrillic alphabets and for digits, revealed stable synesthetic experiences over 2 1/2 - 5 years. Colors of Cyrillic letters were based on Roman letters. Four Stroop tests involving both types of letters showed that MLS was able to name print color faster if the colors matched her synesthetic colors, showing that synesthesia is automatic. Letter-naming times for blocks of color were slower than those of actual letters, supporting unidirectionality of synesthesia. Stroop tests with Roman, but not Cyrillic, letters showed MLS acquired new temporary letter-color pairings and her color-naming times for these were not different from those for her original synesthetic colors.

Color Perception↗
PubMed2001

Application of the multilingual aphasia examination-spanish in the evaluation of Hispanic patients post closed-head trauma.

Despite the rapid increase of Hispanics in the U.S., there continues to be a lack of adequate psychological assessment tools to examine Spanish-speaking patients with cognitive or neuropsychological disturbances. We investigated the clinical utility of the Multilingual Aphasia Examination-Spanish (MAE-S) in the evaluation of language functions of Hispanic subjects post-traumatic brain injury (TBI). The performance of 40 TBI patients was compared to that of 40 age-, gender-, and education-matched normal controls. Subject groups differed on the Visual Naming (VN), Controlled Oral Word Association (COWA), and Token Test subtests. The VN and COWA subtests were the best discriminators of group membership. Distribution of scores for the patient group on the Rating of Articulation scale additionally indicate subtle articulatory difficulties post-TBI. For all subtests, trauma severity per Glasgow Coma Scale was the best predictor of language performance, over and above the contribution of other clinical and demographic variables. These results are consistent with prior reports of dysphasia post-TBI and suggest that the MAE-S is a sensitive and accurate measure to assess language disturbances in Hispanic populations.

Adult↗
PubMed1996

Metalinguistic analysis of therapeutic discourse: flight into a second language when the analyst and the analysand are multilingual.

The choice of a particular language for the conduct of analysis becomes an important theoretical and clinical question when both the analyst and the analysand are multilingual and share the same languages. Shift from one language into another language during analysis is an equally important question. This paper offers an analysis of the flight into a second language by both the analysand and the analyst within the transference-countertransference matrix. The focus of the discussion is the communicative nature of the mother tongue vis-à-vis a second language. The author argues that unconscious fantasies and memories of early childhood experiences are built into the mother tongue and are brought to life in the analytic dialogue by way of that language. Shift into a second language is viewed as primarily defensive in nature. It is, however, noted that a second language may at times provide the only space where the analyst can meet the patient out of each of certain personal and cultural ghosts. Finally, since the mother tongue is viewed as the preverbal register of the transitional space, it is suggested that the working through of preoedipal issues be ultimately carried out in that language.

Adult↗
PubMed2004

Development of a multilingual resource manual.

Providing culturally competent health care is a growing need as the population of culturally diverse women continues to rise. Compilation of a multilingual resource manual about maternal-child and women's health topics that can be used by health educators to provide care to non-English-speaking and limited English proficiency (LEP) clients was achieved to address this need. In this article, significant details of this process are described allowing the reader to produce a similar version of the manual.

Communication Barriers↗
PubMed2004

Multilingualism and healthcare in Nigeria: a management perspective.

Nigeria has a healthcare system that has been described as defective even by its managers. A year 2000 study by the World Health Organization (WHO) of health systems in 191 member countries ranked Nigeria 187th. These several evaluations consistently point to inadequate managerial skills. Regrettably, very little is known of the import of language and communication as management issues in healthcare delivery in this country of 400 languages. This article therefore proposes a language-driven audit of health management in Borno State (northeast Nigeria) as a means of sensitizing policy makers and implementers. Based largely on data from questionnaires completed by 129 health professionals belonging to various professional categories (physicians, nurses, pharmacy staff, laboratory staff, and medical and health workers) and drawn from four hospitals, the study explores the relationship between multilingualism and the following: (a) patients' rights; (b) staff recruitment, deployment and commitment; (c) human asset accounting; (d) physician-population ratio. This language-driven audit reveals a number of points, including: ethically questionable practices; distributional imbalance in personnel; commendable cases of employee commitment; and inequity in renumeration.

Communication Barriers↗
PubMed1999

Towards a multilingual morpheme thesaurus for medical free-text retrieval.

We introduce a methodology for the segmentation of complex compounds into medically plausible morphemes. A tool for thesaurus compilation and management is presented, and design principles for a multilingual morpheme thesaurus are outlined. Our goal is to enhance the quality of medical free-text retrieval by replacing lexically based through morpheme-based search procedures.

Germany↗
PubMed2006

ENN-ICS--implementation and evaluation of a multilingual learning management system for sleep medicine in Europe.

A new web based network aims at the improvement of health care in Europe by integrating advanced e-learning and e-publishing technologies for the training of medical doctors, nurses, and students. The field of application is sleep physiology and sleep medicine. Based on a multilingual, multimedia communication system, ENN-ICS Centre offers direct access to medical information for users, i.e healthcare professionals and citizens, in Europe and worldwide. The use of XML supports the development of media independent contents for multiple target groups. Editorial and distributive processes are supported by customized central editorial, content management and learning management systems (CMS, LMS). ENN-ICS e-health services are evaluated by selected user groups in North, Middle and Southern Europe using reliable and scientifically accepted validation instruments. The compliance with essential quality requirements and criteria is tested and verified by using online questionnaires based on the DISCERN questionnaire for evaluating patient information, the HON principles for health-related websites and the GMDS catalogue of quality criteria for electronic publications in medicine. The system architecture and its exemplary applications can be used as a model for future e-health services dealing with neurological and other medical topics.

Europe↗
PubMed1994

Right hemisphere involvement in processing later-learned languages in multilinguals.

In two experiments, multilingual Papua New Guinean subjects were tested using a divided visual field technique designed to determine hemispheric laterality for English and for Tok Pisin. Various factors including age of acquisition, proficiency, mode of instruction, and number of years that the language had been used were considered in relation to language laterality. Only age of acquisition proved to be a significant contributor to the laterality effects obtained; older acquirers of both English and Tok Pisin showed greater right hemisphere involvement than early acquirers. Although proficiency did not seem to be related to language laterality, it too was systematically affected by acquisition age. Older acquirers of English performed significantly poorer than younger acquirers on all four of the language-usage tests given. The strong influence of acquisition age on cerebral laterality for language and proficiency is interpreted as supporting a critical period for language learning.

Adolescent↗