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Articles 181 - 210 of 228

Full-Text Articles in Public Health Education and Promotion

Knowledge And Awareness Of Vitamin D Among Pregnant Or Lactating Iraqi Refugee Women: A Call For Different Approaches In Health Education And Outreach, Someireh Amirfaiz, Ed.D. Jun 2022

Knowledge And Awareness Of Vitamin D Among Pregnant Or Lactating Iraqi Refugee Women: A Call For Different Approaches In Health Education And Outreach, Someireh Amirfaiz, Ed.D.

Journal of Refugee & Global Health

Vitamin D deficiency during pregnancy and lactation has negative impacts on maternal, fetal, and infant health. Low health literacy and other social determinants of health may increase the risk of deficiency among refugee women. This qualitative study used a survey and in-depth individual interviews to examine knowledge of vitamin D among ten pregnant or breastfeeding Iraqi refugee women in the United States, and sought participants’ recommendations on culture-centered and participatory health promotion strategies. All participants reported having insufficient information and understanding of vitamin D, its health benefits, and the risks of deficiency. The four primary themes that emerged from the …


Public Libraries As Community Health Partners, Melinda Hodges Jun 2022

Public Libraries As Community Health Partners, Melinda Hodges

Certified Public Manager® Applied Research

Public libraries are a combination meeting space, educational resource, information repository, and community building organization. As such, they are already positioned to act as a valuable partner in the public health arena. This article researches the basic tenets of public health and identifies areas that public libraries could participate in productively. This article also reviews literature about the potential of public libraries as health partners, as well as what is already being accomplished from the perspective of both library/information sciences and public health studies. This will include the benefits that libraries can bring to public health work and the barriers …


The Teacher, Yoga, And The Third Eye, Christopher J. Smiley Dds Jun 2022

The Teacher, Yoga, And The Third Eye, Christopher J. Smiley Dds

The Journal of the Michigan Dental Association

This editorial discusses a dental assistant's concern about a teacher promoting unfounded claims about fluoride and the "third eye" concept, impacting students' choices. The author explores the dubious origins of the third eye idea, referencing a yoga article, and emphasizes the importance of evidence-based approaches in dental care. Drawing from historical examples and challenges in patient beliefs, the editorial stresses the need for clinicians to blend scientific evidence, expertise, and patient preferences in a patient-centered approach. The author advocates presenting valid, reliable information in plain language to empower patients in making informed decisions and highlights the obligation to provide care …


Is Health Literacy A Defined Risk Factor? A Literature Review Of Health Literacy As It Relates To Immigrant Populations In The U.S., Kelly Zdanuczyk May 2022

Is Health Literacy A Defined Risk Factor? A Literature Review Of Health Literacy As It Relates To Immigrant Populations In The U.S., Kelly Zdanuczyk

Sustainability and Social Justice

Throughout its lifespan the definition of health literacy in the United States has been ambiguous and disagreeable. This discrepancy has created disparity among health outcomes for vulnerable populations who are classified with lower degrees of health literacy and thus have a harder time interacting with the healthcare system. This paper will review published peer-reviewed literature on the topic of health literacy as it relates to immigrant populations in the United States and explore the ways in which low health literacy results in negative health outcomes. The literature review finds the discrepancies among health literacy, as it pertains to immigrant communities …


Covid-19 And Digital Health Literacy In University Students / Narrative Competence And Cognitive Mapping As A Culturally Sustaining Pedagogy In The Education Of Emergent Bilinguals, Molly Kathleen Hadley May 2022

Covid-19 And Digital Health Literacy In University Students / Narrative Competence And Cognitive Mapping As A Culturally Sustaining Pedagogy In The Education Of Emergent Bilinguals, Molly Kathleen Hadley

Legacy Theses & Dissertations (2009 - 2024)

Early in 2020, the COVID-19 pandemic became a global public health concern. College students became dependent on the online environment for learning, but also for receiving COVID-19 information. Understanding digital health literacy (DHL) in this unique population and subsequent prevention behaviors in a digitally connected population during a public health crisis is crucial to prepare for future pandemics. This study explored DHL in college students, their main sources of pandemic information and other information seeking behaviors, adherence to public health guidelines, and intentions to receive a COVID-19 vaccine. During the summer of 2020, 245 New York state college students completed …


Association Of Health Literacy And Provider Education With Knowledge Of Breast And Cervical Cancer Screening In An Underserved Female Population, Mallory Gandy, Karly A. Meyer, Jennifer Liu, Jenenne Geske Jan 2022

Association Of Health Literacy And Provider Education With Knowledge Of Breast And Cervical Cancer Screening In An Underserved Female Population, Mallory Gandy, Karly A. Meyer, Jennifer Liu, Jenenne Geske

EMET Projects

No abstract provided.


