Beginning reading instruction: Syllables or phonemes? An experimental training study with Arabic-speaking preliterate preschoolers.

This study addressed four research questions: (1) Does teaching using syllables or using phonemes lead to better progress in beginning reading and spelling? (2) Does the effectiveness of syllabic or phonemic instruction depend on children's preferences for these units as predicted by Ziegler and Goswami's (2005) "availability" hypothesis? (3) Do children taught via syllabic consonant-vowel (CV) units spontaneously develop insight into the phonemic basis of an alphabetic writing system, and (4) Do individual differences in reading and spelling gains in phoneme-based instruction depend more on working memory, short-term memory, and Rapid Automatized Naming (RAN) owing to the greater number of units that must be rapidly retrieved and processed? To test these hypotheses, 104 preliterate preschool children were taught to read and spell using an unfamiliar script. Across 14 training sessions, children were taught using either whole CV units, phoneme units, or demiphoneme units. Retention and generalization were evaluated during training and 1 week later.

Insights from Eye Blinks into the Cognitive Processes Involved in Visual Word Recognition.

Behavioral differences in speed and accuracy between reading familiar and unfamiliar words are well-established in the empirical literature. However, these standard measures of skill proficiency are limited in their ability to capture the moment-to-moment processing involved in visual word recognition. In the present study, the effect of word familiarity was initially investigated using an eye blink rate among adults and children.

Language-universal and script-specific factors in the recognition of letters in visual crowding: The effects of lexicality, hemifield, and transitional probabilities in a right-to-left script.

Peripheral letter recognition is fundamentally limited not by the visibility of letters but by the spacing between them, i.e., 'crowding'.

A developmental study of eye movements in Hebrew word reading: the effects of word familiarity, word length, and reading proficiency.

Previous studies examining the link between visual word recognition and eye movements have shown that eye movements reflect the time-course of cognitive processes involved in reading. Whereas most studies have been undertaken in Western European languages written in the Roman alphabet, the present developmental study investigates a non-European language-Hebrew, which is written in a non-alphabetic (abjadic) script. We compared the eye-movements of children in Grades 4 to 6 ( = 30) and university students ( = 30) reading familiar real words and unfamiliar (pseudo)words of 3 letters and 5 letters in length.

Preschool morphological awareness contributes to word reading at the very earliest stages of learning to read in a transparent orthography.

The purpose of the current study was to examine whether morphological awareness measured before children are taught to read (Kindergarten in Israel) predicts reading accuracy and fluency in the middle of first grade, at the very beginning of the process of learning to read pointed Hebrew - a highly transparent orthography, and whether this contribution remains after controlling for phonemic awareness. In a longitudinal design, 680 Hebrew-speaking children were administered morphological and phonemic awareness measures at the end of the preschool year (before they were taught to read) then followed up into first grade when reading was tested in mid-year. The results indicated that even at this early point in learning to read a transparent orthography, preschool morphological awareness contributes significantly to both reading accuracy and reading fluency, even after partialling out age, non-verbal general ability, and phonemic awareness.

A pupillometric study of developmental and individual differences in cognitive effort in visual word recognition.

Throughout the history of modern psychology, the neural basis of cognitive performance, and particularly its efficiency, has been assumed to be an essential determinant of developmental and individual differences in a wide range of human behaviors. Here, we examine one aspect of cognitive efficiency-cognitive effort, using pupillometry to examine differences in word reading among adults (N = 34) and children (N = 34). The developmental analyses confirmed that children invested more effort in reading than adults, as indicated by larger and sustained pupillary responses.

Common Misconceptions about the Phonological Deficit Theory of Dyslexia.

In this discussion paper, I review a number of common misconceptions about the phonological deficit theory (PDH) of dyslexia. These include the common but mistaken idea that the PDH is simply about phonemic awareness (PA), and, consequently, is a circular "pseudo"-explanation or epiphenomenon of reading difficulties. I argue that PA is only the "tip of the phonological iceberg" and that "deeper" spoken-language phonological impairments among dyslexics appear well before the onset of reading and even at birth.

Keeping an Eye on Effort: A Pupillometric Investigation of Effort and Effortlessness in Visual Word Recognition.

Rapid and seemingly effortless word recognition is a virtually unquestioned characteristic of skilled reading, yet the definition and operationalization of the concept of cognitive effort have proven elusive. We investigated the cognitive effort involved in oral and silent word reading using pupillometry among adults (Experiment 1, = 30; Experiment 2, = 20) and fourth through sixth graders (Experiment 3, = 30; Experiment 4, = 18). We compared multiple pupillary measures (mean, peak, and peak latency) for reading familiar words (real words) and unfamiliar letter strings (pseudowords) varying in length.

