Systematic review of communication partner training in aphasia: methodological quality.

PubMed

Cherney, Leora R; Simmons-Mackie, Nina; Raymer, Anastasia; Armstrong, Elizabeth; Holland, Audrey

2013-10-01

Twenty-three studies identified from a previous systematic review examining the effects of communication partner training on persons with aphasia and their communication partners were evaluated for methodological quality. Two reviewers rated the studies on defined methodological quality criteria relevant to each study design. There were 11 group studies, seven single-subject participant design studies, and five qualitative studies. Quality scores were derived for each study. The mean inter-rater reliability of scores for each study design ranged from 85-93%, with Cohen's Kappa indicating substantial agreement between raters. Methodological quality of research on communication partner training in aphasia was highly varied. Overall, group studies employed the least rigorous methodology as compared to single subject and qualitative research. Only two of 11 group studies complied with more than half of the quality criteria. No group studies reported therapist blinding and only one group study reported participant blinding. Across all types of studies, the criterion of treatment fidelity was most commonly omitted. Failure to explicitly report certain methodological quality criteria may account for low ratings. Using methodological rating scales specific to the type of study design may help improve the methodological quality of aphasia treatment studies, including those on communication partner training.

Promoting Strong Written Communication Skills

NASA Astrophysics Data System (ADS)

Narayanan, M.

2015-12-01

The reason that an improvement in the quality of technical writing is still needed in the classroom is due to the fact that universities are facing challenging problems not only on the technological front but also on the socio-economic front. The universities are actively responding to the changes that are taking place in the global consumer marketplace. Obviously, there are numerous benefits of promoting strong written communication skills. They can be summarized into the following six categories. First, and perhaps the most important: The University achieves learner satisfaction. The learner has documented verbally, that the necessary knowledge has been successfully acquired. This results in learner loyalty that in turn will attract more qualified learners.Second, quality communication lowers the cost per pupil, consequently resulting in increased productivity backed by a stronger economic structure and forecast. Third, quality communications help to improve the cash flow and cash reserves of the university. Fourth, having high quality communication enables the university to justify the need for high costs of tuition and fees. Fifth, better quality in written communication skills result in attracting top-quality learners. This will lead to happier and satisfied learners, not to mention greater prosperity for the university as a whole. Sixth, quality written communication skills result in reduced complaints, thus meaning fewer hours spent on answering or correcting the situation. The University faculty and staff are thus able to devote more time on scholarly activities, meaningful research and productive community service. References Boyer, Ernest L. (1990). Scholarship reconsidered: Priorities of the Professorate.Princeton, NJ: Carnegie Foundation for the Advancement of Teaching. Hawkins, P., & Winter, J. (1997). Mastering change: Learning the lessons of the enterprise.London: Department for Education and Employment. Buzzel, Robert D., and Bradley T. Gale. (1987). Profit Impact on Market Strategy: The PIMS Principle.New York: Free Press. Jablonski, Joseph R. (1994). Implementing TQM: Competing in the Nineties Through Total Quality Management. Albuquerque, NM: Technical Management Consortium, Inc.

Team communication during patient handover from the operating room: more than facts and figures.

PubMed

Manser, Tanja; Foster, Simon; Flin, Rhona; Patey, Rona

2013-02-01

This study was aimed at examining team communication during postoperative handover and its relationship to clinicians' self-ratings of handover quality. Adverse events can often be traced back to inadequate communication during patient handover. Research and improvement efforts have mostly focused on the information transfer function of patient handover. However, the specific mechanisms between handover communication processes among teams of transferring and receiving clinicians and handover quality are poorly understood. We conducted a prospective, cross-sectional observation study using a taxonomy for handover behaviors developed on the basis of established approaches for analyzing teamwork in health care. Immediately after the observation, transferring and receiving clinicians rated the quality of the handover using a structured tool for handover quality assessment. Handover communication during 117 handovers in three postoperative settings and its relationship to clinicians' self-ratings of handover quality were analyzed with the use of correlation analyses and analyses of variance. We identified significantly different patterns of handover communication between clinical settings and across handover roles. Assessments provided during handover were related to higher ratings of handover quality overall and to all four dimensions of handover quality identified in this study. If assessment was lacking, we observed compensatory information seeking by the receiving team. Handover quality is more than the correct, complete transmission of patient information. Assessments, including predictions or anticipated problems, are critical to the quality of postoperative handover. The identification of communication behaviors related to high-quality handovers is necessary to effectively support the design and evaluation of handover improvement efforts.

Communication and effectiveness in a US nursing home quality-improvement collaborative.

PubMed

Arling, Priscilla A; Abrahamson, Kathleen; Miech, Edward J; Inui, Thomas S; Arling, Greg

2014-09-01

In this study, we explored the relationship between changes in resident health outcomes, practitioner communication patterns, and practitioner perceptions of group effectiveness within a quality-improvement collaborative of nursing home clinicians. Survey and interview data were collected from nursing home clinicians participating in a quality-improvement collaborative. Quality-improvement outcomes were evaluated using US Federal and State minimum dataset measures. Models were specified evaluating the relationships between resident outcomes, staff perceptions of communication patterns, and staff perceptions of collaborative effectiveness. Interview data provided deeper understanding of the quantitative findings. Reductions in fall rates were highest in facilities where respondents experienced the highest levels of communication with collaborative members outside of scheduled meetings, and where respondents perceived that the collaborative kept them informed and provided new ideas. Clinicians observed that participation in a quality-improvement collaborative positively influenced the ability to share innovative ideas and expand the quality-improvement program within their nursing home. For practitioners, a high level of communication, both inside and outside of meetings, was key to making measurable gains in resident health outcomes. © 2013 Wiley Publishing Asia Pty Ltd.

A systematic quality review of high-tech AAC interventions as an evidence-based practice.

PubMed

Morin, Kristi L; Ganz, Jennifer B; Gregori, Emily V; Foster, Margaret J; Gerow, Stephanie L; Genç-Tosun, Derya; Hong, Ee Rea

2018-06-01

Although high-tech augmentative and alternative communication (AAC) is commonly used to teach social-communication skills to people with autism spectrum disorder or intellectual disabilities who have complex communication needs, there is a critical need to evaluate the efficacy of this approach. The aim of this systematic review was to evaluate the quality of single-case experimental design research on the use of high-tech AAC to teach social-communication skills to individuals with autism spectrum disorder or intellectual disabilities who have complex communication needs, to determine if this intervention approach meets the criteria for evidence-based practices as outlined by the What Works Clearinghouse. Additionally, information on the following extended methodological standards is reported on all included studies: participant description, description of setting and materials, interventionist description, baseline and intervention description, maintenance, generalization, procedural integrity, and social validity. The results from 18 multiple-baseline or multiple-probe experiments across 17 studies indicate that using high-tech AAC to teach social-communication skills to individuals with autism spectrum disorder or intellectual disabilities and complex communication needs can be considered an evidence-based practice, although the review of comparison (i.e., alternating treatment) design studies did not indicate that high-tech AAC is significantly better than low-tech AAC.

Distress and patient-centered communication among veterans with incidental (not screen-detected) pulmonary nodules. A cohort study.

PubMed

Slatore, Christopher G; Golden, Sara E; Ganzini, Linda; Wiener, Renda Soylemez; Au, David H

2015-02-01

Incidental pulmonary nodule detection is postulated to cause distress, but the frequency and magnitude of that distress have not been reported. The quality of patient-clinician communication and the perceived risk of lung cancer may influence distress Objectives: To evaluate the association of communication processes with distress and the perceived risk of lung cancer using validated instruments. We conducted a prospective cohort study of patients with incidentally detected nodules who received care at one Department of Veterans Affairs Medical Center. We measured distress with the Impact of Event Scale and patient-centered communication with the Consultation Care Measure, both validated instruments. Risk of lung cancer was self-reported by participants. We used multivariable adjusted logistic regression to measure the association of communication quality with distress. Among 122 Veterans with incidental nodules, 23%, 12%, and 4% reported experiencing mild, moderate, and severe distress, respectively, at the time they were informed of the pulmonary nodule. Participant-reported risk of lung cancer was not associated with distress. In the adjusted model, high-quality communication was associated with decreased distress (odds ratio [OR] = 0.28, 95% confidence interval [CI] = 0.08-1.00, P = 0.05). Among participants who reported a risk of malignancy of 30% or less, high-quality communication was associated with decreased distress (OR = 0.15, 95% CI = 0.02-0.92, P = 0.04), but was not associated with distress for those who reported a risk greater than 30% (OR = 0.12 (95% CI = 0.00-3.97, P = 0.24), although the P value for interaction was not significant. Veterans with incidental pulmonary nodules frequently reported inadequate information exchange regarding their nodule. Many patients experience distress after they are informed that they have a pulmonary nodule, and high-quality patient-clinician communication is associated with decreased distress. Communication strategies that only target improved knowledge of the risk of malignancy may not be sufficient to reduce the distress associated with nodule detection.

Shooting the messenger to spite the message? Exploring reactions to claims of racial bias.

PubMed

Schultz, Jennifer R; Maddox, Keith B

2013-03-01

Two experiments examined aspects of the communicator, message, and audience in producing evaluative backlash toward minorities who make claims of ongoing racial bias. In Experiment 1, participants evaluated a White or Black confederate who gave a speech expressing no claim, a mild claim, or an extreme claim of racial bias. Results indicated a race-specific evaluative backlash: Participants more negatively rated Black compared with White communicators, but only when the claim was extreme. Experiment 2 found that participants more negatively rated Black (vs. White) communicators when they used low-quality arguments, but this backlash was eliminated when Black communicators used high-quality arguments. Furthermore, participants who held stronger meritocracy beliefs and who heard low-quality arguments were more likely to evaluate Black communicators harshly. These findings clarify the conditions under which people from advantaged groups are more likely to recognize claims of racial bias as legitimate and respond favorably to the communicator.

Quality of communication during telephone triage at Dutch out-of-hours centres.

PubMed

Derkx, Hay P; Rethans, Jan-Joost E; Maiburg, Bas H; Winkens, Ron A; Muijtjens, Arno M; van Rooij, Harrie G; Knottnerus, J André

2009-02-01

To assess the quality of communication skills of triagists, working at out-of-hours (OOH) centres, and to determine the correlation between the communication score and the duration of the telephone consultation. Telephone incognito standardised patients (TISPs) called 17 OOH centres presenting different clinical cases. The assessment of communication skills was carried out using the RICE-communication rating list. The duration of each telephone consultation was determined. The mean overall score for communication skills was 35% of the maximum feasible. Triagists usually asked questions about the clinical situation correctly and little about the patients' personal situation, perception of the problem or expectation. Advice about the outcome of triage and self-care advice was usually given without checking for patients' understanding and acceptance of the advice. Calls were often handled in an unstructured way, without summarizing or clarifying the different steps within the consultation. There was a positive correlation of 0.86 (p<0.01) between the overall communication score and the duration of the telephone consultation. Assessment of communication skills of triagists revealed specific shortcomings and learning points to improve the quality of communication skills during telephone triage. Training in telephone consultation should focus more on patient-centred communication with active listening, active advising and structuring the call. Apart from adequate communication skills, triagists need sufficient time for telephone consultation to enable high quality performance.

QUOTEchemo: a patient-centred instrument to measure quality of communication preceding chemotherapy treatment through the patient's eyes.

PubMed

van Weert, Julia C M; Jansen, Jesse; de Bruijn, Gert-Jan; Noordman, Janneke; van Dulmen, Sandra; Bensing, Jozien M

2009-11-01

Knowing patients' needs is a prerequisite to ensure high quality cancer care. This study describes the development and psychometric properties of a patient-centred instrument to measure needs and actual experiences with communication preceding chemotherapy treatment: QUOTE(chemo). QUOTE-questionnaires (Quality Of care Through the patients' Eyes) are widely used to gain insight into unmet needs, but no validated, standardised questionnaire combining patients' needs and experiences surrounding chemotherapy treatment is available yet. To evaluate the psychometric properties of the QUOTE(chemo), content validity, internal structure and convergent validity were investigated amongst 345 cancer patients, new to chemotherapy, from 10 different hospitals. Literature study, focus group discussions and a categorisation procedure of 67 relevant topics revealed seven main themes: Treatment-related information, Prognosis information, Rehabilitation information, Coping information, Interpersonal communication, Tailored communication and Affective communication. Confirmatory factor analysis using structural equation modelling indicated that the measurement model provided good fit to the data with factor loadings ranging from .43 to .77. The seven QUOTE(chemo) dimensions captured relevant issues of concern with good internal consistency (alpha .72-.92), satisfactory item-total correlations (.35-.79) and satisfactory convergent validity. Affective communication, Treatment-related information and Rehabilitation information were perceived most important by patients. The instrument also appeared to be able to determine which aspects need improvement to ensure high quality care. The highest need for improvement was found for communicating Prognosis information and Rehabilitation information and for Interpersonal communication. These findings provide preliminary evidence of the reliability and validity of the QUOTE(chemo) for use in cancer care surrounding chemotherapy treatment. Researchers and health care providers can use the instrument to measure patients' needs and experiences with communication to identify aspects that need improvement.

Trends of microwave dielectric materials for antenna application

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sulong, T. A. T., E-mail: tuanamirahtuansulong@gmail.com; Osman, R. A. M., E-mail: rozana@unimap.edu.my; Idris, M. S., E-mail: sobri@unimap.edu.my

Rapid development of a modern microwave communication system requires a high quality microwave dielectric ceramic material to be used as mobile and satellite communication. High permittivity of dielectric ceramics leads to fabrication of compact device for electronic components. Dielectric ceramics which used for microwave applications required three important parameters such as high or appropriate permittivity (ε{sub r}), high quality factor (Q {sub f} ≥ 5000 GH z) and good temperature coefficient of resonant frequency (τ{sub f}). This paper review of various dielectric ceramic materials used as microwave dielectric materials and related parameters for antenna applications.

'It depends': medical residents' perspectives on working with nurses.

PubMed

Weinberg, Dana B; Miner, Dianne Cooney; Rivlin, Leetal

2009-07-01

Using the theory of relational coordination, which holds that in high-pressure settings such as hospitals, high-quality communication and strong relationships are necessary for coordinated action, we sought to determine the quality of the nurse-physician relationship by examining the communication and interaction between nurses and residents from the residents' perspective. A sample of 20 medical and surgical residents, selected by a snowball sampling technique, were interviewed about the quality of their communication and relationships with nurses in the workplace. Residents' responses were influenced by their perceptions of nurses' cooperativeness and competence, and their impressions of nurses' professional preparation and demeanor varied widely. Although 19 of 20 residents reported instances of poor communication or problematic relationships with nurses, most believed that this posed no significant threat to patient care because the nurses' role, as they saw it, was one of simply following orders. Given the strong doubts some residents expressed about nurses' cooperativeness and competence, the nursing profession should consider strengthening nursing education and clearly delineating nurses' roles and competencies.

Improving Resident Communication in the Intensive Care Unit. The Proceduralization of Physician Communication with Patients and Their Surrogates.

PubMed

Miller, David C; McSparron, Jakob I; Clardy, Peter F; Sullivan, Amy M; Hayes, Margaret M

2016-09-01

Effective communication between providers and patients and their surrogates in the intensive care unit (ICU) is crucial for delivery of high-quality care. Despite the identification of communication as a key education focus by the American Board of Internal Medicine, little emphasis is placed on teaching trainees how to effectively communicate in the ICU. Data are conflicting on the best way to teach residents, and institutions vary on their emphasis of communication as a key skill. There needs to be a cultural shift surrounding the education of medical residents in the ICU: communication must be treated with the same emphasis, precision, and importance as placing a central venous catheter in the ICU. We propose that high-stakes communications between physicians and patients or their surrogates must be viewed as a medical procedure that can be taught, assessed, and quality controlled. Medical residents require training, observation, and feedback in specific communication skill sets with the goal of achieving mastery. It is only through supervised training, practice in real time, observation, and feedback that medical residents can become skillful practitioners of communication in the ICU.

Exploring Communication, Trust in Government, and Vaccination Intention Later in the 2009 H1N1 Pandemic: Results of a National Survey

PubMed Central

Parmer, John; Freimuth, Vicki S.; Hilyard, Karen M.; Musa, Donald; Kim, Kevin H.

2013-01-01

With the growing recognition of the critical role that risk communication plays in a public health emergency, a number of articles have provided prescriptive best practices to enhance such communication. However, little empirical research has examined perceptions of the quality of communication, the impact of uncertainty on changing communication, use of information sources, and trust in specific government spokespersons. Similarly, although there is significant conceptual focus on trust and communication as important in vaccination intent and acceptance, little research has explored these relationships empirically. We conducted an online survey in late January 2010 with a nationally representative sample (N=2,079) that included Hispanic and African American oversamples. The completion rate was 56%. We found that public health officials were the most trusted spokespersons, with President Obama being the most highly trusted elected official. Demographic variables, including race, accounted for 21% of the variance in trust of the president. Perceptions of the quality of communication were high, including significant understanding of uncertainty and appreciation for officials' openness about evolving information. Other factors that contributed to vaccination acceptance were quality of communication, closely following the news, and confidence in the vaccine because of a role model effect of the Obama daughters' immunizations; these factors significantly increased trust in government actions. Because the challenges of communication often vary over the course of a pandemic, there is a consistent need to pay close attention to both communication content and delivery and prepare public health officials at all levels to be effective communicators. PMID:23617721

Modelling of 10 Gbps Free Space Optics Communication Link Using Array of Receivers in Moderate and Harsh Weather Conditions

NASA Astrophysics Data System (ADS)

Gupta, Amit; Shaina, Nagpal

2017-08-01

Intersymbol interference and attenuation of signal are two major parameters affecting the quality of transmission in Free Space Optical (FSO) Communication link. In this paper, the impact of these parameters on FSO communication link is analysed for delivering high-quality data transmission. The performance of the link is investigated under the influence of amplifier in the link. The performance parameters of the link like minimum bit error rate, received signal power and Quality factor are examined by employing erbium-doped fibre amplifier in the link. The effects of amplifier are visualized with the amount of received power. Further, the link is simulated for moderate weather conditions at various attenuation levels on transmitted signal. Finally, the designed link is analysed in adverse weather conditions by using high-power laser source for optimum performance.