Health Literacy Of The Covid-19 Pandemic On The Behavior Of Street Children’S Mothers In Indonesia, Yanti Tayo, Ninis Agustini Damayani, Atwar Bajari, Wawan Setiawan Mar 2021

Health Literacy Of The Covid-19 Pandemic On The Behavior Of Street Children’S Mothers In Indonesia, Yanti Tayo, Ninis Agustini Damayani, Atwar Bajari, Wawan Setiawan

Library Philosophy and Practice (e-journal)

The COVID-19 virus, which is spreading rapidly and massively around the world, is causing panic and fear in everyone; the Indonesian government is taking quick steps to solve the COVID 19 pandemic that is currently happening. What about the fate of street children currently still on the streets working as street singers, beggars, and hawkers? This study aims to see how health literacy possessed by the mothers of street children who are still on the streets during the COVID-19 pandemic. This study uses a qualitative research method with a phenomenological approach. The resource persons in this study were ten mothers …


How Did We Learn About Sex? —— Sex Education And Sexual Health In Chinese Youth, Yujuan Liu Jan 2021

How Did We Learn About Sex? —— Sex Education And Sexual Health In Chinese Youth, Yujuan Liu

Theses and Dissertations (Comprehensive)

Attitudes toward sexuality among Chinese youth have become more liberal in recent generations, but sex education remains controversial and limited. Due to the lack of awareness of sexual risks, many Chinese youth engage in unprotected sexual activities resulting in unintended pregnancy, abortions, and STIs. Therefore, understanding successful pathways and unique challenges are crucial to develop adequate sex education for youth’s sexual health in China. The current study used semi-structured in-depth interviews and investigated 28 Chinese youths’ experiences of sex education and sexual health. The results mapped out youth’s sex education experiences by age and sources and demonstrated the impacts of …


Health Literacy Of University Students In Covid-19 Pandemic And Infodemic: A Pakistani Perspective, Rozeen Shaukat, Muhammad Asif Naveed Jan 2021

Health Literacy Of University Students In Covid-19 Pandemic And Infodemic: A Pakistani Perspective, Rozeen Shaukat, Muhammad Asif Naveed

Library Philosophy and Practice (e-journal)

This research investigated the levels of health literacy among Pakistani university students in the Covid-19 pandemic and infodemic. The university students were surveyed using an online questionnaire at two public sector universities and one private sector university in Punjab-Pakistan. The administration of the data collection instrument was completed with permission from concerned authorities. A total of 374 responses received which were imported to SPSS and analyzed by applying descriptive as well as inferential statistics. The results revealed that the health literacy of university students in the Covid-19 pandemic and infodemic was not at an optimal level as these participants expressed …


Effect Of The Sims Program On Oral Hygiene Levels Of 5–6-Year-Old Children In The Kampar District, Malaysia: A Cluster-Randomized Controlled Trial, Nurul Hayati Anwar, Nor Azlida Mohd Nor, Zamros Yuzadi Mohd Yusof Aug 2020

Effect Of The Sims Program On Oral Hygiene Levels Of 5–6-Year-Old Children In The Kampar District, Malaysia: A Cluster-Randomized Controlled Trial, Nurul Hayati Anwar, Nor Azlida Mohd Nor, Zamros Yuzadi Mohd Yusof

Makara Journal of Health Research

Background: This study evaluated the effect of the “Senyuman Indah Milik Semua” program (SIMSP) versus the existing preschool oral healthcare program (POHP) on children’s oral health and parents’ oral health literacy (OHL) in Kampar district, Malaysia.

