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This document is a book review of "The impact of plain language on legal English in the United Kingdom" by Christopher Williams. The book offers a unique perspective on plain legal English and its effects. The author, a retired professor, aims to encourage further research on the topic rather than disappoint those who already have expertise in plain language, legal matters, or linguistics. The book covers various aspects, including the history of plain language in the UK, the language of legislation, and the language of court judgments. The author presents interesting details and provides references for further exploration. The text also discusses the use of plain language in legal judgments and online terms and conditions. In the analysis of legal judgments, it is found that sentence length has decreased in criminal cases but increased in civil cases. The length of judgments has also increased over time, particularly in civil cases. The use of Latinisms and first-person pronouns has decreased, while the use of passive verbs remains high. Regarding online terms and conditions, they are often too lengthy and complex for consumers to read. The use of unfamiliar pro-forms and pronominal adverbs varies across different types of contracts. The text concludes that plain language is gradually becoming more common in legal writing, but there is still more work to be done. The author suggests further research in areas such as wills and the impact of plain language on law students' education. [Extracted from the article]

Assessment and evaluation guidelines inform programmatic changes necessary for educational effectiveness. Presently, no widely accepted guidelines exist for educators to assess learners and evaluate programs regarding social determinants of health (SDOH) during physician and physician assistant (PA) education. We sought to garner expert consensus about effective SDOH learner assessment and program evaluation, so as to make recommendations for best practices related to SDOH education. We used a Delphi approach to conduct our study (September 2019 to December 2020). To administer our Delphi survey, we followed a three-step process: 1) literature review, 2) focus groups and semi-structured interviews, 3) question development and refinement. The final survey contained 72 items that addressed SDOH content areas, assessment methods, assessors, assessment integration, and program evaluation. Survey participants included 14 SDOH experts at US medical schools and PA programs. The survey was circulated for three rounds seeking consensus, and when respondents reached consensus on a particular question, that question was removed from subsequent rounds. The geographically diverse sample of experts reached consensus on many aspects of SDOH assessment and evaluation. The experts selected three important areas to assess learners' knowledge, skills, and attitudes about SDOH. They identified assessment methods that were "essential", "useful, but not essential", and "not necessary." The essential assessment methods are performance rating scales for knowledge and attitudes and skill-based assessments. They favored faculty and patients as assessors, as well as learner self-assessment, over assessments conducted by other health professionals. Questions about separation versus incorporation of SDOH assessment with other educational assessment did not yield consensus opinion. The experts reached consensus on priority outcome measures to evaluate a school's SDOH program which included student attitudes toward SDOH, Competence-Based Assessment Scales, and the percentage of graduates involved in health equity initiatives. Based on the Delphi survey results, we make five recommendations that medical and PA educators can apply now when designing learner assessments and evaluating SDOH programming. These recommendations include what should be assessed, using what methods, who should do the assessments, and how they should be incorporated into the curriculum. This expert consensus should guide future development of an assessment and evaluation toolkit to optimize SDOH education and clinical practice. Supplemental data for this article is available online at https://doi.org/10.1080/10401334.2022.2045490. [ABSTRACT FROM AUTHOR]

Random tilings of very large domains will typically lead to a solid, a liquid, and a gas phase. In the two-phase case, the solid–liquid boundary (arctic curve) is smooth, possibly with singularities. At the point of tangency of the arctic curve with the domain boundary, for large-sized domains, the tiles of a certain shape form a singly interlacing set, fluctuating according to the eigenvalues of the principal minors of a Gaussian unitary ensemble-matrix. Introducing non-convexities in large domains may lead to the appearance of several interacting liquid regions: They can merely touch, leading to either a split tacnode (hard tacnode), with two distinct adjacent frozen phases descending into the tacnode, or a soft tacnode. For appropriate scaling of the non-convex domains and probing about such split tacnodes, filaments, evolving in a bricklike sea of dimers of another type, will connect the liquid patches. Nearby, the tiling fluctuations are governed by a discrete tacnode kernel—i.e., a determinantal point process on a doubly interlacing set of dots belonging to a discrete array of parallel lines. This kernel enables us to compute the joint distribution of the dots along those lines. This kernel appears in two very different models: (i) domino tilings of skew-Aztec rectangles and (ii) lozenge tilings of hexagons with cuts along opposite edges. Soft tacnodes appear when two arctic curves gently touch each other amid a bricklike sea of dimers of one type, unlike the split tacnode. We hope that this largely expository paper will provide a view on the subject and be accessible to a wider audience. [ABSTRACT FROM AUTHOR]