Using Nurse Ratings of Physician Communication in the ICU To Identify Potential Targets for Interventions To Improve End-of-Life Care.

PubMed

Ramos, Kathleen J; Downey, Lois; Nielsen, Elizabeth L; Treece, Patsy D; Shannon, Sarah E; Curtis, J Randall; Engelberg, Ruth A

2016-03-01

Communication among doctors, nurses, and families contributes to high-quality end-of-life care, but is difficult to improve. Our objective was to identify aspects of communication appropriate for interventions to improve quality of dying in the intensive care unit (ICU). This observational study used data from a cluster-randomized trial of an interdisciplinary intervention to improve end-of-life care at 15 Seattle/Tacoma area hospitals (2003-2008). Nurses completed surveys for patients dying in the ICU. We examined associations between nurse-assessed predictors (physician-nurse communication, physician-family communication) and nurse ratings of patients' quality of dying (nurse-QODD-1). Based on 1173 nurse surveys, four of six physician-nurse communication topics were positively associated with nurse-QODD-1: family questions, family dynamics, spiritual/religious issues, and cultural issues. Discussions between nurses and physicians about nurses' concerns for patients or families were negatively associated. All physician-family communication ratings, as assessed by nurses, were positively associated with nurse-QODD-1: answering family's questions, listening to family, asking about treatments patient would want, helping family decide patient's treatment wishes, and overall communication. Path analysis suggested overall physician-family communication and helping family incorporate patient's wishes were directly associated with nurse-QODD-1. Several topics of physician-nurse communication, as rated by nurses, were associated with higher nurse-rated quality of dying, whereas one topic, nurses' concerns for patient or family, was associated with poorer ratings. Higher nurse ratings of physician-family communication were uniformly associated with higher quality of dying, highlighting the importance of this communication. Physician support of family decision making was particularly important, suggesting a potential target for interventions to improve end-of-life care.

Using Nurse Ratings of Physician Communication in the ICU To Identify Potential Targets for Interventions To Improve End-of-Life Care

PubMed Central

Downey, Lois; Nielsen, Elizabeth L.; Treece, Patsy D.; Shannon, Sarah E.; Curtis, J. Randall; Engelberg, Ruth A.

2016-01-01

Abstract Background: Communication among doctors, nurses, and families contributes to high-quality end-of-life care, but is difficult to improve. Objective: Our objective was to identify aspects of communication appropriate for interventions to improve quality of dying in the intensive care unit (ICU). Methods: This observational study used data from a cluster-randomized trial of an interdisciplinary intervention to improve end-of-life care at 15 Seattle/Tacoma area hospitals (2003–2008). Nurses completed surveys for patients dying in the ICU. We examined associations between nurse-assessed predictors (physician-nurse communication, physician-family communication) and nurse ratings of patients' quality of dying (nurse-QODD-1). Results: Based on 1173 nurse surveys, four of six physician-nurse communication topics were positively associated with nurse-QODD-1: family questions, family dynamics, spiritual/religious issues, and cultural issues. Discussions between nurses and physicians about nurses' concerns for patients or families were negatively associated. All physician-family communication ratings, as assessed by nurses, were positively associated with nurse-QODD-1: answering family's questions, listening to family, asking about treatments patient would want, helping family decide patient's treatment wishes, and overall communication. Path analysis suggested overall physician-family communication and helping family incorporate patient's wishes were directly associated with nurse-QODD-1. Conclusions: Several topics of physician-nurse communication, as rated by nurses, were associated with higher nurse-rated quality of dying, whereas one topic, nurses' concerns for patient or family, was associated with poorer ratings. Higher nurse ratings of physician-family communication were uniformly associated with higher quality of dying, highlighting the importance of this communication. Physician support of family decision making was particularly important, suggesting a potential target for interventions to improve end-of-life care. PMID:26685082

Effects of headset, flight workload, hearing ability, and communications message quality on pilot performance.

PubMed

Casto, Kristen L; Casali, John G

2013-06-01

This study was designed to determine the effects of hearing loss, aviation headset type, flight workload complexity, and communication signal quality on pilots' performance in an army rotary-wing flight simulator. To maintain flight status, army aviators who do not meet current audiometric standards require a hearing loss waiver, which is based on speech intelligibility in quiet conditions. Because hearing loss characteristics of hearing-impaired aviators can vary greatly, and because performance is likely also influenced by degree of flight workload and communication demand, it was expected that performance among hearing-impaired aviators would also vary. Participants were 20 army helicopter pilots. Pilots flew three flights in a full motion-based helicopter simulator,with a different headset configuration and varying flight workload levels and communication signal quality characterizing each flight. Objective flight performance parameters of heading, altitude, and airspeed deviation and air traffic control command read-backs were measured. Statistically significant results suggest that high levels of flight workload, especially in combination with poor communications signal quality, lead to deficits in flight performance and speech intelligibility. These results support a conclusion that factors other than hearing thresholds and speech intelligibility in quiet should be considered when evaluating helicopter pilots' flight safety. The results also support a recommendation that hearing-impaired pilots use assistive communication technology and not fly with strictly passive headsets. The combined effects of flight environment with individual hearing levels should be considered when making recommendations concerning continued aviation flight status and those concerning communications headsets used in high-noise cockpits.

Communication Partner Training in Aphasia: An Updated Systematic Review.

PubMed

Simmons-Mackie, Nina; Raymer, Anastasia; Cherney, Leora R

2016-12-01

To update a previous systematic review describing the effect of communication partner training on individuals with aphasia and their communication partners, with clinical questions addressing effects of partner training on language, communication activity/participation, psychosocial adjustment, and quality of life. Twelve electronic databases were searched using 23 search terms. References from relevant articles were hand searched. Three reviewers independently reviewed abstracts, excluding those that failed to meet inclusion criteria. Thirty-two full text articles were reviewed by 2 independent reviewers. Articles not meeting inclusion criteria were eliminated, resulting in a corpus of 25 articles for full review. For the 25 articles, 1 reviewer extracted descriptive data regarding participants, intervention, outcome measures, and results. A second reviewer verified the accuracy of the extracted data. The 3-member review team classified studies using the American Academy of Neurology levels of evidence. Two independent reviewers evaluated each article using design-specific tools to assess research quality. All 25 of the current review articles reported positive changes from partner training. Therefore, to date, 56 studies across 2 systematic reviews have reported positive outcomes from communication partner training in aphasia. The results of the current review are consistent with the previous review and necessitate no change to the earlier recommendations, suggesting that communication partner training should be conducted to improve partner skill in facilitating the communication of people with chronic aphasia. Additional high-quality research is needed to strengthen the original 2010 recommendations and expand recommendations to individuals with acute aphasia. High-quality clinical trials are also needed to demonstrate implementation of communication partner training in complex environments (eg, health care). Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Alcohol-specific parenting, adolescents' self-control, and alcohol use: a moderated mediation model.

PubMed

Koning, Ina M; van den Eijnden, Regina J J M; Vollebergh, Wilma A M

2014-01-01

There is convincing evidence that parental rules about alcohol are important in curbing adolescents' alcohol use. However, little is known about the mechanisms through which the direct link between alcohol-specific parenting and alcohol use is obtained. In this study, we investigated the mediating effect of adolescent self-control on the relationship between alcohol-specific rules and adolescents' drinking behavior and whether this mediation effect depends on the level of quality of communication. A total of 883 adolescents participated in this longitudinal study at ages 13, 14, and 15 years. Strict rules predicted lower rates of drinking, but no direct effect of the quality of communication on adolescents' alcohol use was found. A higher level of self-control was related to lower rates of drinking in adolescents. The indirect effect of rules about alcohol through adolescents' self-control was statistically significant, yet only in adolescents with high qualitative parent-child communication about alcohol. In adolescents with low quality of parent-child communication, self-control was not related to drinking. These findings imply that strict rule setting in combination with qualitative parent-child communication is an important target for prevention. In addition, findings point at the importance of high qualitative parent-child communication for adolescents' motivation to engage in self-control to avoid drinking.

Scaffolding the Communication of People with Congenital Deafblindness: An Analysis of Sequential Interaction Patterns

ERIC Educational Resources Information Center

Damen, Saskia; Janssen, Marleen J.; Ruijssenaars, Wied A. J. J. M.; Schuengel, Carlo

2017-01-01

The High Quality Communication intervention aims to stimulate interpersonal communication between individuals with congenital deaf-blindness (CDB) and their social partners. Found effective in multiple-case experiments, the intervention is based on Trevarthen's theory of intersubjective development (Bråten & Trevarthen, 2007), which describes…

The Veterans Administration Experiments in Health Communications on the Applications Technology Satellite (ATS-6). Final Report.

ERIC Educational Resources Information Center

Caldwell, Kathryn S.

Because many of the Veterans Administration hospitals in Appalachia are located great distances from medical teaching facilities, high powered communication satellites have been employed to facilitate quality two-way communication between medical personnel scattered throughout the region. To achieve diagnostic, therapeutic, and educational…

Moving Toward Improved Teamwork in Cancer Care: The Role of Psychological Safety in Team Communication.

PubMed

Jain, Anshu K; Fennell, Mary L; Chagpar, Anees B; Connolly, Hannah K; Nembhard, Ingrid M

2016-11-01

Effective communication is a requirement in the teamwork necessary for improved coordination to deliver patient-centered, value-based cancer care. Communication is particularly important when care providers are geographically distributed or work across organizations. We review organizational and teams research on communication to highlight psychological safety as a key determinant of high-quality communication within teams. We first present the concept of psychological safety, findings about its communication effects for teamwork, and factors that affect it. We focus on five factors applicable to cancer care delivery: familiarity, clinical hierarchy-related status differences, geographic dispersion, boundary spanning, and leader behavior. To illustrate how these factors facilitate or hinder psychologically safe communication and teamwork in cancer care, we review the case of a patient as she experiences the treatment-planning process for early-stage breast cancer in a community setting. Our analysis is summarized in a key principle: Teamwork in cancer care requires high-quality communication, which depends on psychological safety for all team members, clinicians and patients alike. We conclude with a discussion of the implications of psychological safety in clinical care and suggestions for future research.

Patients' views on changes in doctor-patient communication between 1982 and 2001: a mixed-methods study.

PubMed

Butalid, Ligaya; Verhaak, Peter F M; Boeije, Hennie R; Bensing, Jozien M

2012-08-08

Doctor-patient communication has been influenced over time by factors such as the rise of evidence-based medicine and a growing emphasis on patient-centred care. Despite disputes in the literature on the tension between evidence-based medicine and patient-centered medicine, patients' views on what constitutes high quality of doctor-patient communication are seldom an explicit topic for research. The aim of this study is to examine whether analogue patients (lay people judging videotaped consultations) perceive shifts in the quality of doctor-patient communication over a twenty-year period. Analogue patients (N = 108) assessed 189 videotaped general practice consultations from two periods (1982-1984 and 2000-2001). They provided ratings on three dimensions (scale 1-10) and gave written feedback. With a mixed-methods research design, we examined these assessments quantitatively (in relation to observed communication coded with RIAS) and qualitatively. 1) The quantitative analyses showed that biomedical communication and rapport building were positively associated with the quality assessments of videotaped consultations from the first period, but not from the second. Psychosocial communication and personal remarks were related to positive quality assessments of both periods; 2) the qualitative analyses showed that in both periods, participants provided the same balance between positive and negative comments. Listening, giving support, and showing respect were considered equally important in both periods. We identified shifts in the participants' observations on how GPs explained things to the patient, the division of roles and responsibilities, and the emphasis on problem-focused communication (first period) versus solution-focused communication (last period). Analogue patients recognize shifts in the quality of doctor-patient communication from two different periods, including a shift from problem-focused communication to solution-focused communication, and they value an egalitarian doctor-patient relationship. The two research methods were complementary; based on the quantitative analyses we found shifts in communication, which we confirmed and specified in our qualitative analyses.

Stimulating Intersubjective Communication in an Adult with Deafblindness: A Single-Case Experiment

ERIC Educational Resources Information Center

Damen, Saskia; Janssen, Marleen J.; Huisman, Mark; Ruijssenaars, Wied A. J. J. M.; Schuengel, Carlo

2014-01-01

Sensory disabilities may limit a person's development of intersubjectivity, that is, the awareness of self and other, which develops in conjunction with interpersonal communication. This study used intersubjectivity theory to test a new intervention called the High-Quality Communication (HQC) intervention for its effects on a young adult with…

Communication and Quality of Care on Palliative Care Units: A Qualitative Study.

PubMed

Seccareccia, Dori; Wentlandt, Kirsten; Kevork, Nanor; Workentin, Kevin; Blacker, Susan; Gagliese, Lucia; Grossman, Daphna; Zimmermann, Camilla

2015-09-01

Clinician-patient communication is central in palliative care, but it has not been described qualitatively which specific elements of communication are important for high-quality palliative care, particularly in the inpatient setting. Our aim was to identify elements of communication that are central to quality of care and satisfaction with care on palliative care units (PCUs), as described by inpatients, family caregivers, and health care providers. Qualitative interviews with patients/caregivers and focus groups with staff were conducted on four PCUs. Semi-structured interviews and focus groups elicited thoughts about the characteristics of satisfaction with care and quality of care for PCU inpatients and their family caregivers. Data were analyzed using a grounded theory method with an inductive, constant comparison approach; themes were coded to saturation. There were 46 interviews and eight focus groups. Communication was the most prevalent theme regarding satisfaction and quality of care, with five subthemes describing elements important to patients, caregivers, and staff. These included: 1) building rapport with patients and families to build trust and kinship; 2) addressing expectations and explaining goals of care; 3) keeping patients and families informed about the patient's condition; 4) listening actively to validate patients' concerns and individual needs; and 5) providing a safe space for conversations about death and dying. Patients, family caregivers, and health care providers affirmed that communication is a central element of quality of care and family satisfaction on PCUs. The five subthemes identified may serve as a structure for education and for quality improvement tools in palliative care inpatient settings.

The Effect of Communication Skills Training by Video Feedback Method on Clinical Skills of Interns of Isfahan University of Medical Sciences Compared to Didactic Methods

ERIC Educational Resources Information Center

Managheb, S. E.; Zamani, A.; Shams, B.; Farajzadegan, Z.

2012-01-01

Background: Effective communication is essential to the practice of high-quality medicine. There are methodological challenges in communication skills training. This study was performed in order to assess the educational benefits of communication skills training by video feedback method versus traditional formats such as lectures on clinical…

Strengths and Gaps in Physicians' Risk Communication: A Scenario Study of the Influence of Numeracy on Cancer Screening Communication.

PubMed

Petrova, Dafina; Kostopoulou, Olga; Delaney, Brendan C; Cokely, Edward T; Garcia-Retamero, Rocio

2018-04-01

Many patients have low numeracy, which impedes their understanding of important information about health (e.g., benefits and harms of screening). We investigated whether physicians adapt their risk communication to accommodate the needs of patients with low numeracy, and how physicians' own numeracy influences their understanding and communication of screening statistics. UK family physicians ( N = 151) read a description of a patient seeking advice on cancer screening. We manipulated the level of numeracy of the patient (low v. high v. unspecified) and measured physicians' risk communication, recommendation to the patient, understanding of screening statistics, and numeracy. Consistent with best practices, family physicians generally preferred to use visual aids rather than numbers when communicating information to a patient with low (v. high) numeracy. A substantial proportion of physicians (44%) offered high quality (i.e., complete and meaningful) risk communication to the patient. This was more often the case for physicians with higher (v. lower) numeracy who were more likely to mention mortality rates, OR=1.43 [1.10, 1.86], and harms from overdiagnosis, OR=1.44 [1.05, 1.98]. Physicians with higher numeracy were also more likely to understand that increased detection or survival rates do not demonstrate screening effectiveness, OR=1.61 [1.26, 2.06]. Most physicians know how to appropriately tailor risk communication for patients with low numeracy (i.e., with visual aids). However, physicians who themselves have low numeracy are likely to misunderstand the risks and unintentionally mislead patients by communicating incomplete information. High-quality risk communication and shared decision making can depend critically on factors that improve the risk literacy of physicians.

Communication in autism spectrum disorder: a guide for pediatric nurses.

PubMed

Brown, Amanda B; Elder, Jennifer H

2014-01-01

In the United States, one in every 68 children has autism spectrum disorder (ASD) (Centers for Disease Control and Prevention, 2014). ASD is a developmental disorder of the brain that is characterized by impairments in social interaction, communication, and repetitive patterns of behavior (American Psychiatric Association [APA], 2013). Nurses have a duty to provide high quality care to children with ASD. Effective communication is essential to providing quality care. Three main theories attempt to explain how the ASD brain functions and the implications on communication: lack of theory of mind, weak central coherence, and lack of executive function. Children with ASD have difficulties in vocalic, kinesthetic, and proxemic aspects of communication (Notbhom, 2006). Simple adaptations to environment and style can make the communication between nurses and children with ASD easier and more effective (Aylott, 2000; Green et al., 2010).

Effective communication skills in nursing practice.

PubMed

Bramhall, Elaine

2014-12-09

This article highlights the importance of effective communication skills for nurses. It focuses on core communication skills, their definitions and the positive outcomes that result when applied to practice. Effective communication is central to the provision of compassionate, high-quality nursing care. The article aims to refresh and develop existing knowledge and understanding of effective communication skills. Nurses reading this article will be encouraged to develop a more conscious style of communicating with patients and carers, with the aim of improving health outcomes and patient satisfaction.

Effect of the patient-to-patient communication model on dysphagia caused by total laryngectomy.