Methods: This was a cluster-randomized, matched pair, examiner-blind, controlled trial. Using computer-generated random tables, 14 preschools were allocated to the SIMSP intervention over 6 months and another 14 were allocated to the POHP, which was concealed at the cluster level. Healthy 5–6-year-old children and parents who understood the Malay language were recruited. The SIMSP was comprised of preschool visits by dental …


Woodi Health Hub: Promoting Health Information Literacy To Students In The Atlanta University Center, Rosaline Y. Odom Feb 2020

Woodi Health Hub: Promoting Health Information Literacy To Students In The Atlanta University Center, Rosaline Y. Odom

Georgia International Conference on Information Literacy

“Health Literacy is defined as the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions.” National initiatives call for improved health literacy as a means of addressing ongoing health disparities in the U.S. Low health literacy is linked to a poorer overall health status and higher risk of death among at-risk populations. Vulnerable populations include older adults, immigrant populations, minority populations and low income populations. College years are a time when young adults transition from parental control to independence and face new challenges, stressors and messages …


Effects Of Quantitative Literacy On Healthcare Decision-Making: An Aural Context, Robert G. Root, Sonia Bhala Jan 2020

Effects Of Quantitative Literacy On Healthcare Decision-Making: An Aural Context, Robert G. Root, Sonia Bhala

Numeracy

We propose a relationship between sensory modality, numerical formatting, and performance on a survey simulating healthcare decision-making. We examine the current literature on aural health literacy, and specifically aural literacy coupled with health numeracy. We then create a survey instrument called the Bhala test for this purpose and demonstrate that it is moderately internally consistent and provides results that correlate with the NUMi assessment, a widely accepted measure of health numeracy. The quantitative information provided in the Bhala test has two treatments, percentage and natural frequency formats, in an effort to determine which format is easier for subjects to use …


Development Of A Clinical-Academic-Community Collaboration To Improve Health Literacy, Daniela B. Friedman Ph.D., Michelle A. Arent, Brooks Yelton Ma, Lmsw, Mayank Sakhuja, Venice E. Haynes, Samuel Noblet, Heather M. Brandt Ph.D., Ches, William D. Isenhower, Abraham Wandersman, Diana Zona, Cyndi New, Delores Fedrick, Jonathan Scaccia, Larisa Bruner Jan 2020

Development Of A Clinical-Academic-Community Collaboration To Improve Health Literacy, Daniela B. Friedman Ph.D., Michelle A. Arent, Brooks Yelton Ma, Lmsw, Mayank Sakhuja, Venice E. Haynes, Samuel Noblet, Heather M. Brandt Ph.D., Ches, William D. Isenhower, Abraham Wandersman, Diana Zona, Cyndi New, Delores Fedrick, Jonathan Scaccia, Larisa Bruner

Faculty Publications

Limited health literacy is associated with poor patient health outcomes and increased hospitalization rates. Patient-provider communication plays an important role in patient health literacy and the understanding of medical terminology. This study demonstrates how a collaboration between clinical, academic, and community partners was instrumental in the design and implementation of a clinic readiness assessment and a clinic-based pilot intervention to encourage patient-provider communication and improve patient health literacy. A state hospital association, academic research team, and community adult literacy center director collaborated to develop a 60-item clinic readiness assessment and an evidence-informed pilot intervention. The clinic readiness assessment captured clinics’ …


Assessing Cervical Cancer Knowledge Among High-Risk Women Living In The Us-Mexico Border Region In El Paso, Tx, Crystal Costa Jan 2020

Assessing Cervical Cancer Knowledge Among High-Risk Women Living In The Us-Mexico Border Region In El Paso, Tx, Crystal Costa

Open Access Theses & Dissertations

Despite major decreases in cervical cancer incidence rates in the U.S. over the past several decades, certain populations of women continue to be disproportionately affected by it. One of these groups includes US Latina/Hispanic women who have the highest cervical cancer incidence rates as compared to their racial/ethnic counterparts. To improve detection and prevention in US Latina/Hispanic women, it is important to first understand their current knowledge and health literacy with regard to cervical cancer.