Learning to Spell in Arabic: The Impact of Script-Specific Visual-Orthographic Features.

Learning to spell is a challenging process, especially for young learners, in part because it relies on multiple aspects of linguistic knowledge, primarily phonological and morphological. However, alongside these universals, there are significant writing system specifics, namely, language-specific and script-specific factors that may also challenge young readers and writers (Daniels and Share, 2018). The current study focuses on the impact of four distinctive visual-orthographic features of the Arabic abjad on spelling, namely, (i) the similarity of many basic letter-forms, (ii) allography (the positional variants of the letter forms), (iii) ligaturing (the joining of letters), and (iv) non-linearity (extra-linear diacritic-like signs used to mark consonantal, short vowel and morpho-syntactic distinctions).

Michigan Pharmacists Transforming Care and Quality: Developing a Statewide Collaborative of Physician Organizations and Pharmacists to Improve Quality of Care and Reduce Costs.

Background: Inappropriate drug use, increasing complexity of drug regimens, continued pressure to control costs, and focus on shared accountability for clinical measures drive the need to leverage the medication expertise of pharmacists in direct patient care. A statewide strategy based on the collaboration of pharmacists and physicians regarding patient care was developed to improve disease state management and medication-related outcomes.

Program Description: Blue Cross Blue Shield of Michigan (BCBSM) partnered with Michigan Medicine to develop and implement a statewide provider-payer program called Michigan Pharmacists Transforming Care and Quality (MPTCQ), which integrates pharmacists within physician practices throughout the state of Michigan.

Clinical predictors of the medical interventions provided to patients with low back pain in the emergency department.

Background: Low back pain is a common complaint in emergency departments (ED), where deviations from standard of care have been noted.

Objective: To relate the ordering of advanced imaging and opioid prescriptions with the presentation of low back pain in ED.

Methods: Six hundred adults with low back pain from three centers were prospectively analyzed for history, examination, diagnosis, and the ordering of tests and treatments.

Learning to Read a Semitic Abjad: The Triplex Model of Hebrew Reading Development.

We introduce a model of Hebrew reading development that emphasizes both the universal and script-specific aspects of learning to read a Semitic abjad. At the universal level, the study of Hebrew reading acquisition offers valuable insights into the fundamental dilemmas of all writing systems-balancing the competing needs of the novice versus the expert reader (Share, 2008). At the script-specific level, pointed Hebrew initially employs supplementary vowel signs, providing the beginning reader a consistent, phonologically well-specified script while helping the expert-to-be unitize words and morphemes via (consonantal) spelling constancy.

Predicting emergency coronary artery bypass graft following PCI: application of a computational model to refer patients to hospitals with and without onsite surgical backup.

Background: Clinical tools to stratify patients for emergency coronary artery bypass graft (ECABG) after percutaneous coronary intervention (PCI) create the opportunity to selectively assign patients undergoing procedures to hospitals with and without onsite surgical facilities for dealing with potential complications while balancing load across providers. The goal of our study was to investigate the feasibility of a computational model directly optimised for cohort-level performance to predict ECABG in PCI patients for this application.

Methods: Blue Cross Blue Shield of Michigan Cardiovascular Consortium registry data with 69 pre-procedural and angiographic risk variables from 68 022 PCI procedures in 2004-2007 were used to develop a support vector machine (SVM) model for ECABG.

If not now, when? Prescription of evidence-based medical therapy prior to hospital discharge increases utilization at 6 months in patients with symptomatic peripheral artery disease.

We evaluated the impact of the prescription of evidence-based medical therapy (EBMT) including aspirin (ASA), beta-blockers (BB), ACE-inhibitors or angiotensin receptor blockade (ACE/ARB), and statins prior to discharge after peripheral vascular intervention (PVI) on long-term medication utilization in a large multi-specialty, multicenter quality improvement collaborative. Among patients undergoing coronary revascularization, use of the component medications of EBMT at hospital discharge is a major predictor of long-term utilization. Predictors of EBMT use after PVI are largely unknown.

Michigan's fee-for-value physician incentive program reduces spending and improves quality in primary care.

As policy makers and others seek to reduce health care cost growth while improving health care quality, one approach gaining momentum is fee-for-value reimbursement. This payment strategy maintains the traditional fee-for-service arrangement but includes quality and spending incentives. We examined Blue Cross Blue Shield of Michigan's Physician Group Incentive Program, which uses a fee-for-value approach focused on primary care physicians.