PubMed

Tian, L; An, R; Zhang, J; Sun, Y; Zhao, R; Liu, M

2017-03-01

The study aimed to evaluate the effect of a patient-to-patient communication model on dysphagia in laryngeal cancer patients after total laryngectomy. Sixty-five patients who had undergone total laryngectomy were randomly divided into three groups: a routine communication group, a patient communication group (that received the patient-to-patient communication model) and a physician communication group. Questionnaires were used to compare quality of life and swallowing problems among all patient groups. The main factors causing dysphagia in total laryngectomy patients were related to fear and mental health. The patient communication group had improved visual analogue scale scores at one week after starting to eat. Quality of life in swallowing disorders questionnaire scores were significantly higher in the patient communication and physician communication groups than in the routine communication group. In addition, swallowing problems were much more severe in patients educated to high school level and above than in others. The patient-to-patient communication model can be used to resolve swallowing problems caused by psychological factors in total laryngectomy patients.

Information efficiency in visual communication

NASA Astrophysics Data System (ADS)

Alter-Gartenberg, Rachel; Rahman, Zia-ur

1993-08-01

This paper evaluates the quantization process in the context of the end-to-end performance of the visual-communication channel. Results show that the trade-off between data transmission and visual quality revolves around the information in the acquired signal, not around its energy. Improved information efficiency is gained by frequency dependent quantization that maintains the information capacity of the channel and reduces the entropy of the encoded signal. Restorations with energy bit-allocation lose both in sharpness and clarity relative to restorations with information bit-allocation. Thus, quantization with information bit-allocation is preferred for high information efficiency and visual quality in optimized visual communication.

Information efficiency in visual communication

NASA Technical Reports Server (NTRS)

Alter-Gartenberg, Rachel; Rahman, Zia-Ur

1993-01-01

This paper evaluates the quantization process in the context of the end-to-end performance of the visual-communication channel. Results show that the trade-off between data transmission and visual quality revolves around the information in the acquired signal, not around its energy. Improved information efficiency is gained by frequency dependent quantization that maintains the information capacity of the channel and reduces the entropy of the encoded signal. Restorations with energy bit-allocation lose both in sharpness and clarity relative to restorations with information bit-allocation. Thus, quantization with information bit-allocation is preferred for high information efficiency and visual quality in optimized visual communication.

Computer-Mediated Communication with Distant Friends: Relations with Adjustment during Students' First Semester in College

ERIC Educational Resources Information Center

Ranney, John D.; Troop-Gordon, Wendy

2012-01-01

Because of recent technological innovations, college freshmen can readily communicate with friends who they see infrequently (e.g., friends from home). The current study addressed whether computer-mediated communication with these distant friends can compensate for a lack of high-quality on-campus friendships during students' first semester of…

Association of the quality of interpersonal care during family planning counseling with contraceptive use.

PubMed

Dehlendorf, Christine; Henderson, Jillian T; Vittinghoff, Eric; Grumbach, Kevin; Levy, Kira; Schmittdiel, Julie; Lee, Jennifer; Schillinger, Dean; Steinauer, Jody

2016-07-01

Health communication and interpersonal skills are increasingly emphasized in the measurement of health care quality, yet there is limited research on the association of interpersonal care with health outcomes. As approximately 50% of pregnancies in the United States are unintended, whether interpersonal communication influences contraceptive use is of public health importance. The aim of this study was to determine whether the quality of interpersonal care during contraceptive counseling is associated with contraceptive use over time. The Patient-Provider Communication about Contraception study is a prospective cohort study of 348 English-speaking women seen for contraceptive care, conducted between 2009 and 2012 in the San Francisco Bay Area. Quality of communication was assessed using a patient-reported interpersonal quality in family planning care measure based on the dimensions of patient-centered care. In addition, the clinical visit was audio recorded and its content coded according to the validated Four Habits Coding Scheme to assess interpersonal communication behaviors of clinicians. The outcome measures were 6-month continuation of the selected contraceptive method and use of a highly or moderately effective method at 6 months. Results were analyzed using mixed effect logistic regression models controlling for patient demographics, the clinic and the provider at which the visit occurred, and the method selected. Patient participants had a mean age of 26.8 years (SD 6.9 years); 46% were white, 26% Latina, and 28% black. Almost two-thirds of participants had an income of <200% of the Federal Poverty Level. Most of the women (73%) were making visits to a provider whom they had not seen before. Of the patient participants, 41% were still using their chosen contraceptive method at 6-month follow-up. Patients who reported high interpersonal quality of family planning care were more likely to maintain use of their chosen contraceptive method (adjusted odds ratio [aOR], 1.8; 95% CI, 1.1-3.0) and to be using a highly or moderately effective method at 6 months (aOR, 2.0; 95% CI, 1.2-3.5). In addition, 2 of the Four Habits were associated with contraceptive continuation; "invests in the beginning" (aOR, 2.3; 95% CI, 1.2-4.3) and "elicits the patient's perspective" (aOR, 1.8; 95% CI, 1.0-3.2). Our study provides evidence that the quality of interpersonal care, measured using both patient report and observation of provider behaviors, influences contraceptive use. These results provide support for ongoing attention to interpersonal communication as an important aspect of health care quality. The associations of establishing rapport and eliciting the patient perspective with contraceptive continuation are suggestive of areas of focus for provider communication skills training for contraceptive care. Copyright © 2016 Elsevier Inc. All rights reserved.

Practice Environments and Job Satisfaction in Patient-Centered Medical Homes

PubMed Central

Alidina, Shehnaz; Rosenthal, Meredith B.; Schneider, Eric C.; Singer, Sara J.; Friedberg, Mark W.

2014-01-01

PURPOSE We undertook a study to evaluate the effects of medical home transformation on job satisfaction in the primary care setting. METHODS We collected primary data from 20 primary care practices participating in medical home pilot projects in Rhode Island and Colorado from 2009 to 2011. We surveyed clinicians and staff about the quality of their practice environments (eg, office chaos, communication, difficulties in providing safe, high-quality care) and job satisfaction at baseline and 30 months, and about stress, burnout, and intention to leave at 30 months. We interviewed practice leaders about the impact of pilot project participation. We assessed longitudinal changes in the practice environment and job satisfaction and, in the final pilot year, examined cross-sectional associations between the practice environment and job satisfaction, stress, burnout, and intention to leave. RESULTS Between baseline and 30 months, job satisfaction improved in Rhode Island (P =.03) but not in Colorado. For both pilot projects, reported difficulties in providing safe, high-quality care decreased (P <.001), but emphasis on quality and the level of office chaos did not change significantly. In cross-sectional analyses, fewer difficulties in providing safe, high-quality care and more open communication were associated with greater job satisfaction. Greater office chaos and an emphasis on electronic information were associated with greater stress and burnout. CONCLUSIONS Medical home transformations that emphasize quality and open communication while minimizing office chaos may offer the best chances of improving job satisfaction. PMID:25024241

Single-electron random-number generator (RNG) for highly secure ubiquitous computing applications

NASA Astrophysics Data System (ADS)

Uchida, Ken; Tanamoto, Tetsufumi; Fujita, Shinobu

2007-11-01

Since the security of all modern cryptographic techniques relies on unpredictable and irreproducible digital keys generated by random-number generators (RNGs), the realization of high-quality RNG is essential for secure communications. In this report, a new RNG, which utilizes single-electron phenomena, is proposed. A room-temperature operating silicon single-electron transistor (SET) having nearby an electron pocket is used as a high-quality, ultra-small RNG. In the proposed RNG, stochastic single-electron capture/emission processes to/from the electron pocket are detected with high sensitivity by the SET, and result in giant random telegraphic signals (GRTS) on the SET current. It is experimentally demonstrated that the single-electron RNG generates extremely high-quality random digital sequences at room temperature, in spite of its simple configuration. Because of its small-size and low-power properties, the single-electron RNG is promising as a key nanoelectronic device for future ubiquitous computing systems with highly secure mobile communication capabilities.

Caregiver social support quality when interacting with cancer survivors: advancing the dual-process model of supportive communication.

PubMed

Harvey-Knowles, Jacquelyn; Faw, Meara H

2018-04-01

Cancer caregivers often experience significant challenges in their motivation and ability to comfort cancer survivors, particularly in a spousal or romantic context. Spousal cancer caregivers have been known to report even greater levels of burden and distress than cancer sufferers, yet still take on the role of acting as an informal caregiver so they can attend to their partner's needs. The current study tested whether a theoretical model of supportive outcomes-the dual-process model of supportive communication-explained variations in cancer caregivers' motivation and ability to create high-quality support messages. The study also tested whether participant engagement with reflective journaling on supportive acts was associated with increased motivation or ability to generate high-quality support messages. Based upon the dual-process model, we posited that, following supportive journaling tasks, caregivers of spouses currently managing a cancer experience would report greater motivation but also greater difficulty in generating high-quality support messages, while individuals caring for a patient in remission would report lower motivation but greater ability to create high-quality support messages. Findings provided support for these assertions and suggested that reflective journaling tasks might be a useful tool for improving remission caregivers' ability to provide high-quality social support to survivors. Corresponding theoretical and applied implications are discussed.

[Communication behavior between parents and their adolescent children and correlation with indicators of self concept].

PubMed

Kreppner, K

1996-01-01

Formats of communication within families are believed to be relevant contexts for children's development. Cultural values, norms, and interpretation patterns are transferred from parents to children within the family's specific communication framework. By the same token, skills to maintain the balance of living together or to realize one's own wishes are acquired within the scope of extant formats of exchange among family members. Puberty is a period, where a child strives for more autonomy and tends to dispute present parent-child relationships. The focus of the study is on links between formats of communication within the family and adolescents' estimations of the relationships with their parents and also adolescents' judgments about their self-esteem. 67 families with an adolescent child (between 11 and 12 years old at the beginning of data collection) participated in a longitudinal study, in which adolescents judged the quality of their relationship with parents as well as their self-esteem every six months over a period of three and a half years (8 waves). In addition, concrete communication behavior between parents and adolescents was observed and recorded during the first, fourth, sixth, and eight wave of data collection. Results point to considerable differences among adolescents' judgments concerning their quality of relationship with the parents and their self-esteem. Groups could be formed according to these differences. Data also show that adolescents show a high degree of constancy in their estimations over time. However, communication behaviors in parent-adolescent dyads showed divergent patterns of communication across the different groups on the one hand, and different degrees of variation of communication formats within groups over time on the other, dependent on whether adolescents belonged to the group of high quality relationship and self-esteem (considerable variation over time) or to the group of low quality relationship and self-esteem (less variation over time). Results are discussed under the perspective of adolescents' different experiences in family communication, and implications of possible links between development of self-esteem and adaptive or nonadaptive variations in family communication are considered.

Development of a telediagnosis endoscopy system over secure internet.

PubMed

Ohashi, K; Sakamoto, N; Watanabe, M; Mizushima, H; Tanaka, H

2008-01-01

We developed a new telediagnosis system to securely transmit high-quality endoscopic moving images over the Internet in real time. This system would enable collaboration between physicians seeking advice from endoscopists separated by long distances, to facilitate diagnosis. We adapted a new type of digital video streaming system (DVTS) to our teleendoscopic diagnosis system. To investigate its feasibility, we conducted a two-step experiment. A basic experiment was first conducted to transmit endoscopic video images between hospitals using a plain DVTS. After investigating the practical usability, we incorporated a secure and reliable communication function into the system, by equipping DVTS with "TCP2", a new security technology that establishes secure communication in the transport layer. The second experiment involved international transmission of teleendoscopic image between Hawaii and Japan using the improved system. In both the experiments, no serious transmission delay was observed to disturb physicians' communications and, after subjective evaluation by endoscopists, the diagnostic qualities of the images were found to be adequate. Moreover, the second experiment showed that "TCP2-equipped DVTS" successfully executed high-quality secure image transmission over a long distance network. We conclude that DVTS technology would be promising for teleendoscopic diagnosis. It was also shown that a high quality, secure teleendoscopic diagnosis system can be developed by equipping DVTS with TCP2.

Transitions From Hospitals to Skilled Nursing Facilities for Persons With Dementia: A Challenging Convergence of Patient and System-Level Needs.

PubMed

Gilmore-Bykovskyi, Andrea L; Roberts, Tonya J; King, Barbara J; Kennelty, Korey A; Kind, Amy J H

2017-10-01

To describe skilled nursing facility (SNF) nurses' perspectives on the experiences and needs of persons with dementia (PwD) during hospital-to-SNF transitions and to identify factors related to the quality of these transitions. Grounded dimensional analysis study using individual and focus group interviews with nurses (N = 40) from 11 SNFs. Hospital-to-SNF transitions were largely described as distressing for PwD and their caregivers and dominated by dementia-related behavioral symptoms that were perceived as being purposely under-communicated by hospital personnel in discharge communications. SNF nurses described PwD as having unique transitional care needs, which primarily involved needing additional discharge preplanning to enable preparation of a tailored behavioral/social care plan and physical environment prior to transfer. SNF nurses identified inaccurate/limited hospital discharge communication regarding behavioral symptoms, short discharge timeframes, and limited nursing control over SNF admission decisions as factors that contributed to poorer-quality transitions producing increased risk for resident harm, rehospitalization, and negative resident/caregiver experiences. Engaged caregivers throughout the transition and the presence of high-quality discharge communication were identified as factors that improved the quality of transitions for PwD. Findings from this study provide important insight into factors that may influence transitional care quality during this highly vulnerable transition. Additional research is needed to explore the association between these factors and transitional care outcomes such as rehospitalization and caregiver stress. Future work should also explore strategies to improve inter-setting communication and care coordination for PwD exhibiting challenging behavioral symptoms. Published by Oxford University Press on behalf of the Gerontological Society of America 2016.

Post-school quality of life for individuals with developmental disabilities who use AAC.

PubMed

Hamm, Bruce; Mirenda, Pat

2006-06-01

Even when augmentative and alternative communication (AAC) interventions enhance the communication skills and educational achievements of students with complex communication needs while they are in school, there is no guarantee that these gains will be maintained following students' transition to adult life. Unfortunately, information on the post-school quality of life and related outcomes of individuals with complex communication needs is scarce. This study addressed this issue by examining the post-school outcomes of eight Canadian individuals with developmental disabilities who used AAC technology while they were in school. Two surveys were used to compile the data: the Quality of Life Profile: People with Physical and Sensory Disabilities (Renwick, Rudman, Raphael, & Brown, 1998) and a Communication Survey designed specifically for this study. Four of the participants and the people who knew them best also participated in brief interviews in which they discussed the positive and negative aspects of their school and post-school experiences. Results indicated that participant outcomes in important life domains were generally discouraging. A high positive correlation was found between quality of life and quality of communication scores, and participants who achieved relatively better outcomes showed evidence of higher communicative competence. However, the majority of participants and their supporters were very dissatisfied with the lack of AAC and other services that were available to them as young adults. The results are discussed in relation to outcomes for adults with development disabilities who use AAC and their implications for future research, practice, and advocacy efforts related to transition planning.

Secure communications of CAP-4 and OOK signals over MMF based on electro-optic chaos.

PubMed

Ai, Jianzhou; Wang, Lulu; Wang, Jian

2017-09-15

Chaos-based secure communication can provide a high level of privacy in data transmission. Here, we experimentally demonstrate secure signal transmission over two kinds of multimode fiber (MMF) based on electro-optic intensity chaos. High-quality synchronization is achieved in an electro-optic feedback configuration. Both 5  Gbit/s carrier-less amplitude/phase (CAP-4) modulation and 10  Gbit/s on-off key (OOK) signals are recovered efficiently in electro-optic chaos-based communication systems. Degradations of chaos synchronization and communication system due to mismatch of various hardware keys are also discussed.

Interpreter services, language concordance, and health care quality. Experiences of Asian Americans with limited English proficiency.

PubMed

Green, Alexander R; Ngo-Metzger, Quyen; Legedza, Anna T R; Massagli, Michael P; Phillips, Russell S; Iezzoni, Lisa I

2005-11-01

Patients with limited English proficiency (LEP) have more difficulty communicating with health care providers and are less satisfied with their care than others. Both interpreter- and language-concordant clinicians may help overcome these problems but few studies have compared these approaches. To compare self-reported communication and visit ratings for LEP Asian immigrants whose visits involve either a clinic interpreter or a clinician speaking their native language. Cross-sectional survey-response rate 74%. Two thousand seven hundred and fifteen LEP Chinese and Vietnamese immigrant adults who received care at 11 community-based health centers across the U.S. Five self-reported communication measures and overall rating of care. Patients who used interpreters were more likely than language-concordant patients to report having questions about their care (30.1% vs 20.9%, P<.001) or about mental health (25.3% vs 18.2%, P=.005) they wanted to ask but did not. They did not differ significantly in their response to 3 other communication measures or their likelihood of rating the health care received as "excellent" or "very good" (51.7% vs 50.9%, P=.8). Patients who rated their interpreters highly ("excellent" or "very good") were more likely to rate the health care they received highly (adjusted odds ratio 4.8, 95% confidence interval, 2.3 to 10.1). Assessments of communication and health care quality for outpatient visits are similar for LEP Asian immigrants who use interpreters and those whose clinicians speak their language. However, interpreter use may compromise certain aspects of communication. The perceived quality of the interpreter is strongly associated with patients' assessments of quality of care overall.

Impact of communication delays to and from the International Space Station on self-reported individual and team behavior and performance: A mixed-methods study

NASA Astrophysics Data System (ADS)

Kintz, Natalie M.; Chou, Chih-Ping; Vessey, William B.; Leveton, Lauren B.; Palinkas, Lawrence A.

2016-12-01

Deep space explorations will involve significant delays in communication to and from Earth that will likely impact individual and team outcomes. However, the extent of these impacts and the appropriate countermeasures for their mitigation remain largely unknown. This study utilized the International Space Station (ISS), a high-fidelity analog for deep space, as a research platform to assess the impact of communication delays on individual and team performance, mood, and behavior. Three astronauts on the ISS and 18 mission support personnel performed tasks with and without communication delays (50-s one-way) during a mission lasting 166 days. Self-reported assessments of individual and team performance and mood were obtained after each task. Secondary outcomes included communication quality and task autonomy. Qualitative data from post-mission interviews with astronauts were used to validate and expand on quantitative data, and to elicit recommendations for countermeasures. Crew well-being and communication quality were significantly reduced in communication delay tasks compared to control. Communication delays were also significantly associated with increased individual stress/frustration. Qualitative data suggest communication delays impacted operational outcomes (i.e. task efficiency), teamwork processes (i.e. team/task coordination) and mood (i.e. stress/frustration), particularly when tasks involved high task-related communication demands, either because of poor communication strategies or low crew autonomy. Training, teamwork, and technology-focused countermeasures were identified to mitigate or prevent adverse impacts.