This cross-sectional study examined perceived self-knowledge of cervical cancer and cervical cancer functional health literacy in high-risk Hispanic women living in the El Paso, Texas …


Predictors Of Intention To Use Health Literacy Strategies Among Physicians In Grenada, Arlette Wildman Jan 2020

Predictors Of Intention To Use Health Literacy Strategies Among Physicians In Grenada, Arlette Wildman

Walden Dissertations and Doctoral Studies

Low health literacy is linked to poor health outcomes. Adequate health literacy depends on effective communication between patients and their healthcare providers, so it is important physicians use health literacy strategies. Grounded in the theory of planned behavior, the aim of this quantitative correlational study was to investigate the relationship between health literacy knowledge, health literacy experience, gender, the region of training, years of practice, and intentions to use health literacy strategies among physicians in Grenada. One hundred and eighteen physicians were sampled using a cross-sectional survey method. The results of the multiple linear regression analysis were significant, F(5, 112) …


Exploring The Relationship Of Digital Information Sources And Medication Adherence, Cody Arbuckle, Daniel Tomaszewski, Lawrence Brown, Jon C. Schommer, Donald Morisky, Chelsea Parlett-Pelleriti, Erik J. Linstead Apr 2019

Exploring The Relationship Of Digital Information Sources And Medication Adherence, Cody Arbuckle, Daniel Tomaszewski, Lawrence Brown, Jon C. Schommer, Donald Morisky, Chelsea Parlett-Pelleriti, Erik J. Linstead

Pharmacy Faculty Articles and Research

We present a retrospective analysis of data collected in the United States from the 2015 National Consumer Survey on the Medication Experience and Pharmacists’ Role in order to model the relationship between health information sources and medication adherence and perception. Our results indicate that while the digital age has presented prescription users with many non-traditional alternatives for health information, the use of digital content has a significant negative correlation with pharmaceutical adherence and attitudes toward medication. These findings along with previous research suggest that in order to fully realize the potential benefits of the digital age in regards to patient …


Improving The Quality Of Consumer Health Information On Wikipedia: Case Series., Shira Schecter Weiner, Jill S. Horbacewicz, Lane Rasberry, Yocheved Bensinger-Brody Mar 2019

Improving The Quality Of Consumer Health Information On Wikipedia: Case Series., Shira Schecter Weiner, Jill S. Horbacewicz, Lane Rasberry, Yocheved Bensinger-Brody

The School of Health Sciences Publications and Research

BACKGROUND: Wikipedia is one of the most consulted health resources in the world. Since the public is using health information from Wikipedia to make health care decisions, improving the quality of that health information is in the public interest. The open editable content design of Wikipedia and quality control processes in place provide an opportunity to add high-value, evidence-based information and take an active role in improving the health care information infrastructure.

OBJECTIVE: The aim of this project was to enhance Wikipedia health pages using high-quality, current research findings and track the persistence of those edits and number of page …


Health Awareness On High Blood Pressure, High Cholesterol, And Risk For Cardiovascular Disease, Innocent Bibi Jan 2019

Health Awareness On High Blood Pressure, High Cholesterol, And Risk For Cardiovascular Disease, Innocent Bibi

Walden Dissertations and Doctoral Studies

Cardiovascular disease (CVD) is responsible for 25% of the annual deaths in the United States and represents a major public health burden, as patients often require screening and lifestyle changes related to multiple risk factors such as high blood pressure and high cholesterol. The purpose of this quantitative correlational study was to determine if there was a statistically significant association between high blood pressure and high cholesterol awareness (prevention and management) and cardiovascular health outcomes (angina pectoris, coronary heart disease, and heart attack). The theoretical framework that guided this study was the health belief model. Data from adults over the …


Ethnic Minority Young Adult Perspectives On Health Literacy Readiness For Adulthood, Selwyn A. B. Carrington Jan 2019

Ethnic Minority Young Adult Perspectives On Health Literacy Readiness For Adulthood, Selwyn A. B. Carrington

Walden Dissertations and Doctoral Studies

Health literacy is a social determinant of health and health disparity and low health literacy contributes to poor health outcomes in ethnic minority young adults (EMYAs). There is a gap in the literature regarding the health literacy readiness (HLR) of EMYAs transitioning to adulthood. The overarching research question concerned the perspectives of EMYAs on HLR for the transition to adulthood. A phenomenological study design was used with a theoretical framework that integrated concepts from the socioecological and health belief models. Twelve purposefully selected EMYAs ages 18-22 from a southern U.S. county participated in the study. Data were collected by telephone …


An Examination Of The Relationship Between Health Literacy And Dietary Practices Among College Students: A Test Of The Integrated Model Of Health Literacy, Alison B. Oberne Oct 2018

An Examination Of The Relationship Between Health Literacy And Dietary Practices Among College Students: A Test Of The Integrated Model Of Health Literacy, Alison B. Oberne

USF Tampa Graduate Theses and Dissertations

Overweight and obesity continue to plague Americans and contribute to decreased quantity and quality of life. Americans of all ages experience overweight and obesity; however, increasing rates occur during young adulthood. Young adults develop dietary practice behaviors that persist into adulthood and can contribute to weight-related chronic diseases. Approximately half of all young adults are enrolled in college, and, approximately 38% of college students are either overweight or obese.