Introduction: Temporary transvenous cardiac pacing (TVP) is a critical intervention that emergency physicians perform infrequently in clinical practice. Prior simulation studies revealed that emergency medicine (EM) residents and board-certified emergency physicians perform TVP poorly during checklist-based assessments. Our objective in this report was to describe the design and implementation of a simulation-based mastery learning (SBML) curriculum and evaluate its impact on EM residents' ability to perform TVP. Methods: An expert panel of emergency physicians and cardiologists set a minimum passing standard (MPS) for a previously developed 30-item TVP checklist using the Mastery Angoff approach. Emergency medicine residents were assessed using this checklist and a high-fidelity TVP task trainer. Residents who did not meet the MPS during baseline testing viewed a procedure video and completed a 30-minute individual deliberate practice session before retesting. Residents who did not meet the MPS during initial post-testing completed additional deliberate practice and assessment until meeting or exceeding the MPS. Results: The expert panel set an MPS of correctly performing 28 (93.3%) checklist items. Fifty-seven EM residents participated. Mean checklist scores improved from 13.4 (95% CI 11.8-15.0) during baseline testing to 27.5 (95% CI 26.9-28.1) during initial post-testing (P < 0.01). No residents met the MPS at baseline testing. The 21 (36.8%) residents who did not meet the MPS during initial post-testing all met or exceeded the MPS after completing one additional 30-minute deliberate practice session. Conclusion: Emergency medicine residents demonstrated significantly improved TVP performance with reduced variability in checklist scores after completing a simulation-based mastery learning curriculum. [ABSTRACT FROM AUTHOR]

Background: A variety of approaches to defining sepsis using administrative datasets have been previously reported. We aimed to compare estimates, demographics, treatment factors, outcomes and longitudinal trends of patients identified with sepsis in United States emergency departments (EDs) using differing sets of sepsis criteria. Methods: We performed a cross-sectional study using the National Healthcare Ambulatory Medical Care Survey, a complex survey of nonfederal US ED encounters between 2002 to 2018. We obtained survey-weighted population-adjusted encounters of sepsis using the following criteria: explicit sepsis, severe sepsis, and quick Sequential Organ Failure Assessment (qSOFA) score combined with the presence of infection. Results: Age-adjusted for US adults, 18.6, 16.1 and 8.9 encounters per 10 000 population were identified when using the explicit, severe sepsis and qSOFA definitions, respectively. A higher proportion of the explicit cohort was hospitalized and had blood cultures performed, compared to cohorts ascertained using severe sepsis and qSOFA criteria, though confidence intervals overlapped. Antibiotic use was highest in encounters meeting qSOFA criteria. When inspecting unweighted encounters meeting each set of criteria, there was minimal overlap, with only 3% meeting all three. Encounters meeting the explicit and severe sepsis criteria were increasing over time. Conclusion: The explicit, severe sepsis and qSOFA criteria generated similar annual rates of presentation when applied to US ED encounters, with some evidence of the explicit sepsis cohort being higher acuity. There was minimal overlap of cases and instability in estimates when assessed longitudinally. Our findings inform research efforts to accurately identify sepsis among ED encounters using administrative data. [ABSTRACT FROM AUTHOR]

Studied the literature about computer assisted instruction (CAI) in medical education by searching the Medline and ERIC databases. Medical CAI appears to be an increasingly popular topic of research and publication, but such studies tend to be published in journals with smaller circulations and are more likely to be demonstration articles than evaluations. (SLD)