Perceptions of Search Consultants of Qualities School Boards Seek in Superintendents.

ERIC Educational Resources Information Center

Lyons, James E.

1993-01-01

Summarizes a study to determine the qualities sought by school boards when employing superintendents, as perceived by superintendent search consultants. Highly desirable qualities included performance in previous positions, performance during the interview, evidence of leadership and managerial skills, communication skills, and experience and…

Evaluating the message or the messenger? Implications for self-validation in persuasion.

PubMed

Clark, Jason K; Wegener, Duane T; Sawicki, Vanessa; Petty, Richard E; Briñol, Pablo

2013-12-01

Characteristics of persuasive message sources have been extensively studied. However, little attention has been paid to situations when people are motivated to form an evaluation of the communicator rather than the communicated issue. We postulated that these different foci can affect how a source validates message-related cognitions. Participants focused on the source (Studies 1 and 2) or the issue (Study 2) while reading weak or strong message arguments. Later, the communicator was described as low or high in credibility. When focused on the source, highly motivated participants were more confident and their attitudes were more reflective of thoughts when argument quality matched (e.g., weak arguments-low credibility) rather than mismatched (e.g., weak arguments-high credibility) source credibility. Conversely, when participants were focused on the issue, self-validation was greater when credibility was high rather than low-regardless of argument quality. Implications of these findings for the study and practice of persuasion are discussed.

Experimental entanglement purification of arbitrary unknown states.

PubMed

Pan, Jian-Wei; Gasparoni, Sara; Ursin, Rupert; Weihs, Gregor; Zeilinger, Anton

2003-05-22

Distribution of entangled states between distant locations is essential for quantum communication over large distances. But owing to unavoidable decoherence in the quantum communication channel, the quality of entangled states generally decreases exponentially with the channel length. Entanglement purification--a way to extract a subset of states of high entanglement and high purity from a large set of less entangled states--is thus needed to overcome decoherence. Besides its important application in quantum communication, entanglement purification also plays a crucial role in error correction for quantum computation, because it can significantly increase the quality of logic operations between different qubits. Here we demonstrate entanglement purification for general mixed states of polarization-entangled photons using only linear optics. Typically, one photon pair of fidelity 92% could be obtained from two pairs, each of fidelity 75%. In our experiments, decoherence is overcome to the extent that the technique would achieve tolerable error rates for quantum repeaters in long-distance quantum communication. Our results also imply that the requirement of high-accuracy logic operations in fault-tolerant quantum computation can be considerably relaxed.

Expressive electronic journal writing: freedom of communication for survivors of acquired brain injury.

PubMed

Fraas, Michael; Balz, Magdalen A

2008-03-01

In addition to the impaired ability to effectively communicate, adults with acquired brain injury (ABI) also experience high incidences of depression, social isolation, and decreased quality of life. Expressive writing programs have been shown to be effective in alleviating these concomitant impairments in other populations including incarcerated inmates (Lane, Writing as a road to self-discovery, F & W, Cincinnati 1993). In addition, computer applications such as email have been suggested as an effective means of improving communication and social isolation in adults with brain injury (Sohlberg et al. [2003]. Brain Injury, 17(7), 609-629). This investigation examines the effects of on-line expressive journal writing on the communication, emotional status, social integration and quality of life of individuals with brain injury.

Frequency, satisfaction and quality dimensions of perceived parent-adolescent communication among Chinese adolescents in Hong Kong.

PubMed

Shek, Daniel T L; Lee, Britta M; Lee, Tak Yan; Lam, Ching Man

2006-01-01

Chinese adolescents (N=88) responded to instruments measuring three dimensions of parent-adolescent communication (frequency of parent-adolescent communication, satisfaction with parent-adolescent communication and quality of parent-adolescent communication) and adolescent psychological well-being (mastery and life satisfaction). Results showed that Chinese adolescents perceived sharp distinction between fathers and mothers in terms of these three dimensions: fathers were perceived to have less communication with adolescents than did the mothers; the satisfaction and quality ratings for father-adolescent communication were lower than those based on mother-adolescent communication. Results also showed that relative to the frequency of parent-adolescent communication, satisfaction with and quality of parent-adolescent communication were more strongly related to adolescent psychological well-being. Although global quality of father-adolescent communication and mother-adolescent communication were related to adolescent life satisfaction, global quality of father-adolescent communication appeared to have a stronger relationship with adolescent mastery than did mother-adolescent communication.

75 FR 22821 - Statement of Organization, Functions, and Delegations of Authority

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-30

...) plans and executes CDC's global health communications strategy and public affairs media response... through communication materials and coordinating dissemination of resources to the media, partners, and... fiscal accountability; (7) facilitates the conduct and maintenance of ethical and high quality, evidence...

Relationships among Communication Self-Efficacy, Communication Burden, and the Mental Health of the Families of Persons with Aphasia.

PubMed

Tatsumi, Hiroshi; Nakaaki, Shutaro; Satoh, Masayuki; Yamamoto, Masahiko; Chino, Naohito; Hadano, Kazuo

2016-01-01

The purpose of this study was to elucidate the relationships among communication self-efficacy (SE), communication burden, and the mental health of the families of persons with aphasia using structural equation modeling (SEM). This study examined 110 pairs of persons with aphasia receiving home care and 1 family caregiver per person with aphasia. The survey items for this study consisted of the Communication Self-efficacy Scale, the Communication Burden Scale, the Geriatric Depression Scale-Short Form-Japanese, and the Health-Related Quality of Life: SF-8 Health Survey. The relationships between the constructive concept of "communication self-efficacy" and "communication burden," and "mental-health status" were analyzed using SEM. The results of the SEM analysis revealed that a high communication SE of the families was associated with low burden of communication and good mental-health status. Psychoeducational programs that address the communication SE of family caregivers may have the potential to reduce the burden of communication and to improve the mental health of caregivers. These programs could lead to an enhanced quality of life for both persons with aphasia and their families. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Developing Patient-Centered Communication Skills Training for Oncologists: Describing the Content and Efficacy of Training

ERIC Educational Resources Information Center

Brown, Richard F.; Bylund, Carma L.; Gueguen, Jennifer A.; Diamond, Catherine; Eddington, Julia; Kissane, David

2010-01-01

Communication Skills Training (CST) is a proven aid to help oncologists achieve high quality patient-centered communication. No research studies have provided clear guidelines for developing the content of CST. The aim of this work is to describe a method of developing such content and evaluation of effectiveness of CST training workshops (based…

Racial and Ethnic Disparities in Patient-Provider Communication, Quality-of-Care Ratings, and Patient Activation Among Long-Term Cancer Survivors

PubMed Central

Palmer, Nynikka R.A.; Kent, Erin E.; Forsythe, Laura P.; Arora, Neeraj K.; Rowland, Julia H.; Aziz, Noreen M.; Blanch-Hartigan, Danielle; Oakley-Girvan, Ingrid; Hamilton, Ann S.; Weaver, Kathryn E.

2014-01-01

Purpose We examined racial and ethnic disparities in patient-provider communication (PPC), perceived care quality, and patient activation among long-term cancer survivors. Methods In 2005 to 2006, survivors of breast, prostate, colorectal, ovarian, and endometrial cancers completed a mailed survey on cancer follow-up care. African American, Asian/Pacific Islander (Asian), Hispanic, and non-Hispanic white (white) survivors who had seen a physician for follow-up care in the past 2 years (n = 1,196) composed the analytic sample. We conducted linear and logistic regression analyses to identify racial and ethnic differences in PPC (overall communication and medical test communication), perceived care quality, and patient activation in clinical care (self-efficacy in medical decisions and perceived control). We further examined the potential contribution of PPC to racial and ethnic differences in perceived care quality and patient activation. Results Compared with white survivors (mean score, 85.16), Hispanic (mean score, 79.95) and Asian (mean score, 76.55) survivors reported poorer overall communication (P = .04 and P < .001, respectively), and Asian survivors (mean score, 79.97) reported poorer medical test communication (P = .001). Asian survivors were less likely to report high care quality (odds ratio, 0.47; 95% CI, 0.30 to 0.72) and reported lower self-efficacy in medical decisions (mean score, 74.71; P < .001) compared with white survivors (mean score, 84.22). No disparity was found in perceived control. PPC was positively associated with care quality (P < .001) and self-efficacy (P < .001). After adjusting for PPC and other covariates, when compared with whites, Asian disparities remained significant. Conclusion Asian survivors report poorer follow-up care communication and care quality. More research is needed to identify contributing factors beyond PPC, such as cultural influences and medical system factors. PMID:25403220

Racial and ethnic disparities in patient-provider communication, quality-of-care ratings, and patient activation among long-term cancer survivors.

PubMed

Palmer, Nynikka R A; Kent, Erin E; Forsythe, Laura P; Arora, Neeraj K; Rowland, Julia H; Aziz, Noreen M; Blanch-Hartigan, Danielle; Oakley-Girvan, Ingrid; Hamilton, Ann S; Weaver, Kathryn E

2014-12-20

We examined racial and ethnic disparities in patient-provider communication (PPC), perceived care quality, and patient activation among long-term cancer survivors. In 2005 to 2006, survivors of breast, prostate, colorectal, ovarian, and endometrial cancers completed a mailed survey on cancer follow-up care. African American, Asian/Pacific Islander (Asian), Hispanic, and non-Hispanic white (white) survivors who had seen a physician for follow-up care in the past 2 years (n = 1,196) composed the analytic sample. We conducted linear and logistic regression analyses to identify racial and ethnic differences in PPC (overall communication and medical test communication), perceived care quality, and patient activation in clinical care (self-efficacy in medical decisions and perceived control). We further examined the potential contribution of PPC to racial and ethnic differences in perceived care quality and patient activation. Compared with white survivors (mean score, 85.16), Hispanic (mean score, 79.95) and Asian (mean score, 76.55) survivors reported poorer overall communication (P = .04 and P < .001, respectively), and Asian survivors (mean score, 79.97) reported poorer medical test communication (P = .001). Asian survivors were less likely to report high care quality (odds ratio, 0.47; 95% CI, 0.30 to 0.72) and reported lower self-efficacy in medical decisions (mean score, 74.71; P < .001) compared with white survivors (mean score, 84.22). No disparity was found in perceived control. PPC was positively associated with care quality (P < .001) and self-efficacy (P < .001). After adjusting for PPC and other covariates, when compared with whites, Asian disparities remained significant. Asian survivors report poorer follow-up care communication and care quality. More research is needed to identify contributing factors beyond PPC, such as cultural influences and medical system factors. © 2014 by American Society of Clinical Oncology.

Scaffolding the Communication of People With Congenital Deafblindness: An Analysis of Sequential Interaction Patterns.

PubMed

Damen, Saskia; Janssen, Marleen J; Ruijssenaars, Wied A; Schuengel, Carlo

2017-01-01

The High Quality Communication intervention aims to stimulate interpersonal communication between individuals with congenital deaf-blindness (CDB) and their social partners. Found effective in multiple-case experiments, the intervention is based on Trevarthen's theory of inter-subjective development (Bråten & Trevarthen, 2007), which describes children's innate and developing ability to share subjective states in interpersonal communication and social partners' mediating role in this development. One implication of this theory is that social partners can support the emergence of higher-complexity communication behaviors in individuals who are still developing these behaviors. To test this proposition, communication patterns between individuals with CDB and their parents, teachers, and professional caregivers were analyzed. Analysis of two-event sequences of communicative behaviors showed a highly significant correspondence between the behavior of the social partner and the subsequent behavior of the individual with CDB, confirming that social partners can scaffold higher-complexity communication within interpersonal communication.

Using School Websites to Support Parent Engagement

ERIC Educational Resources Information Center

Piper, Tracy

2012-01-01

A middle school of 1,000 students is a busy place. With dwindling resources and increased accountability, a well-designed school website is vital. Students and parents visit high quality websites through a variety of devices and expect equally high quality school-to-home communication. With the support of a professional web design company, the…

A design of wireless sensor networks for a power quality monitoring system.

PubMed

Lim, Yujin; Kim, Hak-Man; Kang, Sanggil

2010-01-01

Power grids deal with the business of generation, transmission, and distribution of electric power. Recently, interest in power quality in electrical distribution systems has increased rapidly. In Korea, the communication network to deliver voltage, current, and temperature measurements gathered from pole transformers to remote monitoring centers employs cellular mobile technology. Due to high cost of the cellular mobile technology, power quality monitoring measurements are limited and data gathering intervals are large. This causes difficulties in providing the power quality monitoring service. To alleviate the problems, in this paper we present a communication infrastructure to provide low cost, reliable data delivery. The communication infrastructure consists of wired connections between substations and monitoring centers, and wireless connections between pole transformers and substations. For the wireless connection, we employ a wireless sensor network and design its corresponding data forwarding protocol to improve the quality of data delivery. For the design, we adopt a tree-based data forwarding protocol in order to customize the distribution pattern of the power quality information. We verify the performance of the proposed data forwarding protocol quantitatively using the NS-2 network simulator.

Oncologists' communication about end of life: the relationship among secondary traumatic stress, compassion satisfaction, and approach and avoidance communication.

PubMed

Granek, Leeat; Nakash, Ora; Cohen, Michal; Ben-David, Merav; Ariad, Samuel

2017-11-01

Oncologists must communicate effectively with patients and their families about end of life (EOL). Despite the importance of communicating on this topic, many oncologists avoid these conversations. The objective of this study was to examine the associations between secondary traumatic stress and compassion satisfaction and approach and avoidant communication about EOL with cancer patients. A convenience sample of 79 oncologists (n = 27 men, n = 52 women) participated in the study. Oncologists completed a survey that included a sociodemographic and clinical information questionnaire, the Professional Quality of Life Scale, and Communication about End of Life Survey. To examine the effect of secondary traumatic stress and compassion satisfaction on approach and avoidant communication, while controlling for gender and age, 2 hierarchical linear regression analyses were computed. Oncologists reported high levels of secondary traumatic stress and high compassion satisfaction. Scores on the approach and avoidant communication scales were in the mid-range of the scale. Lower reports of secondary traumatic stress and higher compassion satisfaction were associated with higher approach communication strategies: however, only higher secondary traumatic stress was associated with higher avoidant communication strategies. Our findings indicate that there is an association between emotional factors and approach communication. The findings have clinical implications in designing effective communication skills training. Further research and training should take secondary traumatic stress and compassion satisfaction into consideration to be able to ensure that terminal patients and their families receive the best quality EOL care. Copyright © 2016 John Wiley & Sons, Ltd.

Assurance of energy efficiency and data security for ECG transmission in BASNs.

PubMed

Ma, Tao; Shrestha, Pradhumna Lal; Hempel, Michael; Peng, Dongming; Sharif, Hamid; Chen, Hsiao-Hwa

2012-04-01

With the technological advancement in body area sensor networks (BASNs), low cost high quality electrocardiographic (ECG) diagnosis systems have become important equipment for healthcare service providers. However, energy consumption and data security with ECG systems in BASNs are still two major challenges to tackle. In this study, we investigate the properties of compressed ECG data for energy saving as an effort to devise a selective encryption mechanism and a two-rate unequal error protection (UEP) scheme. The proposed selective encryption mechanism provides a simple and yet effective security solution for an ECG sensor-based communication platform, where only one percent of data is encrypted without compromising ECG data security. This part of the encrypted data is essential to ECG data quality due to its unequally important contribution to distortion reduction. The two-rate UEP scheme achieves a significant additional energy saving due to its unequal investment of communication energy to the outcomes of the selective encryption, and thus, it maintains a high ECG data transmission quality. Our results show the improvements in communication energy saving of about 40%, and demonstrate a higher transmission quality and security measured in terms of wavelet-based weighted percent root-mean-squared difference.

Service quality in community pharmacy: an exploration of determinants.

PubMed

White, Lesley; Klinner, Christiane

2012-01-01

Although various instruments have been developed to measure customer satisfaction with community pharmacy services, there is limited research regarding pharmacy staffs' understanding of service quality and its determinants. This study aimed to explore the perceptions of pharmacy staff regarding the factors that constitute a high level of service quality using the service quality determinants proposed by the Conceptual Model of Service Quality. Structured interviews were conducted with 27 pharmacy assistants and 6 pharmacists in 3 community pharmacies in Sydney. The interview questions focused on the participants' perceptions of consumer expectations, the translation of these perceptions into service quality specifications, the actual service delivery, and the communication to customers. From the pharmacy staff perspective, service quality is significantly limited by insufficient internal communication and control processes that impede role clarity and the resolution of conflicting role expectations among customer service personnel. Participants indicated that these problems could be alleviated through the implementation of more transparent, realistic, measurable, and accepted quality specifications by pharmacy management. The study indicates that the extent to which pharmacy management sets, maintains, and communicates service quality specifications to staff directly affects role clarity, role conflict, and organizational commitment among customer service staff, which in turn directly influence the level of service quality provided to the customers. Copyright © 2012 Elsevier Inc. All rights reserved.

The human factor: the critical importance of effective teamwork and communication in providing safe care.

PubMed

Leonard, M; Graham, S; Bonacum, D

2004-10-01

Effective communication and teamwork is essential for the delivery of high quality, safe patient care. Communication failures are an extremely common cause of inadvertent patient harm. The complexity of medical care, coupled with the inherent limitations of human performance, make it critically important that clinicians have standardised communication tools, create an environment in which individuals can speak up and express concerns, and share common "critical language" to alert team members to unsafe situations. All too frequently, effective communication is situation or personality dependent. Other high reliability domains, such as commercial aviation, have shown that the adoption of standardised tools and behaviours is a very effective strategy in enhancing teamwork and reducing risk. We describe our ongoing patient safety implementation using this approach within Kaiser Permanente, a non-profit American healthcare system providing care for 8.3 million patients. We describe specific clinical experience in the application of surgical briefings, properties of high reliability perinatal care, the value of critical event training and simulation, and benefits of a standardised communication process in the care of patients transferred from hospitals to skilled nursing facilities. Additionally, lessons learned as to effective techniques in achieving cultural change, evidence of improving the quality of the work environment, practice transfer strategies, critical success factors, and the evolving methods of demonstrating the benefit of such work are described.