Dietary practices are health behaviors that can either increase or decrease risk for overweight and obesity. Much research has explored predictors of dietary practices among college students; however, there is a …


Prostate Cancer Information Available In Health-Care Provider Offices: An Analysis Of Content, Readability, And Cultural Sensitivity, Seul Ki Choi, Jessica S. Seel, Brooks Yelton Ma, Lmsw, Susan E. Steck Phd, Mph, Rd, Douglas P. Mccormick, Johnny Payne, Anthony Minter, Elizabeth K. Deutchki, James Hébert Scd, Daniela B. Friedman Ph.D. Jul 2018

Prostate Cancer Information Available In Health-Care Provider Offices: An Analysis Of Content, Readability, And Cultural Sensitivity, Seul Ki Choi, Jessica S. Seel, Brooks Yelton Ma, Lmsw, Susan E. Steck Phd, Mph, Rd, Douglas P. Mccormick, Johnny Payne, Anthony Minter, Elizabeth K. Deutchki, James Hébert Scd, Daniela B. Friedman Ph.D.

Faculty Publications

Prostate cancer (PrCA) is the most common cancer affecting men in the United States, and African American men have the highest incidence among men in the United States. Little is known about the PrCA-related educational materials being provided to patients in health-care settings. Content, readability, and cultural sensitivity of materials available in providers’ practices in South Carolina were examined. A total of 44 educational materials about PrCA and associated sexual dysfunction was collected from 16 general and specialty practices. The content of the materials was coded, and cultural sensitivity was assessed using the Cultural Sensitivity Assessment Tool. Flesch Reading Ease, …


Health Literacy Best Practices In Policy Development, Stacie Lee Trueheart Jan 2018

Health Literacy Best Practices In Policy Development, Stacie Lee Trueheart

Walden Dissertations and Doctoral Studies

Low health literacy is a problem the U.S. faces and, like health care itself, is a complex issue stemming from patient demographics and the healthcare providers being very diverse. Tools have been developed to mitigate the risks of low health literacy, however, without formal policy. The purpose of this qualitative case study was to explore and compare commonalities in health literacy best practices of organizations that are recognized as leaders in health literacy and are addressing low health literacy in their communities. By comparing the organizations' abilities to implement standards of plain language and health literacy tools/guidelines, best practice and …


Improving Chronic Constipation Health Literacy Proficiency: Animation Versus Traditional Written Pamphlets, Jason Baker Jan 2018

Improving Chronic Constipation Health Literacy Proficiency: Animation Versus Traditional Written Pamphlets, Jason Baker

Walden Dissertations and Doctoral Studies

The U.S. health care system is evolving from medical centric to patient centered, augmenting the importance for patients to comprehend and process medical information. The Department of Education indicated that 77 million Americans have a basic or below basic health literacy proficiency and 12% register as health literacy proficient. Animation is a time-tested device for improving health by enhancing comprehension. Chronic constipation (CC) complexity entails physiological, anatomical, and environmental mechanisms. Using the cognitive theory of multimedia learning and dual-channel auditory and visual processing, the primary research question addressed whether an animated educational video improved health literacy for CC more than …


Health Literacy As A Measure To Reduce Cost, Improve Health And Access, Vivian Dee Jan 2018

Health Literacy As A Measure To Reduce Cost, Improve Health And Access, Vivian Dee

Walden Dissertations and Doctoral Studies

The United States dedicates greater than 17% of its gross national product to healthcare. This percentage is expected to go up to 20% by 2018. Despite the high cost of care, the health care system remains inefficient and ineffective. Barriers include reduced access to care related to low health literacy. Complicating low health literacy is the high readability score of patient education materials. The high readability score is in part due to tools that are not standardized and measure different aspects of education materials creating varying readability scores. The purpose of this quality improvement project was to adopt a tool, …


