the Breakfast Club

Summer is the best season for lunch
in the balcony floating on the Seine

Worry wears layered clothing, so that 
if she accidentally flies to 

You make coffee for me every morning.
You don’t know me.

You think you are good at loving,
Until the world falls apart when

Kiwifruits march in formation
with camouflage of loss and anger,

Once upon a time, there was an old, retired hunter living in his hermitage.
One day, a tiger came for him. "Our forest is occupied," the tiger said, "please help us. All we want is a place that everyone could live equally."
"Why me?" The old hunter hesitated.
"All other hunters were defeated. You are our only hope." The tiger begged.
"What should I do?" The hunter asked.
"Just kill the cunning boss. Me and all other animals will fight our own battle and take our land back." The tiger answered rapidly. "All we need is a little help from your proficient skill." He added.
"Well then. I’ll give it a try." The hunter said.
"Your help is much, much appreciated, sir!" The tiger cheered. He took out a leather pouch, "I was not allowed to present this until you said yes. This is a magic pouch. When you fight the boss, reach your hand into it, and you can pull out whatever weapon you need. But it could only be used for three times." The tiger put the pouch on the table, took a bow, and left.

After my wife passed away six months ago, I tried to keep myself busy. But somehow I just couldn't forget about her. I couldn’t move on.
I went on a business trip to Philadelphia. My wife loved art but I didn't, so I never went to a museum with her before. This time I decided to go to the Philadelphia Museum of Art, one of the places she always mentioned that she wanted to go with me.

I long to see my first love story. It was in my 8th grade when I fell in love with the most good-looking boy in the class. When I say "see" I I really mean it. I want to go back to the past and watch the whole scenes like a theatre audience. I want to stand in the school hallway right beside him and the younger me and listen to him saying "I like you"; I want to walk with me and him when we had our first date in a bookstore, maybe try to pick a lovely bookmark with secret messages on it, and slip it into the boring gift I bought him; I want to be at my house, watch him kiss me the very first time, and whisper to myself "kiss him back you fool!" ; I want to be on the street that night, witness the stupid me saying sorry to him again and again because she kissed another boy. And maybe slap the younger me on the face, then cry with both of them. I think I long not just to see my first love story. I long to stop it. To change it. To start all over again and laugh in the end. But none of these I can do. I can't even "just" see. I long to see...

In these four chapters there are three of them continue discuss about knowing the audience of the Health Literacy (HL), so I would keep using the same title this time.
Literacy
After reading this chapter I really think that the author should put it in the first chapter instead of the 21st.
The 2003 U.S. National Assessment for Adult Literacy (NAAL), which is the most recent and comprehensive measure, defines literacy as using “printed and written information to function in society, to achieve one’s goals, and to develop one’s knowledge and potential”. There are three type of literacy within it: prose literacy, document literacy, and quantitative literacy. And there are four levels of literacy: below basic, basic, intermediate, and proficient. Here is the research result of each literacy and level:

The author spends 7 chapters talking about knowing the audience. I think in any field of literacy, the “reader” is always the most important subject. Considering the 500 words limit, I decide to stick to my four-chapter-one article strategy. Here are the four “audience”:

Children

In clinical settings, what is more complex about pediatric Health Literacy (HL) is that it must be considered in both parents’, caregivers’ and children’s HL. I think this is not only because, as the author states, that if you let children actively participate they would be more cooperative in treatment and be more honest about their health related behavior. But more importantly, as my past job in a hospital in Taiwan trained me, it is more “ethical” to let the patient himself/herself involves in the whole process. However it’s harder than adults, since children are usually ill and need to have unpleasant medical procedures. Using humor and real-life examples in hospitals might help the communication. For health children, provide age-appropriate education in school such as teaching them to read the nutrition labels is also an important HL skill training.

Although I am still trying to title every article, when each contains four chapters it’s actually a lot more than that. But I think this is also a way of summarizing my reading, so I will keep doing this.
I always think that literacy is cultural, and it presents in many elements, such as media, writing and attitude. In the field of Health Literacy (HL) it’s even more obvious. Since we are living in this melting pot, many times the word “cultural” is more “multicultural”.
First, for example, the author discusses about media. Unlike the old days when most people learned about health from their doctors, today they are more from television, radio, websites, newspapers and magazines. The good side is people might be taught more health knowledge, but the bad side is they might be too panic about decease, have too high of expectation toward treatment—one famous study is that in TV shows the success rate of CPR, about 55%, is actually much higher than in real life, about 10%—, or get pursued by ads to buy medicine they don’t need. Another example the author points out is that “the picture of a cute teddy bear or sleeping baby on the label of children’s medication may encourage parents to buy it”.
 