A scoping review of patient discharge from intensive care: opportunities and tools to improve care.

PubMed

Stelfox, Henry T; Lane, Dan; Boyd, Jamie M; Taylor, Simon; Perrier, Laure; Straus, Sharon; Zygun, David; Zuege, Danny J

2015-02-01

We conducted a scoping review to systematically review the literature reporting patient discharge from ICUs, identify facilitators and barriers to high-quality care, and describe tools developed to improve care. We searched Medline, Embase, CINAHL, and the Cochrane Central Register of Controlled Trials. Data were extracted on the article type, study details for research articles, patient population, phase of care during discharge, and dimensions of health-care quality. From 8,154 unique publications we included 224 articles. Of these, 131 articles (58%) were original research, predominantly case series (23%) and cohort (16%) studies; 12% were narrative reviews; and 11% were guidelines/policies. Common themes included patient and family needs/experiences (29% of articles) and the importance of complete and accurate information (26%). Facilitators of high-quality care included provider-patient communication (30%), provider-provider communication (25%), and the use of guidelines/policies (29%). Patient and family anxiety (21%) and limited availability of ICU and ward resources (26%) were reported barriers to high-quality care. A total of 47 tools to facilitate patient discharge from the ICU were identified and focused on patient evaluation for discharge (29%), discharge planning and teaching (47%), and optimized discharge summaries (23%). Common themes, facilitators and barriers related to patient and family needs/experiences, communication, and the use of guidelines/policies to standardize patient discharge from ICU transcend the literature. Candidate tools to improve care are available; comparative evaluation is needed prior to broad implementation and could be tested through local quality-improvement programs.

Improving organizational climate for quality and quality of care: does membership in a collaborative help?

PubMed

Nembhard, Ingrid M; Northrup, Veronika; Shaller, Dale; Cleary, Paul D

2012-11-01

The lack of quality-oriented organizational climates is partly responsible for deficiencies in patient-centered care and poor quality more broadly. To improve their quality-oriented climates, several organizations have joined quality improvement collaboratives. The effectiveness of this approach is unknown. To evaluate the impact of collaborative membership on organizational climate for quality and service quality. Twenty-one clinics, 4 of which participated in a collaborative sponsored by the Institute for Clinical Systems Improvement. Pre-post design. Preassessments occurred 2 months before the collaborative began in January 2009. Postassessments of service quality and climate occurred about 6 months and 1 year, respectively, after the collaborative ended in January 2010. We surveyed clinic employees (eg, physicians, nurses, receptionists, etc.) about the organizational climate and patients about service quality. Prioritization of quality care, high-quality staff relationships, and open communication as indicators of quality-oriented climate and timeliness of care, staff helpfulness, doctor-patient communication, rating of doctor, and willingness to recommend doctor's office as indicators of service quality. There was no significant effect of collaborative membership on quality-oriented climate and mixed effects on service quality. Doctors' ratings improved significantly more in intervention clinics than in control clinics, staff helpfulness improved less, and timeliness of care declined more. Ratings of doctor-patient communication and willingness to recommend doctor were not significantly different between intervention and comparison clinics. Membership in the collaborative provided no significant advantage for improving quality-oriented climate and had equivocal effects on service quality.

Perceived Quality of In-Service Communication and Counseling Among Adolescents Undergoing Voluntary Medical Male Circumcision.

PubMed

Van Lith, Lynn M; Mallalieu, Elizabeth C; Patel, Eshan U; Dam, Kim H; Kaufman, Michelle R; Hatzold, Karin; Marcell, Arik V; Mavhu, Webster; Kahabuka, Catherine; Mahlasela, Lusanda; Njeuhmeli, Emmanuel; Seifert Ahanda, Kim; Ncube, Getrude; Lija, Gissenge; Bonnecwe, Collen; Tobian, Aaron A R

2018-04-03

Experience with providers shapes the quality of adolescent health services, including voluntary medical male circumcision (VMMC). This study examined the perceived quality of in-service communication and counseling during adolescent VMMC services. A postprocedure quantitative survey measuring overall satisfaction, comfort, perceived quality of in-service communication and counseling, and perceived quality of facility-level factors was administered across 14 VMMC sites in South Africa, Tanzania, and Zimbabwe. Participants were adolescent male clients aged 10-14 years (n = 836) and 15-19 years (n = 457) and completed the survey 7 to 10 days following VMMC. Adjusted prevalence ratios (aPRs) were estimated by multivariable modified Poisson regression with generalized estimating equations and robust variance estimation to account for site-level clustering. Of 10- to 14-year-olds and 15- to 19-year-olds, 97.7% and 98.7%, respectively, reported they were either satisfied or very satisfied with their VMMC counseling experience. Most were also very likely or somewhat likely (93.6% of 10- to 14-year olds and 94.7% of 15- to 19-year olds) to recommend VMMC to their peers. On a 9-point scale, the median perceived quality of in-service (counselor) communication was 9 (interquartile range [IQR], 8-9) among 15- to 19-year-olds and 8 (IQR, 7-9) among 10- to 14-year-olds. The 10- to 14-year-olds were more likely than 15- to 19-year-olds to perceive a lower quality of in-service (counselor) communication (score <7; 21.5% vs. 8.2%; aPR, 1.61 [95% confidence interval, 1.33-1.95]). Most adolescents were more comfortable with a male rather than female counselor and provider. Adolescents of all ages wanted more discussion about pain, wound care, and healing time. Adolescents perceive the quality of in-service communication as high and recommend VMMC to their peers; however, many adolescents desire more discussion about key topics outlined in World Health Organization guidance.

Estimating and communicating prognosis in advanced neurologic disease

PubMed Central

Gramling, Robert; Kelly, Adam G.

2013-01-01

Prognosis can no longer be relegated behind diagnosis and therapy in high-quality neurologic care. High-stakes decisions that patients (or their surrogates) make often rest upon perceptions and beliefs about prognosis, many of which are poorly informed. The new science of prognostication—the estimating and communication “what to expect”—is in its infancy and the evidence base to support “best practices” is lacking. We propose a framework for formulating a prediction and communicating “what to expect” with patients, families, and surrogates in the context of common neurologic illnesses. Because neurologic disease affects function as much as survival, we specifically address 2 important prognostic questions: “How long?” and “How well?” We provide a summary of prognostic information and highlight key points when tailoring a prognosis for common neurologic diseases. We discuss the challenges of managing prognostic uncertainty, balancing hope and realism, and ways to effectively engage surrogate decision-makers. We also describe what is known about the nocebo effects and the self-fulfilling prophecy when communicating prognoses. There is an urgent need to establish research and educational priorities to build a credible evidence base to support best practices, improve communication skills, and optimize decision-making. Confronting the challenges of prognosis is necessary to fulfill the promise of delivering high-quality, patient-centered care. PMID:23420894

Does physician communication style impact patient report of decision quality for breast cancer treatment?

PubMed

Martinez, Kathryn A; Resnicow, Ken; Williams, Geoffrey C; Silva, Marlene; Abrahamse, Paul; Shumway, Dean A; Wallner, Lauren P; Katz, Steven J; Hawley, Sarah T

2016-12-01

Provider communication that supports patient autonomy has been associated with numerous positive patient outcomes. However, to date, no research has examined the relationship between perceived provider communication style and patient-assessed decision quality in breast cancer. Using a population-based sample of women with localized breast cancer, we assessed patient perceptions of autonomy-supportive communication from their surgeons and medical oncologists, as well as patient-reported decision quality. We used multivariable linear regression to examine the association between autonomy-supportive communication and subjective decision quality for surgery and chemotherapy decisions, controlling for sociodemographic and clinical factors, as well as patient-reported communication preference (non-directive or directive). Among the 1690 women included in the overall sample, patient-reported decision quality scores were positively associated with higher levels of perceived autonomy-supportive communication from surgeons (β=0.30; p<0.001) and medical oncologists (β=0.26; p<0.001). Patient communication style preference moderated the association between physician communication style received and perceived decision quality. Autonomy-supportive communication by physicians was associated with higher subjective decision quality among women with localized breast cancer. These results support future efforts to design interventions that enhance autonomy-supportive communication. Autonomy-supportive communication by cancer doctors can improve patients' perceived decision quality. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Does physician communication style impact patient report of decision quality for breast cancer treatment?

PubMed Central

Resnicow, Ken; Williams, Geoffrey C.; Silva, Marlene; Abrahamse, Paul; Shumway, Dean; Wallner, Lauren; Katz, Steven; Hawley, Sarah

2016-01-01

Objective Provider communication that supports patient autonomy has been associated with numerous positive patient outcomes. However, to date, no research has examined the relationship between perceived provider communication style and patient-assessed decision quality in breast cancer. Methods Using a population-based sample of women with localized breast cancer, we assessed patient perceptions of autonomy-supportive communication from their surgeons and medical oncologists, as well as patient-reported decision quality. We used multivariable linear regression to examine the association between autonomy-supportive communication and subjective decision quality for surgery and chemotherapy decisions, controlling for sociodemographic and clinical factors, as well as patient-reported communication preference (non-directive or directive). Results Among the 1,690 women included in the overall sample, patient-reported decision quality scores were positively associated with higher levels of perceived autonomy-supportive communication from surgeons (β=0.30; p<0.001) and medical oncologists (β=0.26; p<0.001). Patient communication style preference moderated the association between physician communication style received and perceived decision quality. Conclusion Autonomy-supportive communication by physicians was associated with higher subjective decision quality among women with localized breast cancer. These results support future efforts to design interventions that enhance autonomy-supportive communication. Practice Implications Autonomy-supportive communication by cancer doctors can improve patients’ perceived decision quality. PMID:27395750

A Distributed Middleware Architecture for Attack-Resilient Communications in Smart Grids

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hodge, Brian S; Wu, Yifu; Wei, Jin

Distributed Energy Resources (DERs) are being increasingly accepted as an excellent complement to traditional energy sources in smart grids. As most of these generators are geographically dispersed, dedicated communications investments for every generator are capital cost prohibitive. Real-time distributed communications middleware, which supervises, organizes and schedules tremendous amounts of data traffic in smart grids with high penetrations of DERs, allows for the use of existing network infrastructure. In this paper, we propose a distributed attack-resilient middleware architecture that detects and mitigates the congestion attacks by exploiting the Quality of Experience (QoE) measures to complement the conventional Quality of Service (QoS)more » information to detect and mitigate the congestion attacks effectively. The simulation results illustrate the efficiency of our proposed communications middleware architecture.« less

A Distributed Middleware Architecture for Attack-Resilient Communications in Smart Grids: Preprint

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wu, Yifu; Wei, Jin; Hodge, Bri-Mathias

Distributed energy resources (DERs) are being increasingly accepted as an excellent complement to traditional energy sources in smart grids. Because most of these generators are geographically dispersed, dedicated communications investments for every generator are capital-cost prohibitive. Real-time distributed communications middleware - which supervises, organizes, and schedules tremendous amounts of data traffic in smart grids with high penetrations of DERs - allows for the use of existing network infrastructure. In this paper, we propose a distributed attack-resilient middleware architecture that detects and mitigates the congestion attacks by exploiting the quality of experience measures to complement the conventional quality of service informationmore » to effectively detect and mitigate congestion attacks. The simulation results illustrate the efficiency of our proposed communications middleware architecture.« less

Efficient resource allocation scheme for visible-light communication system

NASA Astrophysics Data System (ADS)

Kim, Woo-Chan; Bae, Chi-Sung; Cho, Dong-Ho; Shin, Hong-Seok; Jung, D. K.; Oh, Y. J.

2009-01-01

A visible-light communication utilizing LED has many advantagies such as visibility of information, high SNR (Signal to Noise Ratio), low installation cost, usage of existing illuminators, and high security. Furthermore, exponentially increasing needs and quality of LED have helped the development of visible-light communication. The visibility is the most attractive property in visible-light communication system, but it is difficult to ensure visibility and transmission efficiency simultaneously during initial access because of the small amount of initial access process signals. In this paper, we propose an efficient resource allocation scheme at initial access for ensuring visibility with high resource utilization rate and low data transmission failure rate. The performance has been evaluated through the numerical analysis and simulation results.

Application of the VALUE communication principles in ACTIVE hospice team meetings.

PubMed

Washington, Karla T; Wittenberg-Lyles, Elaine; Parker Oliver, Debra; Demiris, George; Shaunfield, Sara; Crumb, Edith

2013-01-01

The ACTIVE (Assessing Caregivers for Team Intervention through Video Encounters) intervention uses technology to enable family caregivers to participate in hospice interdisciplinary team (IDT) meetings from geographically remote locations. Previous research has suggested that effective communication is critical to the success of these meetings. The purpose of this study was to explore communication in ACTIVE IDT meetings involving family caregivers and to assess the degree to which hospice teams use specific communication principles (summarized in the mnemonic VALUE: value, acknowledge, listen, understand, and elicit), which have been supported in previous research in intensive care settings. Researchers analyzed team-family communication during 84 video- and/or audio-recorded care plan discussions that took place during ACTIVE team meetings, using a template approach to text analysis to determine the extent and quality of VALUE principles. The total content analyzed was 9 hours, 28 minutes in length. Hospice clinicians routinely employed the VALUE communication principles in communication during ACTIVE IDT meetings with family caregivers, but the quality of this communication was frequently rated moderate or poor. The majority of such communication was task-focused. Less often, communication centered on emotional concerns and efforts to gain a more holistic understanding of patients and families. This analysis suggests an opportunity for improving support for family members during ACTIVE IDT meetings. Members of hospice IDTs should remain aware of the opportunity for additional attention to the emotional realities of the hospice experience for family caregivers and could improve support for family caregivers during IDT meetings by ensuring that messages used to exemplify VALUE principles during team-family communication are of a high quality.

Patterns of communication in high-fidelity simulation.

PubMed

Anderson, Judy K; Nelson, Kimberly

2015-01-01

High-fidelity simulation is commonplace in nursing education. However, critical thinking, decision making, and psychomotor skills scenarios are emphasized. Scenarios involving communication occur in interprofessional or intraprofessional settings. The importance of effective nurse-patient communication is reflected in statements from the American Nurses Association and Quality and Safety Education for Nurses, and in the graduate outcomes of most nursing programs. This qualitative study examined the patterns of communication observed in video recordings of a medical-surgical scenario with 71 senior students in a baccalaureate program. Thematic analysis revealed patterns of (a) focusing on tasks, (b) communicating-in-action, and (c) being therapeutic. Additional categories under the patterns included missing opportunities, viewing the "small picture," relying on informing, speaking in "medical tongues," offering choices…okay?, feeling uncomfortable, and using therapeutic techniques. The findings suggest the importance of using high-fidelity simulation to develop expertise in communication. In addition, the findings reinforce the recommendation to prioritize communication aspects of scenarios and debriefing for all simulations. Copyright 2015, SLACK Incorporated.

A conceptual model of the role of communication in surrogate decision making for hospitalized adults.

PubMed

Torke, Alexia M; Petronio, Sandra; Sachs, Greg A; Helft, Paul R; Purnell, Christianna

2012-04-01

To build a conceptual model of the role of communication in decision making, based on literature from medicine, communication studies and medical ethics. We proposed a model and described each construct in detail. We review what is known about interpersonal and patient-physician communication, described literature about surrogate-clinician communication, and discussed implications for our developing model. The communication literature proposes two major elements of interpersonal communication: information processing and relationship building. These elements are composed of constructs such as information disclosure and emotional support that are likely to be relevant to decision making. We propose these elements of communication impact decision making, which in turn affects outcomes for both patients and surrogates. Decision making quality may also mediate the relationship between communication and outcomes. Although many elements of the model have been studied in relation to patient-clinician communication, there is limited data about surrogate decision making. There is evidence of high surrogate distress associated with decision making that may be alleviated by communication-focused interventions. More research is needed to test the relationships proposed in the model. Good communication with surrogates may improve both the quality of medical decisions and outcomes for the patient and surrogate. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Assessment of Factors Influencing Communication in Clinical Pharmacy.

PubMed

Yao, Dongning; Jiang, Liang; Huang, Yuankai; Chen, Lei; Wang, Yitao; Xi, Xiaoyu

2018-01-01

This study aimed to identify and assess the factors that influence communication quality between clinical pharmacists and patients using a structural equation model based on the predisposing, reinforcing, and enabling constructs in educational/environmental diagnosis and evaluation-policy, regulatory, and organizational constructs in educational and ecological development model to identify the most effective path to increase their communication quality. A survey was conducted at 253 Class-A tertiary hospitals in China from March to December 2016. During on-site observations, verbal communications between clinical pharmacists ( n = 752) and patients were audio recorded, and communication quality was rated by an expert panel on an 8-item Quality of Communication Rating Scale. Clinical pharmacists completed questionnaires that examined the predisposing, enabling, and reinforcing factors that influenced communication quality. Finally, AMOS was employed to examine the relationships between the three factors and communication quality. The results indicated that all three factors positively affected communication quality, with correlation coefficients of .26, .13, and .17, respectively. The most influential predisposing factor was attitude (.77), the most influential enabling factors were self-efficacy (.71) and confidence (.72), and the most influential reinforcing factor was rewards (.74). The findings suggest that pharmacists' attitudes toward, perceived knowledge of, and skill and confidence in communication, and the rewards offered by pharmacy management are the most influential factors that influence communication quality.

Reliability and validity of the Daily Cognitive-Communication and Sleep Profile: a new instrument for monitoring sleep, wakefulness and daytime function.

