A multi-speciality approach to the protection of children from sexual offences act: A review.

Children constitute vulnerable section of the society, and governments have moral responsibility to safeguard their interests and safety. It does so by enacting various laws and providing framework for its implementation. Child sexual abuse (CSA) is widely prevalent in all societies and World Health Organization has promulgated broad guidelines against such practices. There are enough provisions against such perpetrators in India and suitable amendments have been provisioned based on inputs from various sections of the society. This article delves into the provisions of the act, its medicolegal application, and psychodynamics of such behaviors among the perpetrators.

Are English-language online patient education materials related to breast cancer risk assessment understandable, readable, and actionable?

PURPOSE: To evaluate the readability, understandability, and actionability of online patient education materials (OPEM) related to breast cancer risk assessment. MATERIAL AND METHODS: We queried seven English-language search terms related to breast cancer risk assessment: breast cancer high-risk, breast cancer risk factors, breast cancer family history, BRCA, breast cancer risk assessment, Tyrer-Cuzick, and Gail model. Websites were categorized as: academic/hospital-based, commercial, government, non-profit or academic based on the organization hosting the site. Grade-level readability of qualifying websites and categories was determined using readability metrics and generalized estimating equations based on written content only. Readability scores were compared to the recommended parameters set by the American Medical Association (AMA). Understandability and actionability of OPEM related to breast cancer high-risk were evaluated using the Patient Education Materials Assessment Tool (PEMAT) and compared to criteria set at ≥70%. Descriptive statistics and inter-rater reliability analysis were utilized. RESULTS: 343 websites were identified, of which 162 met study inclusion criteria. The average grade readability score was 12.1 across all websites (range 10.8-13.4). No website met the AMA recommendation. Commercial websites demonstrated the highest overall average readability of 13.1. Of the 26 websites related to the search term breast cancer high-risk, the average understandability and actionability scores were 62% and 34% respectively, both below criteria. CONCLUSIONS: OPEM on breast cancer risk assessment available to the general public do not meet criteria for readability, understandability, or actionability. To ensure patient comprehension of medical information online, future information should be published in simpler, more appropriate terms.

A Multimetric Evaluation of Online Patient Educational Materials for Breast Implant-associated Anaplastic Large Cell Lymphoma.

OBJECTIVE: To assess understandability, actionability, and readability of online patient educational materials (OPEM) related to breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). METHODS: Search volumes for query terms related to BIA-ALCL including "breast implant associated lymphoma," "breast implant associated anaplastic large cell lymphoma," and "BIA-ALCL" were analyzed in one-week increments and normalized to total Google search volume. The same terms were then queried using an online search engine to identify commonly accessed OPEM on this topic. Understandability and actionability of OPEM were evaluated using the Patient Education Materials Assessment Tool. Grade-level readability was determined using generalized estimating equations, with observations nested within readability metrics from each website. All interval estimates were calculated for 95% confidence. RESULTS: Overall, 24 websites were identified based on search parameters. Of these websites, 11 (45.8%) met criteria for understandability, and 1 (4.2%) met criteria for actionability. Overall, readability ranged from 10.2 to 17.3 for all websites with an average grade level readability of 12.4; 0 websites were written at or below a sixth-grade reading level. Government websites had the highest average grade reading level at 14.0, followed by commercial websites at 13.2, nonprofit websites at 12.0, and then academic/hospital-based websites at 11.5. CONCLUSION: The quality of available OPEM on BIA-ALCL is limited. Future development of OPEM should be designed with the goal of improving both comprehension and actionability to help reduce patient anxiety and unnecessary clinical appointments related to this disease.

Characterization of very virulent Marek's disease viruses isolated in Japan.

Pathogenicity of two isolates of Marek's disease virus (MDV), MS1 and MS2, from chickens was examined in two genetically different strains of chickens, MD-susceptible P-2 chickens and less susceptible PDL-1 chickens. The isolates induced an early mortality syndrome unassociated with lymphoproliferative lesions in P-2 chickens. There were no significant differences in pathogenicity between our isolates and the Md/5 strain of very virulent MDV (vvMDV) in both P-2 and PDL-1 chickens. Protective indices of turkey herpes virus (HVT) vaccine against challenge with MS1 or MS2 in P-2 chickens were 54% and 28%, respectively, whereas HVT gave more than 80% protection in PDL-1 chickens. These results indicate that the two isolates could be classified as vvMDV. In contrast, a bivalent vaccine composed of HVT and serotype 2 MDV, and CVI988 vaccine gave good protection against challenge with the isolates in P-2 chickens; however, the best protection was given by the CBI988 vaccine. This is the first report of isolation of vvMDV in Japan.