Comparative effectiveness and safety of a catheterization laboratory-only eptifibatide dosing strategy in patients undergoing percutaneous coronary intervention.

Background: Eptifibatide, a small-molecule glycoprotein IIb/IIIa inhibitor, is conventionally administered as a bolus plus infusion. A growing number of clinicians are using a strategy of catheterization laboratory-only eptifibatide (an off-label use) as procedural pharmacotherapy for patients undergoing percutaneous coronary intervention although the comparative effectiveness of this approach is unknown.

Methods And Results: We compared the in-hospital outcome of patients undergoing percutaneous coronary intervention across 47 hospitals and treated with eptifibatide bolus plus infusion with those treated with a catheterization laboratory-only regimen.

Hospital performance for pharmacologic venous thromboembolism prophylaxis and rate of venous thromboembolism : a cohort study.

Importance: Hospitalization for acute medical illness is associated with increased risk of venous thromboembolism (VTE). Although efforts designed to increase use of pharmacologic VTE prophylaxis are intended to reduce hospital-associated VTE, whether higher rates of prophylaxis reduce VTE in medical patients is unknown.

Objective: To examine the association between pharmacologic VTE prophylaxis rates and hospital-associated VTE.

The epidemiology and outcomes of percutaneous coronary intervention before high-risk noncardiac surgery in contemporary practice: insights from the Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2) Registry.

Background: Percutaneous coronary intervention (PCI) is sometimes performed with the intent to lower cardiovascular risk before high-risk noncardiac surgery (HRNCS). There are limited data on the frequency and outcome of PCIs performed in this setting.

Methods And Results: We assessed the frequency, characteristics, and in-hospital outcomes of patients undergoing PCI as part of the preoperative workup for HRNCS among all 61 145 elective PCIs performed between 2002 and 2009 at 14 hospitals in the Blue Cross Blue Shield of Michigan Cardiovascular Consortium.

A random forest based risk model for reliable and accurate prediction of receipt of transfusion in patients undergoing percutaneous coronary intervention.

Background: Transfusion is a common complication of Percutaneous Coronary Intervention (PCI) and is associated with adverse short and long term outcomes. There is no risk model for identifying patients most likely to receive transfusion after PCI. The objective of our study was to develop and validate a tool for predicting receipt of blood transfusion in patients undergoing contemporary PCI.

The association between contrast dose and renal complications post PCI across the continuum of procedural estimated risk.

Background: Prior studies have proposed to restrict the contrast volume (CV) to <3x calculated creatinine clearance (CCC), to prevent contrast induced nephropathy (CIN) post percutaneous coronary interventions (PCI). The predictive value of this algorithm for CIN and therefore the benefit of this approach in high risk patients has been questioned. The aim of our study was to assess the association between contrast dose and the occurrence of CIN in patients at varying predicted risks of CIN and baseline CCC following contemporary PCI.

Comparative safety of vascular closure devices and manual closure among patients having percutaneous coronary intervention.

Background: The role of vascular closure devices (VCDs) in patients having percutaneous coronary intervention (PCI) is controversial, and recommendations for use vary.

Objective: To examine the use of and outcomes associated with VCDs in real-world practice.

Design: Observational cohort study.

Orthographic learning and self-teaching in a bilingual and biliterate context.

The aim of this study was to examine self-teaching in the context of English as a foreign language literacy acquisition. Three groups comprising 88 sixth-grade children participated. The first group consisted of Russian-Hebrew-speaking bilinguals who had acquired basic reading skills in Russian as their first language (L1) and literacy and who were literate in Hebrew as a second language.

Composite measures for profiling hospitals on bariatric surgery performance.

Importance: The optimal approach for profiling hospital performance with bariatric surgery is unclear.

Objective: To develop a novel composite measure for profiling hospital performance with bariatric surgery.

Design, Setting, And Participants: Using clinical registry data from the Michigan Bariatric Surgery Collaborative, we studied all patients undergoing bariatric surgery from January 1, 2008, through December 31, 2010.

The clinical outcomes of percutaneous coronary intervention performed without pre-procedural aspirin.

Objectives: The purpose of this study was to examine the incidence and outcomes of percutaneous coronary intervention (PCI) performed in patients who had not received pre-procedural aspirin.

Background: Aspirin is an essential component of peri-PCI pharmacotherapy. Previous studies suggest that pre-procedural aspirin is not administered to a clinically significant number of patients undergoing PCI.