PubMed

Fung, Christina Hoi Ling; Nguyen, Michelle; Moineddin, Rahim; Colantonio, Angela; Wiseman-Hakes, Catherine

2014-06-01

The Daily Cognitive Communicative and Sleep Profile (DCCASP) is a seven-item instrument that captures daily subjective sleep quality, perceived mood, cognitive, and communication functions. The objective of this study was to evaluate the reliability and validity of the DCCASP. The DCCASP was self-administered daily to a convenience sample of young adults (n = 54) for two two-week blocks, interspersed with a two-week rest period. Afterwards, participants completed the Pittsburgh Sleep Quality Index (PSQI). Internal consistency and criterion validity were calculated by Cronbach's α coefficient, Concordance Correlation Coefficient (CCC), and Spearman rank (rs) correlation coefficient, respectively. Results indicated high internal consistency (Cronbach-s α = 0.864-0.938) among mean ratings of sleep quality on the DCCASP. There were significant correlations between mean ratings of sleep quality and all domains (rs=0.38-0.55, p<0.0001). Criterion validity was established between mean sleep quality ratings on the DCCASP and PSQI (rs=0.40, p<0.001). The DCCASP is a reliable and valid self-report instrument to monitor daily sleep quality and perceived mood, cognitive, and communication functions over time, amongst a normative sample of young adults. Further studies on its psychometric properties are necessary to clarify its utility in a clinical population. Copyright © 2014 John Wiley & Sons, Ltd.

Facial appearance affects science communication.

PubMed

Gheorghiu, Ana I; Callan, Mitchell J; Skylark, William J

2017-06-06

First impressions based on facial appearance predict many important social outcomes. We investigated whether such impressions also influence the communication of scientific findings to lay audiences, a process that shapes public beliefs, opinion, and policy. First, we investigated the traits that engender interest in a scientist's work, and those that create the impression of a "good scientist" who does high-quality research. Apparent competence and morality were positively related to both interest and quality judgments, whereas attractiveness boosted interest but decreased perceived quality. Next, we had members of the public choose real science news stories to read or watch and found that people were more likely to choose items that were paired with "interesting-looking" scientists, especially when selecting video-based communications. Finally, we had people read real science news items and found that the research was judged to be of higher quality when paired with researchers who look like "good scientists." Our findings offer insights into the social psychology of science, and indicate a source of bias in the dissemination of scientific findings to broader society.

Far field and wavefront characterization of a high-power semiconductor laser for free space optical communications

NASA Technical Reports Server (NTRS)

Cornwell, Donald M., Jr.; Saif, Babak N.

1991-01-01

The spatial pointing angle and far field beamwidth of a high-power semiconductor laser are characterized as a function of CW power and also as a function of temperature. The time-averaged spatial pointing angle and spatial lobe width were measured under intensity-modulated conditions. The measured pointing deviations are determined to be well within the pointing requirements of the NASA Laser Communications Transceiver (LCT) program. A computer-controlled Mach-Zehnder phase-shifter interferometer is used to characterize the wavefront quality of the laser. The rms phase error over the entire pupil was measured as a function of CW output power. Time-averaged measurements of the wavefront quality are also made under intensity-modulated conditions. The measured rms phase errors are determined to be well within the wavefront quality requirements of the LCT program.

Parent-Adolescent Sexual and Reproductive Health Communication Is Very Limited and Associated with Adolescent Poor Behavioral Beliefs and Subjective Norms: Evidence from a Community Based Cross-Sectional Study in Eastern Ethiopia.

PubMed

Dessie, Yadeta; Berhane, Yemane; Worku, Alemayehu

2015-01-01

While parent-adolescent sexual and reproductive health (SRH) communication is one potential source of SRH information for adolescents, it appears to be inadequately practiced in Ethiopia. This study was designed to investigate the factors that limit or improve parent-adolescent SRH communication in Harar, Eastern Ethiopia. A community based cross-sectional study was done on 4,559 adolescents of age 13-18. SRH communication was measured using a nine-item scale whose response ranged from "not at all" to "always." Summated composite score ranging from 0-36 was generated; higher score indicates high SRH communication. A median value of the composite score was 4 out of the possible 36 with an Interquartile Range (IQR) of 7. Respondents were ranked as very poor, poor and satisfactory communicators based on 33rd and 67th percentiles values. Generalized ordered logit model was applied to investigate the factors associated with SRH communication. Results showed that the adolescents who were more likely to practice poor-very poor/very poor SRH communication were those who had poor behavioral beliefs on and poor subjective norms of communicating sexual issues with parents and those who perceived their parents' reproductive health (RH) knowledge as poor. Nonetheless, the probability of poor-very poor/very poor SRH communication was less with high adolescent-parent communication quality, television co-viewing and discussions, and self-disclosure. Curtailing the adolescents' underlying poor beliefs and norms, and improving adolescent-parent communication quality, self-disclosure, and television co-viewing and discussions are essential to engage the parents in sexual and reproductive health education of the adolescents.

Parent-Adolescent Sexual and Reproductive Health Communication Is Very Limited and Associated with Adolescent Poor Behavioral Beliefs and Subjective Norms: Evidence from a Community Based Cross-Sectional Study in Eastern Ethiopia

PubMed Central

2015-01-01

Introduction While parent-adolescent sexual and reproductive health (SRH) communication is one potential source of SRH information for adolescents, it appears to be inadequately practiced in Ethiopia. This study was designed to investigate the factors that limit or improve parent-adolescent SRH communication in Harar, Eastern Ethiopia. Methods A community based cross-sectional study was done on 4,559 adolescents of age 13–18. SRH communication was measured using a nine-item scale whose response ranged from “not at all” to “always.” Summated composite score ranging from 0–36 was generated; higher score indicates high SRH communication. A median value of the composite score was 4 out of the possible 36 with an Interquartile Range (IQR) of 7. Respondents were ranked as very poor, poor and satisfactory communicators based on 33rd and 67th percentiles values. Generalized ordered logit model was applied to investigate the factors associated with SRH communication. Results Results showed that the adolescents who were more likely to practice poor-very poor/very poor SRH communication were those who had poor behavioral beliefs on and poor subjective norms of communicating sexual issues with parents and those who perceived their parents’ reproductive health (RH) knowledge as poor. Nonetheless, the probability of poor-very poor/very poor SRH communication was less with high adolescent-parent communication quality, television co-viewing and discussions, and self-disclosure. Conclusions Curtailing the adolescents’ underlying poor beliefs and norms, and improving adolescent-parent communication quality, self-disclosure, and television co-viewing and discussions are essential to engage the parents in sexual and reproductive health education of the adolescents. PMID:26167860

Probabilistic Assessment of High-Throughput Wireless Sensor Networks

PubMed Central

Kim, Robin E.; Mechitov, Kirill; Sim, Sung-Han; Spencer, Billie F.; Song, Junho

2016-01-01

Structural health monitoring (SHM) using wireless smart sensors (WSS) has the potential to provide rich information on the state of a structure. However, because of their distributed nature, maintaining highly robust and reliable networks can be challenging. Assessing WSS network communication quality before and after finalizing a deployment is critical to achieve a successful WSS network for SHM purposes. Early studies on WSS network reliability mostly used temporal signal indicators, composed of a smaller number of packets, to assess the network reliability. However, because the WSS networks for SHM purpose often require high data throughput, i.e., a larger number of packets are delivered within the communication, such an approach is not sufficient. Instead, in this study, a model that can assess, probabilistically, the long-term performance of the network is proposed. The proposed model is based on readily-available measured data sets that represent communication quality during high-throughput data transfer. Then, an empirical limit-state function is determined, which is further used to estimate the probability of network communication failure. Monte Carlo simulation is adopted in this paper and applied to a small and a full-bridge wireless networks. By performing the proposed analysis in complex sensor networks, an optimized sensor topology can be achieved. PMID:27258270

Assessing air quality index awareness and use in Mexico City.

PubMed

Borbet, Timothy C; Gladson, Laura A; Cromar, Kevin R

2018-04-23

The Mexico City Metropolitan Area has an expansive urban population and a long history of air quality management challenges. Poor air quality has been associated with adverse pulmonary and cardiac health effects, particularly among susceptible populations with underlying disease. In addition to reducing pollution concentrations, risk communication efforts that inform behavior modification have the potential to reduce public health burdens associated with air pollution. This study investigates the utilization of Mexico's IMECA risk communication index to inform air pollution avoidance behavior among the general population living in the Mexico City Metropolitan Area. Individuals were selected via probability sampling and surveyed by phone about their air quality index knowledge, pollution concerns, and individual behaviors. The results indicated reasonably high awareness of the air quality index (53% of respondents), with greater awareness in urban areas, among older and more educated individuals, and for those who received air quality information from a healthcare provider. Additionally, behavior modification was less influenced by index reports as it was by personal perceptions of air quality, and there was no difference in behavior modification among susceptible and non-susceptible groups. Taken together, these results suggest there are opportunities to improve the public health impact of risk communication through an increased focus on susceptible populations and greater encouragement of public action in response to local air quality indices.

A Conceptual Model of the Role of Communication in Surrogate Decision Making for Hospitalized Adults

PubMed Central

Torke, Alexia M.; Petronio, Sandra; Sachs, Greg A.; Helft, Paul R.; Purnell, Christianna

2011-01-01

Objective To build a conceptual model of the role of communication in decision making, based on literature from medicine, communication studies and medical ethics. Methods We propose a model and describe each construct in detail. We review what is known about interpersonal and patient-physician communication, describe literature about surrogate-clinician communication, and discuss implications for our developing model. Results The communication literature proposes two major elements of interpersonal communication: information processing and relationship building. These elements are composed of constructs such as information disclosure and emotional support that are likely to be relevant to decision making. We propose these elements of communication impact decision making, which in turn affects outcomes for both patients and surrogates. Decision making quality may also mediate the relationship between communication and outcomes. Conclusion Although many elements of the model have been studied in relation to patient-clinician communication, there is limited data about surrogate decision making. There is evidence of high surrogate distress associated with decision making that may be alleviated by communication–focused interventions. More research is needed to test the relationships proposed in the model. Practice Implications Good communication with surrogates may improve both the quality of medical decisions and outcomes for the patient and surrogate. PMID:21889865

Reliable cues and signals of fruit quality are contingent on the habitat in black elder (Sambucus nigra).

PubMed

Schaefer, H Martin; Braun, Julius

2009-06-01

Communication mediates interactions between organisms and can be based on signals or cues. Signals are selected for their signaling function, whereas cues evolve for reasons other than signaling. To be evolutionarily stable, communication needs to be reliable on average, but the mechanisms that enforce reliability are hotly debated in light of strong environmental influence on signals and cues. While fruit quality in black elder (Sambucus nigra) is unrelated to fruit color, it is indicated by alternative pedicel phenotypes. Information on fruit quality has thus been transferred from the fruit to the developmentally associated pedicels, which are environmentally determined cues. Within each phenotype, color variation indicates fruit quality. Communication by black elder is thus reliable, but the proximate mechanisms enforcing reliability are habitat specific. High irradiance increases both the contrasts of the visual cue and fruit quality in the anthocyanin-based red pedicel phenotype, while shaded plants of the chlorophyll-based green phenotype apparently use signals by forgoing photosynthesis. This is because lower chlorophyll content in green pedicels creates contrasting pedicels, and higher contrasts indicate higher sugar content in the fruits of green pedicels. Because anthocyanins are light-induced, plants use cues when exposed to high irradiance, whereas they apparently use costly signals in the shade by reducing chlorophyll content in the pedicels. In behavioral field and laboratory experiments we document that avian seed dispersers select among pedicel phenotypes that indicate different fruit quality. Plants can thus increase their reproductive success by sending highly informative cues. Our results indicate how reliable information transfer can be maintained both in cues and signals in spite of substantial environmental influence on visual traits.

Wafer scale millimeter-wave integrated circuits based on epitaxial graphene in high data rate communication.

PubMed

Habibpour, Omid; He, Zhongxia Simon; Strupinski, Wlodek; Rorsman, Niklas; Zirath, Herbert

2017-02-01

In recent years, the demand for high data rate wireless communications has increased dramatically, which requires larger bandwidth to sustain multi-user accessibility and quality of services. This can be achieved at millimeter wave frequencies. Graphene is a promising material for the development of millimeter-wave electronics because of its outstanding electron transport properties. Up to now, due to the lack of high quality material and process technology, the operating frequency of demonstrated circuits has been far below the potential of graphene. Here, we present monolithic integrated circuits based on epitaxial graphene operating at unprecedented high frequencies (80-100 GHz). The demonstrated circuits are capable of encoding/decoding of multi-gigabit-per-second information into/from the amplitude or phase of the carrier signal. The developed fabrication process is scalable to large wafer sizes.

Empowering certified nurse's aides to improve quality of work life through a team communication program.

PubMed

Howe, Erin E

2014-01-01

The purpose of this pilot study was to explore the impact of a certified nurse's aide (CNA)-led interdisciplinary teamwork and communication intervention on perceived quality of work environment and six-month job intentions. CNAs are frequently excluded from team communication and decision-making, which often leads to job dissatisfaction with high levels of staff turnover. Using a mixed quantitative and qualitative approach with pre- post-program design, the intervention utilized the strategy of debriefing from the national patient safety initiative, TeamSTEPPS. Inherent in the program design, entitled Long Term Care (LTC) Team Talk, was the involvement of the CNAs in the development of the intervention as an empowering process on two wings of a transitional care unit in a long-term care facility in upstate NY. CNAs' perceptions of work environment quality were measured using a Quality of Work Life (QWL) instrument. Additionally, job turnover intent within six months was assessed. Results indicated improved scores on nearly all QWL subscales anticipated to be impacted, and enhanced perceived empowerment of the CNAs on each wing albeit through somewhat different experiential processes. The program is highly portable and can potentially be implemented in a variety of long-term care settings. Copyright © 2014 Mosby, Inc. All rights reserved.

Quality of Communication in Robotic Surgery and Surgical Outcomes.

PubMed

Schiff, Lauren; Tsafrir, Ziv; Aoun, Joelle; Taylor, Andrew; Theoharis, Evan; Eisenstein, David

2016-01-01

Robotic surgery has introduced unique challenges to surgical workflow. The association between quality of communication in robotic-assisted laparoscopic surgery and surgical outcomes was evaluated. After each gynecologic robotic surgery, the team members involved in the surgery completed a survey regarding the quality of communication. A composite quality-of-communication score was developed using principal component analysis. A higher composite quality-of-communication score signified poor communication. Objective parameters, such as operative time and estimated blood loss (EBL), were gathered from the patient's medical record and correlated with the composite quality-of-communication scores. Forty robotic cases from March through May 2013 were included. Thirty-two participants including surgeons, circulating nurses, and surgical technicians participated in the study. A higher composite quality-of-communication score was associated with greater EBL (P = .010) and longer operative time (P = .045), after adjustment for body mass index, prior major abdominal surgery, and uterine weight. Specifically, for every 1-SD increase in the perceived lack of communication, there was an additional 51 mL EBL and a 31-min increase in operative time. The most common reasons reported for poor communication in the operating room were noise level (28/36, 78%) and console-to-bedside communication problems (23/36, 64%). Our study demonstrates a significant association between poor intraoperative team communication and worse surgical outcomes in robotic gynecologic surgery. Employing strategies to decrease extraneous room noise, improve console-to-bedside communication and team training may have a positive impact on communication and related surgical outcomes.

Culture, communication and safety: lessons from the airline industry.

PubMed

d'Agincourt-Canning, Lori G; Kissoon, Niranjan; Singal, Mona; Pitfield, Alexander F

2011-06-01

Communication is a critical component of effective teamwork and both are essential elements in providing high quality of care to patients. Yet, communication is not an innate skill but a process influenced by internal (personal/cultural values) as well as external (professional roles and hierarchies) factors. To provide illustrative cases, themes and tools for improving communication. Literature review and consensus opinion based on extensive experience. Professional autonomy should be de-emphasized. Tools such as SBAR and simulation are important in communication and teamwork. Tools designed to improve communication and safety in the aviation industry may have applicability to the pediatric intensive care unit.

Effect of a multi-level intervention on nurse—patient communication in the intensive care unit: Results of the SPEACS trial

PubMed Central

Happ, Mary Beth; Garrett, Kathryn L.; Tate, Judith A.; DiVirgilio, Dana; Houze, Martin P.; Demirci, Jill R.; George, Elisabeth; Sereika, Susan M.

2014-01-01

Objective To test the impact of two levels of intervention on communication frequency, quality, success, and ease between nurses and intubated intensive care unit (ICU) patients. Design Quasi-experimental, 3-phase sequential cohort study: (1) usual care, (2) basic communication skills training (BCST) for nurses, (3) additional training in augmentative and alternative communication devices and speech language pathologist consultation (AAC + SLP). Trained observers rated four 3-min video-recordings for each nurseepatient dyad for communication frequency, quality and success. Patients self-rated communication ease. Setting Two ICUs in a university-affiliated medical center. Participants 89 intubated patients awake, responsive and unable to speak and 30 ICU nurses. Main results Communication frequency (mean number of communication acts within a communication exchange) and positive nurse communication behaviors increased significantly in one ICU only. Percentage of successful communication exchanges about pain were greater for the two intervention groups than the usual care/control group across both ICUs (p = .03) with more successful sessions about pain and other symptoms in the AAC + SLP group (p = .07). Patients in the AAC SLP intervention group used significantly more AAC methods (p = .002) and rated communication at high difficulty less often (p < .01). Conclusions This study provides support for the feasibility, utility and efficacy of a multi-level communication skills training, materials and SLP consultation intervention in the ICU. PMID:24495519

Expressive Electronic Journal Writing: Freedom of Communication for Survivors of Acquired Brain Injury

ERIC Educational Resources Information Center

Fraas, Michael; Balz, Magdalen A.

2008-01-01

In addition to the impaired ability to effectively communicate, adults with acquired brain injury (ABI) also experience high incidences of depression, social isolation, and decreased quality of life. Expressive writing programs have been shown to be effective in alleviating these concomitant impairments in other populations including incarcerated…

Wireless Data Communications Prototyping: A Flexible, High-Quality, and Cost-Effective Information System for Education.