As one “treatment”, the author introduce a website called Health News Review that uses stringent criteria to grade health stories on a scale of 1 to 5.
Second, the author discusses about words in HL, which include translation, jargon and acronyms. In the States, about 20% of the population speak a language other than English at home. The author suggests three points that could have ESL patients:
1. Provide translated tools of basic phrases in clinical settings (but of course, patients must be able to read in their native language).
2. Communicate the message in alternative ways, such as body languages (of course must be cultural appropriately), drawings, an anatomic model, a visual rating scale, audio or video.
 
    Here are two websites that the author recommends. One is called Ethnomed, which is about integrating cultural information into clinical practice. The other is called MedlinePlus, which provides translated materials.
3. Use meaningful examples and illustrations. But remember to make sure that they are “consistent with the culture, age, and interests” of the readers.
Third, the use of jargons or acronyms. This reminds me of the “Discourse” Gee stated in his article. If you are not a member of one Discourse, nor a member-to-be through apprenticeship, it’s almost impossible for you to know the meaning of some words. One example the author points out is that in health care, the term “unremarkable” generally has a good meaning of “you are find”, while the term “positive” has a bad meaning of “you are not”, and this is quite different than our “feelings” toward these words.
Last, the author talks about being humor in the serious business of health care. While there are many conversations about life-and-death issues that can’t and shouldn’t be taken lightly, there also are occasions, either in clinical setting, in print or in video, when humor can improve learning and understanding.
Question for thinking:
1. The author suggests that we can include a dose of humor with cleaver illustrations or ridiculous examples in print. Do you agree with her? If so, how do we do it under the multicultural perspective?

Although writing and reading seems to be the “traditional” elements of literacy in the modern fields such as health and media, undeniably, they are still one of the most important things in health literacy (HL), as well the complicated things.
In these four chapters the author talks mainly about the writing materials of HL. First, unlike the literature or journal paper, these “practical” writing requires different skills, ideas and perspectives. Usually, printed and Web materials not only need to be written clearly and simply, they also should be designed in ways that readers find inviting and appealing. This kind of “information design” refers to the art of doing, for example, combining words and images to encourage readers to start, and keep, reading.
This is exactly what a blog, or all other modern digital writing should pursue, because nowadays we are all, when writing online and seeking potential readers, “authors”. Therefore I think not only the health materials such as a Website or a pamphlet, but also a blog, an email and even a literature, when people look at a text that is confusing, they don't feel respect because they feel as though they are not “being talked to”, just “being talked at”. Writers should remember that reading isn’t just an intellectual cognitive activity, but also an emotional one, sometimes even toward the efferent texts. In this point of view, the writing of “information design” is more like an art, not a science, with lots of room for subjective judgement from both writers and readers.
However, this is not an easy task for writers. Health materials, whether it’s medical instructions or informed consent forms, always content difficult concepts. How to make it simple without omitting too many information, how to use easy words to explain hard terms, and how to present statistic numbers are all challenges. A good way to identify project goals is by asking yourself what readers should know, do, and feel after reading this document.
But not only documents that has writing. In clinical settings, there are signs everywhere. Even before you walk into a hospital you need to find the right “entrance”.
 
Patients and families today speak a wide variety of languages, come from many different countries, and vary widely in their learning abilities. To help people more easily find their way, using symbols such as pictograms or images is a good idea.
 
Readers sometimes struggle, too. Today, health care is filled with forms and other “reading-to-do” documents, which the author refers to “written materials that require readers to perform word-based tasks such as filling in numbers, rating satisfaction, checking off instructions, and signing consent”. According to studies, about 1/3 adults has insufficient literacy level to do these. Even our general literacy is ok, when it comes to professional terms we still suffer sometime. Therefore providers should not only try to use plain language, but also provide an environment where people could feel comfortable to read, think and write, and could easily access assistance when needed.
Questions for thinking:
1. Do we need to teach students different kinds of writing, such as the digital writing, in classroom? If so, how?