Assessing Organizational Health Literacy At An Academic Health Center: A Quantitative Research Study, Latrina Y. Prince May 2017

Assessing Organizational Health Literacy At An Academic Health Center: A Quantitative Research Study, Latrina Y. Prince

Graduate Theses and Dissertations

Inadequate health literacy is a national health problem that affects about 90 million Americans. Health literacy is the degree to which a person is able to make good health decisions based on his/her ability to read, understand, and use health information and services. Organizational Health Literacy (OHL) is the degree to which an organization considers and promotes the health literacy of patients by providing easy to read, understand, and use health information and services. Since it is difficult to determine which patients have inadequate health literacy, a recommended intervention for addressing health literacy is to use OHL practices at all …


Ambulatory Registered Nurse Perspectives On Health Literacy Roles And Patient Communication, Gloria Medina Redden Jan 2017

Ambulatory Registered Nurse Perspectives On Health Literacy Roles And Patient Communication, Gloria Medina Redden

Walden Dissertations and Doctoral Studies

Registered nurses (RNs) have a significant role in communicating health information to patients. The problem addressed in this study was RNs roles with health literacy and communicating health information using words that the patient understands. This study found that ambulatory RN perspectives on their roles in health literacy and patient communication may improve health outcomes and optimal wellness. The purpose of this qualitative study was to examine and describe ambulatory RN perspectives on their roles in health literacy and patient communication, as these are necessary components linked to better health outcomes. The conceptual framework for this study was the nurse …


Development Of Health Education Materials To Prevent Sexually Transmitted Infections Among University Of Southern Maine Students, Lily Parenteau Jan 2017

Development Of Health Education Materials To Prevent Sexually Transmitted Infections Among University Of Southern Maine Students, Lily Parenteau

Muskie School Capstones and Dissertations

The purpose of this project was to develop health education materials that can be used to educate college students about the risks, symptoms, and prevention measures associated with chlamydia and gonorrhea infections, as well as provide information about current disease information in the state of Maine.


Maternal Health Literacy, Antenatal Care, And Pregnancy Outcomes In Lagos, Nigeria, Olubunmi Adanri Jan 2017

Maternal Health Literacy, Antenatal Care, And Pregnancy Outcomes In Lagos, Nigeria, Olubunmi Adanri

Walden Dissertations and Doctoral Studies

Maternal mortality, an example of poor maternal health outcomes, is widely accepted as an indicator of the overall health of a population. One of the Millennium Development Goals was reduction in maternal mortality by 3 quarters by 2015. These goals were not met in Nigeria and it is important to look at some of the reasons why. Education has been shown to have positive impact on pregnancy outcomes; however, the characteristics of pregnant women, their health literacy level, their usage of antenatal care services and how these impact pregnancy outcomes are yet to be analyzed in Lagos, Nigeria. Guided by …


Influences Of Provider-Patient Communication On Health Literacy And Public Policy Relevant Outcomes, Rachel Carla Cartwright-Vanzant Jan 2017

Influences Of Provider-Patient Communication On Health Literacy And Public Policy Relevant Outcomes, Rachel Carla Cartwright-Vanzant

Walden Dissertations and Doctoral Studies

Several artifacts of federal policy address the connection between health literacy of patients and health outcomes. These laws include The Plain Writing Act, Health Information Technology for Economic and Clinical Health, and the Health Insurance Portability and Accountability Act. Even with this policy structure, little is known about how nurses' knowledge of health literacy may influence patient understanding of medical information and health outcomes. Using Knowles' principles of effective communication, the purpose of this mixed-methods study was to concurrently examine the relationship between nurse knowledge of health literacy and communication techniques used by nurses to identify any causal relationships in …


Your Teaching Strategy Matters: How Engagement Impacts Application In Health Information Literacy Instruction, Heather A. Johnson, Laura C. Barrett Jan 2017

Your Teaching Strategy Matters: How Engagement Impacts Application In Health Information Literacy Instruction, Heather A. Johnson, Laura C. Barrett

Dartmouth Scholarship

The purpose of this study was to compare two pedagogical methods, active learning and passive instruction, to determine which is more useful in helping students to achieve the learning outcomes in a one-hour research skills instructional session.