ERIC Educational Resources Information Center

Juliano, Benjoe A.; Sheel, Stephen J.

In this paper, potential applications of wireless data communications and mobile satellite technology are described which aim at improving education. The motivation behind this work is that the technology now exists for providing today's teachers and students with not only better access to educational facilities, but also instantaneous…

Considerations in the design of a communication network for an autonomously managed power system

NASA Technical Reports Server (NTRS)

Mckee, J. W.; Whitehead, Norma; Lollar, Louis

1989-01-01

The considerations involved in designing a communication network for an autonomously managed power system intended for use in space vehicles are examined. An overview of the design and implementation of a communication network implemented in a breadboard power system is presented. An assumption that the monitoring and control devices are distributed but physically close leads to the selection of a multidrop cable communication system. The assumption of a high-quality communication cable in which few messages are lost resulted in a simple recovery procedure consisting of a time out and retransmit process.

Testing a pharmacist-patient relationship quality model among older persons with diabetes.

PubMed

Worley, Marcia M

2006-03-01

Considering recent changes to the Medicare program, pharmacists will have unique opportunities to be reimbursed for providing Medication Therapy Management Services to older persons with diabetes. A high-quality pharmacist-patient relationship can lay the foundation for effective provision of Medication Therapy Management Services and improved care in this cohort. To test a pharmacist-patient relationship quality model in a group of older persons with diabetes from the patient's perspective. Antecedents to relationship quality were pharmacist participative behavior/patient-centeredness of relationship, patient participative behavior, and pharmacist-patient interpersonal communication. Pharmacist-patient relationship commitment was the outcome of relationship quality studied. Data were collected via mailed questionnaire from a random sample of 600 community-dwelling adults in the United States who (1) were 65 years of age and older, (2) had type 1 or type 2 diabetes, (3) used at least one prescription medication to treat their diabetes, and (4) used some type of nonmail order pharmacy as their primary source of obtaining prescription medications. Model relationships were tested using path analysis. The adjusted response rate was 41.6% (221/531). The models explained 47% and 49% of the variance in relationship quality and relationship commitment, respectively. In the relationship quality model, pharmacist participative behavior/patient-centeredness of relationship (beta=.51, P<.001) and pharmacist-patient interpersonal communication (beta=.17, P=.008) had direct effects on relationship quality. In the relationship commitment model, relationship quality had a direct effect on relationship commitment (beta=.60, P<.001). Pharmacist participative behavior/patient-centeredness and pharmacist-patient interpersonal communication had indirect effects on relationship commitment through their effects on relationship quality, which is a mediator in the model. Results affirm findings from previous research showing that patients' perceptions of pharmacist participative behavior/patient-centeredness of relationship and pharmacist-patient interpersonal communication are positively related to perceptions of relationship quality. Also, relationship quality is a strong mediator between pharmacist participative behavior/patient-centeredness of relationship and relationship commitment, as well as between pharmacist-patient interpersonal communication and relationship commitment.

The Communication AssessmenT Checklist in Health (CATCH): a tool for assessing the quality of printed educational materials for clinicians.

PubMed

Genova, Juliana; Nahon-Serfaty, Isaac; Dansokho, Selma Chipenda; Gagnon, Marie-Pierre; Renaud, Jean-Sébastien; Giguère, Anik M C

2014-01-01

There is little guidance available on strategies to improve the communication quality of printed educational materials (PEMs) for clinicians. The purposes of this study were to conceptualize PEM communication quality, develop a checklist based on this conceptualization, and validate the checklist with a selection of PEMs. From a literature review of the strategies influencing communication quality, we generated a conceptual map and developed the Communication AssessmenT Checklist in Health (CATCH) consisting of 55 items nested in 12 concepts. Two raters independently applied CATCH to 45 PEMs evaluated in the studies included in a Cochrane systematic review. From these results, we conducted an item analysis and assessed content validity of CATCH using a hierarchical cluster analysis to explore the extent to which our CATCH operationalization truly represented the communication quality concepts. Some concepts were better covered in the studied PEMs, whereas others were not covered consistently. We observed 3 contrasting PEM clusters. A first cluster (n = 22) was characterized by longer PEMs and comprised mostly high-impact peer-reviewed scientific articles or clinical practice guidelines. A second cluster (n = 22) consisted of PEMs shorter than 4 pages that used special fonts, color, pictures, and graphics. A third cluster consisted of a single brief PEM. With CATCH it is possible to categorize and understand the mechanisms that can trigger a change in behavior in health care providers. Additional research is needed to validate CATCH before it can be recommended for use. © 2014 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital Medical Education.

Identifying family members who may struggle in the role of surrogate decision maker.

PubMed

Majesko, Alyssa; Hong, Seo Yeon; Weissfeld, Lisa; White, Douglas B

2012-08-01

Although acting as a surrogate decision maker can be highly distressing for some family members of intensive care unit patients, little is known about whether there are modifiable risk factors for the occurrence of such difficulties. To identify: 1) factors associated with lower levels of confidence among family members to function as surrogates and 2) whether the quality of clinician-family communication is associated with the timing of decisions to forego life support. We conducted a prospective study of 230 surrogate decision makers for incapacitated, mechanically ventilated patients at high risk of death in four intensive care units at University of California San Francisco Medical Center from 2006 to 2007. Surrogates completed a questionnaire addressing their perceived ability to act as a surrogate and the quality of their communication with physicians. We used clustered multivariate logistic regression to identify predictors of low levels of perceived ability to act as a surrogate and a Cox proportional hazard model to determine whether quality of communication was associated with the timing of decisions to withdraw life support. There was substantial variability in family members' confidence to act as surrogate decision makers, with 27% rating their perceived ability as 7 or lower on a 10-point scale. Independent predictors of lower role confidence were the lack of prior experience as a surrogate (odds ratio 2.2, 95% confidence interval [1.04-4.46], p=.04), no prior discussions with the patient about treatment preferences (odds ratio 3.7, 95% confidence interval [1.79-7.76], p<.001), and poor quality of communication with the ICU physician (odds ratio 1.2, 95% confidence interval [1.09-1.35] p<.001). Higher quality physician-family communication was associated with a significantly shorter duration of life-sustaining treatment among patients who died (β=0.11, p=.001). Family members without prior experience as a surrogate and those who had not engaged in advanced discussions with the patient about treatment preferences were at higher risk to report less confidence in carrying out the surrogate role. Better-quality clinician-family communication was associated with both more confidence among family members to act as surrogates and a shorter duration of use of life support among patients who died.

Optical communication for space missions

NASA Technical Reports Server (NTRS)

Firtmaurice, M.

1991-01-01

Activities performed at NASA/GSFC (Goddard Space Flight Center) related to direct detection optical communications for space applications are discussed. The following subject areas are covered: (1) requirements for optical communication systems (data rates and channel quality; spatial acquisition; fine tracking and pointing; and transmit point-ahead correction); (2) component testing and development (laser diodes performance characterization and life testing; and laser diode power combining); (3) system development and simulations (The GSFC pointing, acquisition and tracking system; hardware description; preliminary performance analysis; and high data rate transmitter/receiver systems); and (4) proposed flight demonstration of optical communications.

Educational interventions to train healthcare professionals in end-of-life communication: a systematic review and meta-analysis.

PubMed

Chung, Han-Oh; Oczkowski, Simon J W; Hanvey, Louise; Mbuagbaw, Lawrence; You, John J

2016-04-29

Practicing healthcare professionals and graduates exiting training programs are often ill-equipped to facilitate important discussions about end-of-life care with patients and their families. We conducted a systematic review to evaluate the effectiveness of educational interventions aimed at providing healthcare professionals with training in end-of-life communication skills, compared to usual curriculum. We searched MEDLINE, Embase, CINAHL, ERIC and the Cochrane Central Register of Controlled Trials from the date of inception to July 2014 for randomized control trials (RCT) and prospective observational studies of educational training interventions to train healthcare professionals in end-of-life communication skills. To be eligible, interventions had to provide communication skills training related to end-of-life decision making; other interventions (e.g. breaking bad news, providing palliation) were excluded. Our primary outcomes were self-efficacy, knowledge and end-of-life communication scores with standardized patient encounters. Sufficiently similar studies were pooled in a meta-analysis. The quality of evidence was assessed using GRADE. Of 5727 candidate articles, 20 studies (6 RCTs, 14 Observational) were included in this review. Compared to usual teaching, educational interventions to train healthcare professionals in end-of-life communication skills were associated with greater self-efficacy (8 studies, standardized mean difference [SMD] 0.57;95% confidence interval [CI] 0.40-0.75; P < 0.001; very low quality evidence), more knowledge (4 studies, SMD 0.76;95% CI 0.40-1.12; p < 0.001; low quality evidence), and improvements in communication scores (8 studies, SMD 0.69; 95% CI 0.41-0.96; p < 0.001; very low quality evidence). There was insufficient evidence to determine whether these educational interventions affect patient-level outcomes. Very low to low quality evidence suggests that end-of-life communication training may improve healthcare professionals' self-efficacy, knowledge, and EoL communication scores compared to usual teaching. Further studies comparing two active educational interventions are recommended with a continued focus on contextually relevant high-level outcomes. PROSPERO CRD42014012913.

How do you perceive this author? Understanding and modeling authors’ communication quality in social media

PubMed Central

2018-01-01

In this study, we leverage human evaluations, content analysis, and computational modeling to generate a comprehensive analysis of readers’ evaluations of authors’ communication quality in social media with respect to four factors: author credibility, interpersonal attraction, communication competence, and intent to interact. We review previous research on the human evaluation process and highlight its limitations in providing sufficient information for readers to assess authors’ communication quality. From our analysis of the evaluations of 1,000 Twitter authors’ communication quality from 300 human evaluators, we provide empirical evidence of the impact of the characteristics of the reader (demographic, social media experience, and personality), author (profile and social media engagement), and content (linguistic, syntactic, similarity, and sentiment) on the evaluation of an author’s communication quality. In addition, based on the author and message characteristics, we demonstrate the potential for building accurate models that can indicate an author’s communication quality. PMID:29389979

How do you perceive this author? Understanding and modeling authors' communication quality in social media.

PubMed

Han, Kyungsik

2018-01-01

In this study, we leverage human evaluations, content analysis, and computational modeling to generate a comprehensive analysis of readers' evaluations of authors' communication quality in social media with respect to four factors: author credibility, interpersonal attraction, communication competence, and intent to interact. We review previous research on the human evaluation process and highlight its limitations in providing sufficient information for readers to assess authors' communication quality. From our analysis of the evaluations of 1,000 Twitter authors' communication quality from 300 human evaluators, we provide empirical evidence of the impact of the characteristics of the reader (demographic, social media experience, and personality), author (profile and social media engagement), and content (linguistic, syntactic, similarity, and sentiment) on the evaluation of an author's communication quality. In addition, based on the author and message characteristics, we demonstrate the potential for building accurate models that can indicate an author's communication quality.

Development and evaluation of the nurse quality of communication with patient questionnaire.

PubMed

Vuković, Mira; Gvozdenović, Branislav S; Stamatović-Gajić, Branka; Ilić, Miodrag; Gajić, Tomislav

2010-01-01

Nurse/patient relationship as a complex interrelation or as an interaction of the factor patient and factor nurse has been a subject of a number of studies during the past ten years. Nurse/patient communication is a special entity, usually observed within a framework of the wider nurse/patient relationship. In that regard, we wanted to develop a standardized questionnaire that could reliably measure the quality of communication between nurse and patient, and be used by nurses. The main goal of this study was to develop and evaluate construct validity of the Nurse Quality of Communication with Patient Questionnaire (NQCPQ), as well as to evaluate its reliability. The goal was also to establish a measure of inter-raters reliability, using two repeated measurements of results by items and scores of the NQCPQ, on the same observed units by two assessors. The starting NQCPQ that consists of 25 items, was filled in by two groups of nurses. Each nurse was questioned during morning and afternoon shifts, in order to evaluate their communication with hospitalized patients, using marks from 1 to 6. To evaluate construct validity, we used the analysis of main components, while reliability was assessed using intraclass correlation coefficient and Cronbach-alpha coefficient. To evaluate interraters reliability, we used Pearson correlation coefficient. Using a group of 118 patients, we explained 86% of the unknown, regarding the investigated phenomenon (communication nurse/patient), using one component by which we separated 6 items of the questionnaire. Inter-item correlation (alpha) in this component was 0.96. Pearson correlation coefficient was highly significant, value 0.7 by item, and correlation coefficient for scores at repeated measurements was 0.84. NQCPQ is 6-item instrument with high construct validity. It can be used to measure quality of nurse/patient communication in a simple, fast and reliable way. It could contribute to more adequate research and defining of this problem, and as such could be used in studies of interaction of psychometric, clinical, biochemical, socio-cultural, demographic and other parameters as well.

Long-distance multi-channel bidirectional chaos communication based on synchronized VCSELs subject to chaotic signal injection

NASA Astrophysics Data System (ADS)

Xie, Yi-Yuan; Li, Jia-Chao; He, Chao; Zhang, Zhen-Dong; Song, Ting-Ting; Xu, Chang-Jun; Wang, Gui-Jin

2016-10-01

A novel long-distance multi-channel bidirectional chaos communication system over multiple paths based on two synchronized 1550 nm vertical-cavity surface-emitting lasers (VCSELs) is proposed and studied theoretically. These two responding VCSELs (R-VCSELs) can output similar chaotic signals served as chaotic carrier in two linear polarization (LP) modes with identical signal injection from a driving VCSEL (D-VCSEL), which is subject to optical feedback and optical injection, simultaneously. Through the numerical simulations, high quality chaos synchronization between the two R-VCSELs can be obtained. Besides, the effects of varied qualities of chaos synchronization on communication performances in 20 km single mode fiber (SMF) channels are investigated by regulating different internal parameters mismatch after adopting chaos masking (CMS) technique. With the decrease of the maximum cross correlation coefficient (Max-C) between the two R-VCSELs, the bit error rate (BER) of decoded message increase. Meanwhile, the BER can still be less than 10-9 when the Max-C degrades to 0.982. Based on high quality synchronization, when the dispersion compensating fiber (DCF) links are introduced, 4n messages of 10 Gbit/s can transmit in 180 km SMF channels over n coupling paths, bidirectionally and simultaneously. Thorough tests are carried out with detailed analysis, demonstrating long-distance, multi-channel, bidirectional chaos communication based on VCSELs with chaotic signal injection.

Quality control management and communication between radiologists and technologists.

PubMed

Nagy, Paul G; Pierce, Benjamin; Otto, Misty; Safdar, Nabile M

2008-06-01

The greatest barrier to quality control (QC) in the digital imaging environment is the lack of communication and documentation between those who interpret images and those who acquire them. Paper-based QC methods are insufficient in a digital image management system. Problem work flow must be incorporated into reengineering efforts when migrating to a digital practice. The authors implemented a Web-based QC feedback tool to document and facilitate the communication of issues identified by radiologists. The goal was to promote a responsive and constructive tool that contributes to a culture of quality. The hypothesis was that by making it easier for radiologists to submit quality issues, the number of QC issues submitted would increase. The authors integrated their Web-based quality tracking system with a clinical picture archiving and communication system so that radiologists could report quality issues without disrupting clinical work flow. Graphical dashboarding techniques aid supervisors in using this database to identify the root causes of different types of issues. Over the initial 12-month rollout period, starting in the general section, the authors recorded 20 times more QC issues submitted by radiologists, accompanied by a rise in technologists' responsiveness to QC issues. For technologists with high numbers of QC issues, the incorporation of data from this tracking system proved useful in performance appraisals and in driving individual improvement. This tool is an example of the types of information technology innovations that can be leveraged to support QC in the digital imaging environment. Initial data suggest that the result is not only an improvement in quality but higher levels of satisfaction for both radiologists and technologists.

Wafer scale millimeter-wave integrated circuits based on epitaxial graphene in high data rate communication

PubMed Central

Habibpour, Omid; He, Zhongxia Simon; Strupinski, Wlodek; Rorsman, Niklas; Zirath, Herbert

2017-01-01

In recent years, the demand for high data rate wireless communications has increased dramatically, which requires larger bandwidth to sustain multi-user accessibility and quality of services. This can be achieved at millimeter wave frequencies. Graphene is a promising material for the development of millimeter-wave electronics because of its outstanding electron transport properties. Up to now, due to the lack of high quality material and process technology, the operating frequency of demonstrated circuits has been far below the potential of graphene. Here, we present monolithic integrated circuits based on epitaxial graphene operating at unprecedented high frequencies (80–100 GHz). The demonstrated circuits are capable of encoding/decoding of multi-gigabit-per-second information into/from the amplitude or phase of the carrier signal. The developed fabrication process is scalable to large wafer sizes. PMID:28145513

Key concepts relevant to quality of complex and shared decision-making in health care: a literature review.

PubMed

Dy, Sydney M; Purnell, Tanjala S

2012-02-01

High-quality provider-patient decision-making is key to quality care for complex conditions. We performed an analysis of key elements relevant to quality and complex, shared medical decision-making. Based on a search of electronic databases, including Medline and the Cochrane Library, as well as relevant articles' reference lists, reviews of tools, and annotated bibliographies, we developed a list of key concepts and applied them to a decision-making example. Key concepts identified included provider competence, trustworthiness, and cultural competence; communication with patients and families; information quality; patient/surrogate competence; and roles and involvement. We applied this concept list to a case example, shared decision-making for live donor kidney transplantation, and identified the likely most important concepts as provider and cultural competence, information quality, and communication with patients and families. This concept list may be useful for conceptualizing the quality of complex shared decision-making and in guiding research in this area. Copyright © 2011 Elsevier Ltd. All rights reserved.

Secure Military Communications on 3G, 4G and WiMAX

DTIC Science & Technology

2013-09-01

per bit, low latency, good quality of service, good coverage and support for mobility at high speeds. Thus, 4G wireless technologies are based on 3G ...security for military communications. 87 LIST OF REFERENCES [1] C. Blanchard, “Security for the third generation ( 3G ) mobile system,” Elsevier Science...COMMUNICATIONS ON 3G , 4G AND WIMAX by Panagiotis Schoinas September 2013 Thesis Advisor: Gurminder Singh Co-Advisor: John H. Gibson

VideoBeam portable laser communicator

NASA Astrophysics Data System (ADS)

Mecherle, G. Stephen; Holcomb, Terry L.

1999-01-01

A VideoBeamTM portable laser communicator has been developed which provides full duplex communication links consisting of high quality analog video and stereo audio. The 3.2-pound unit resembles a binocular-type form factor and has an operational range of over two miles (clear air) with excellent jam-resistance and low probability of interception characteristics. The VideoBeamTM unit is ideally suited for numerous military scenarios, surveillance/espionage, industrial precious mineral exploration, and campus video teleconferencing applications.

An adaptive narrow band frequency modulation voice communication system

NASA Technical Reports Server (NTRS)

Wishna, S.

1972-01-01

A narrow band frequency modulation communication system is described which provides for the reception of good quality voice at low carrier-to-noise ratios. The high level of performance is obtained by designing a limiter and phase lock loop combination as a demodulator, so that the bandwidth of the phase lock loop decreases as the carrier level decreases. The system was built for the position location and aircraft communication equipment experiment of the ATS 6 program.

Arts Education and the Whole Child

ERIC Educational Resources Information Center

Nelson, Hal

2009-01-01

For years, professional journals have published articles that communicate the importance of high-quality arts education programs. This article talks about how educators can use quality arts programs to contribute to the intellectual, physical, and emotional well-being of learners. The author also discusses what principals can do to advance arts…

Interventions to improve communication between people with dementia and nursing staff during daily nursing care: A systematic review.

PubMed

Machiels, Mariska; Metzelthin, Silke F; Hamers, Jan P H; Zwakhalen, Sandra M G

2017-01-01

To provide adequate nursing care it is important for nursing staff to communicate effectively with people with dementia. Due to their limited communication skills, people with dementia have difficulties in understanding communication and expressing themselves verbally. Nursing staff members often report communication difficulties with people with dementia, which emphasises the urgent need for interventions to improve their communication with people in this specific target group. To provide an up-to-date overview of communication interventions that are applicable during daily nursing care activities, irrespective of care setting, and to describe the effects on communication outcomes in people with dementia and nursing staff. Systematic literature review DATA SOURCES: The Cochrane Library, CINAHL, PsycINFO, and Pubmed databases were searched for all articles published until the 23rd of February 2016. Papers were included, if: (1) interventions focused on communication between nursing staff and people with dementia and were applicable during daily nursing care; (2) studies were (randomised) controlled trials; (3) papers were written in English, Dutch, or German. Data were extracted on content and communication outcomes of interventions, and on methodological quality of the studies. The data extraction form and methodological quality checklist were based on the Method Guidelines for Systematic Reviews for the Cochrane Back Review Group. Six studies on communication interventions were included. All of the studies incorporated a communication skills training for nursing staff with a broad range in frequency, duration and content. In addition, there was wide variation in the communication outcome measures used. Four studies measured non-verbal communication, all found positive effects on at least some of the communication outcomes. Four studies measured verbal communication, of which three found positive effects on at least one of the measured outcomes. Methodological quality assessment demonstrated a high risk of bias in five of the six studies. Few studies have been identified with wide variation in interventions and outcome measures. In addition, the methodological shortcomings make it difficult, to draw conclusions about the effectiveness. More research is needed to develop and evaluate communication interventions. Additionally, it is useful to reach consensus on defining and measuring communication. Copyright © 2017 Elsevier Ltd. All rights reserved.

Perceptions of Provider Communication Among Vulnerable Patients With Diabetes: Influences of Medical Mistrust and Health Literacy.

PubMed

White, Richard O; Chakkalakal, Rosette J; Presley, Caroline A; Bian, Aihua; Schildcrout, Jonathan S; Wallston, Kenneth A; Barto, Shari; Kripalani, Sunil; Rothman, Russell

2016-01-01

Patient-provider communication is modifiable and is linked to diabetes outcomes. The association of communication quality with medical mistrust is unknown. We examined these factors within the context of a low-literacy/numeracy-focused intervention to improve diabetes care, using baseline data from diverse patients enrolled in a randomized trial of a health communication intervention. Demographics, measures of health communication (Communication Assessment Tool [CAT], Interpersonal Processes of Care survey [IPC-18]), health literacy (Short Test of Functional Health Literacy in Adults), depression, medical mistrust, and glycemic control were ascertained. Adjusted proportional odds models were used to test the association of mistrust with patient-reported communication quality. The interaction effect of health literacy on mistrust and communication quality was also assessed. A total of 410 patients were analyzed. High levels of mistrust were observed. In multivariable modeling, patients with higher mistrust had lower adjusted odds of reporting a higher CAT score (adjusted odds ratio [AOR] = 0.67, 95% confidence interval [CI] [0.52, 0.86], p = .003) and higher scores on the Communication (AOR = 0.69, 95% CI [0.55, 0.88], p = .008), Decided Together (AOR = 0.74, 95% CI [0.59, 0.93], p = .02), and Interpersonal Style (AOR = 0.69, 95% CI [0.53, 0.90], p = .015) subscales of the IPC-18. We observed evidence of an interaction effect of health literacy for the association between mistrust and the Decided Together subscale of the IPC-18 such that patients with higher mistrust and lower literacy perceived worse communication relative to mistrustful patients with higher literacy. In conclusion, medical mistrust was associated with poorer communication with providers in this public health setting. Patients' health literacy level may vary the effect of mistrust on interactional aspects of communication. Providers should consider the impact of mistrust on communication with vulnerable diabetes populations and focus efforts on mitigating its influence.

Perceptions of Provider Communication Among Vulnerable Patients With Diabetes: influences of Medical Mistrust and Health Literacy

PubMed Central

White, Richard O.; Chakkalakal, Rosette J.; Presley, Caroline A.; Bian, Aihua; Schildcrout, Jonathan S.; Wallston, Kenneth A.; Barto, Shari; Kripalani, Sunil; Rothman, Russell

2017-01-01

Patient-provider communication is modifiable and linked to diabetes outcomes. The association of communication quality with medical mistrust is unknown. We examined these factors within the context of a low-literacy/numeracy-focused intervention to improve diabetes care, using baseline data from diverse patients enrolled in a randomized trial of a health communication intervention. Demographics, measures of health communication (Communication Assessment Tool [CAT], Interpersonal Processes of Care [IPC-18]), health literacy (Short Test of Functional Health Literacy in Adults [s-TOFHLA]), depression, medical mistrust, and glycemic control were ascertained. Adjusted proportional odds models were used to test the association of mistrust with patient-reported communication quality. The interaction effect of health literacy on mistrust and communication quality was also assessed. A total of 410 patients were analyzed. High levels of mistrust were observed. In multivariable modeling, patients with higher mistrust had lower adjusted odds of reporting higher CAT score [adjusted odds ratio (AOR) 0.67 [95% CI: 0.52–0.86], p=0.003], and higher score for the Communication [AOR 0.69 [0.55–0.88], p=0.008], Decided Together [AOR 0.74 [0.59–0.93], p=0.02], and Interpersonal Style [AOR 0.69 [0.53–0.90], p=0.015] subscales of the IPC-18. We observed evidence for an interaction effect of health literacy for the association between mistrust and the Decided Together subscale of the IPC-18 such that patients with higher mistrust and lower literacy perceived worse communication relative to mistrustful patients with higher literacy. In conclusion, medical mistrust was associated with poorer communication with providers in this public health setting. Patients’ health literacy level may vary the effect of mistrust on the interactional aspects of communication. Providers should consider the impact of mistrust on communication with vulnerable diabetes populations and focus efforts on mitigating its influence. PMID:27662442

Intraoperative neurophysiological monitoring team's communiqué with anesthesia professionals.

PubMed

Tewari, Anurag; Francis, Lisa; Samy, Ravi N; Kurth, Dean C; Castle, Joshua; Frye, Tiffany; Mahmoud, Mohamed

2018-01-01

Intraoperative neurophysiological monitoring (IONM) is the standard of care during many spinal, vascular, and intracranial surgeries. High-quality perioperative care requires the communication and cooperation of several multidisciplinary teams. One of these multidisciplinary services is intraoperative neuromonitoring (IONM), while other teams represent anesthesia and surgery. Few studies have investigated the IONM team's objective communication with anesthesia providers. We conducted a retrospective review of IONM-related quality assurance data to identify how changes in the evoked potentials observed during the surgery were communicated within our IONM-anesthesia team and determined the resulting qualitative outcomes. Quality assurance records of 3,112 patients who underwent surgical procedures with IONM (from 2010 to 2015) were reviewed. We examined communications regarding perioperative evoked potential or electroencephalography (EEG) fluctuations that prompted neurophysiologists to alert/notify the anesthesia team to consider alteration of anesthetic depth/drug regimen or patient positioning and analyzed the outcomes of these interventions. Of the total of 1280 (41.13%) communications issued, there were 347 notifications and 11 alerts made by the neurophysiologist to the anesthesia team for various types of neuro/orthopedic surgeries. Prompt communication led to resolution of 90% of alerts and 80% of notifications after corrective measures were executed by the anesthesiologists. Notifications mainly related to limb malpositioning and extravasation of intravenous fluid. Based on our institutions' protocol and algorithm for intervention during IONM-supported surgeries, our findings of resolution in alerts and notifications indicate that successful communications between the two teams could potentially lead to improved anesthetic care and patient safety.

Patient-reported Communication Quality and Perceived Discrimination in Maternity Care.

PubMed

Attanasio, Laura; Kozhimannil, Katy B

2015-10-01

High-quality communication and a positive patient-provider relationship are aspects of patient-centered care, a crucial component of quality. We assessed racial/ethnic disparities in patient-reported communication problems and perceived discrimination in maternity care among women nationally and measured racial/ethnic variation in the correlates of these outcomes. Data for this analysis came from the Listening to Mothers III survey, a national sample of women who gave birth to a singleton baby in a US hospital in 2011-2012. Outcomes were reluctance to ask questions and barriers to open discussion in prenatal care, and perceived discrimination during the birth hospitalization, assessed using multinomial and logistic regression. We also estimated models stratified by race/ethnicity. Over 40% of women reported communication problems in prenatal care, and 24% perceived discrimination during their hospitalization for birth. Having hypertension or diabetes was associated with higher levels of reluctance to ask questions and higher odds of reporting each type of perceived discrimination. Black and Hispanic (vs. white) women had higher odds of perceived discrimination due to race/ethnicity. Higher education was associated with more reported communication problems among black women only. Although having diabetes was associated with perceptions of discrimination among all women, associations were stronger for black women. Race/ethnicity was associated with perceived racial discrimination, but diabetes and hypertension were consistent predictors of communication problems and perceptions of discrimination. Efforts to improve communication and reduce perceived discrimination are an important area of focus for improving patient-centered care in maternity services.

Improving Patient Safety: Improving Communication.

PubMed

Bittner-Fagan, Heather; Davis, Joshua; Savoy, Margot

2017-12-01

Communication among physicians, staff, and patients is a critical element in patient safety. Effective communication skills can be taught and improved through training and awareness. The practice of family medicine allows for long-term relationships with patients, which affords opportunities for ongoing, high-quality communication. There are many barriers to effective communication, including patient factors, clinician factors, and system factors, but tools and strategies exist to address these barriers, improve communication, and engage patients in their care. Use of universal precautions for health literacy, appropriate medical interpreters, and shared decision-making are evidence-based tools that improve communication and increase patient safety. Written permission from the American Academy of Family Physicians is required for reproduction of this material in whole or in part in any form or medium.

Facial appearance affects science communication

PubMed Central

Gheorghiu, Ana I.; Callan, Mitchell J.; Skylark, William J.

2017-01-01

First impressions based on facial appearance predict many important social outcomes. We investigated whether such impressions also influence the communication of scientific findings to lay audiences, a process that shapes public beliefs, opinion, and policy. First, we investigated the traits that engender interest in a scientist’s work, and those that create the impression of a “good scientist” who does high-quality research. Apparent competence and morality were positively related to both interest and quality judgments, whereas attractiveness boosted interest but decreased perceived quality. Next, we had members of the public choose real science news stories to read or watch and found that people were more likely to choose items that were paired with “interesting-looking” scientists, especially when selecting video-based communications. Finally, we had people read real science news items and found that the research was judged to be of higher quality when paired with researchers who look like “good scientists.” Our findings offer insights into the social psychology of science, and indicate a source of bias in the dissemination of scientific findings to broader society. PMID:28533389

Energy efficient lighting and communications

NASA Astrophysics Data System (ADS)

Zhou, Z.; Kavehrad, M.; Deng, P.

2012-01-01

As Light-Emitting Diode (LED)'s increasingly displace incandescent lighting over the next few years, general applications of Visible Light Communication (VLC) technology are expected to include wireless internet access, vehicle-to-vehicle communications, broadcast from LED signage, and machine-to-machine communications. An objective in this paper is to reveal the influence of system parameters on the power distribution and communication quality, in a general plural sources VLC system. It is demonstrated that sources' Half-Power Angles (HPA), receivers' Field-Of Views (FOV), sources layout and the power distribution among sources are significant impact factors. Based on our findings, we developed a method to adaptively change working status of each LED respectively according to users' locations. The program minimizes total power emitted while simultaneously ensuring sufficient light intensity and communication quality for each user. The paper also compares Orthogonal Frequency-Division Multiplexing (OFDM) and On-Off Keying (OOK) signals performance in indoor optical wireless communications. The simulation is carried out for different locations where different impulse response distortions are experienced. OFDM seems a better choice than prevalent OOK for indoor VLC due to its high resistance to multi-path effect and delay spread. However, the peak-to-average power limitations of the method must be investigated for lighting LEDs.

Measuring the quality of junior hospital doctors in general medicine.

PubMed

Jones, J M; Sanderson, C F; Black, N A

1992-05-01

During the course of a larger study aimed at relating staffing levels of junior doctors in general medicine to the safety of the care provided, it became clear that consultant doctors considered the quality of their junior staff as being at least as important as the quantity. This paper describes several attempts to develop a feasible and valid method of measuring the quality of senior house officers (SHOs) and registrars using routinely available data. Having rejected three methods and had difficulties with three other methods, a modified Delphi survey was used to explore the extent to which consultants agreed on the key attributes of a high quality SHO or registrar. Sixty-seven (60%) of all consultants in the South-West Thames and Trent regions responded to two rounds of questionnaires which revealed communication skills as being consistently the most significant factor. This was confirmed in a second, anonymous survey of 198 (78%) SHO and registrar posts in the North-West Thames region. It also became clear that consultants viewed the quality of their own SHOs and registrars as generally high. This being so it is argued that the requirement to adjust for quality, when comparing SHO and registrar levels between hospitals, is of minor importance. These results also suggest that the explicit teaching of communication skills should have a high priority in undergraduate and postgraduate education.

Satellite Antenna Pointing Procedure Driven by the Ground Service Quality

NASA Astrophysics Data System (ADS)

Yasui, Yoshitsugu

A satellite antenna alignment technique is proposed to ensure terrestrial service quality for users. The antenna bore sight orientation is calculated directly from measured data acquired from general ground receivers, which intercept the communication radio waves from any position on the earth's surface. The method coordinates the satellite pointing parameters with signal strength at the receivers while considering location-specific geographical and antenna radiation characteristics and control accuracy. The theoretical development and its validity are examined in the course of equation derivation. Actual measured data of an existing satellite at the maneuver was applied to the method, and the capability was demonstrated and verified. With the wide diversity of satellite usage, such as for mobile communications, temporary network deployment or post-launch positioning accommodations, the proposed method provides a direct evaluation of satellite communication performance at the service level, in conjunction with using high frequency spot beam antennas, which are highly susceptible to pointing gain. This can facilitate swift and flexible satellite service planning and deployment for operators.

Intraorganizational Communication and Job Satisfaction Among Flemish Hospital Nurses: An Exploratory Multicenter Study.

PubMed

Vermeir, Peter; Downs, Cal; Degroote, Sophie; Vandijck, Dominique; Tobback, Els; Delesie, Liesbeth; Mariman, An; De Veugele, Myriam; Verhaeghe, Rik; Cambré, Bart; Vogelaers, Dirk

2018-01-01

Intraorganizational communication affects job satisfaction and turnover. The goal of this study was to explore relationships between communication and job satisfaction, intention to leave, and burnout among Flemish hospital nurses. A multicenter questionnaire study was conducted in three hospitals using the Communication Satisfaction Questionnaire, the Turnover Intention subscale of the Questionnaire on the Experience and Evaluation of Work, and the Maslach Burnout Inventory. A visual analog scale measured job satisfaction. The mean job satisfaction score was 7.49/10 (±1.43). Almost 7% of nurse participants (93/1,355) reported a high intent to leave, and 2.9% of the respondents (41/1,454) had a score indicative of burnout. All dimensions of communication were associated with job satisfaction. A low score on any dimension of communication satisfaction, except "Relationship With Employees," was associated with higher intent to leave and burnout. Study findings support the need for management interventions to enhance efficient communication and ensure high-quality care and patient safety.

CODEMamb - an observational communication behavior assessment tool for use in ambulatory dementia care.

PubMed

Knebel, Maren; Haberstroh, Julia; Kümmel, Anne; Pantel, Johannes; Schröder, Johannes

2016-12-01

Communication improves well-being and quality of life for both people with dementia and their professional and family caregivers. Individualized communication, as required in informed consent procedures and psychosocial interventions, can improve quality of life, especially in ambulatory settings. However, few valid and reliable instruments exist that enable communication to be assessed and communication and behavioral resources to be identified. We, therefore, extended and adapted the newly developed observational instrument CODEM for use in ambulatory settings (CODEM amb ). Reliability and validity of the new instrument were studied in a total of 171 patients, whereby principal component analysis revealed three important factors: relationship aspects, verbal communication behavior and nonverbal communication behavior. CODEM amb [Formula: see text]s internal consistency, interrater and retest reliability were satisfactory to excellent. Convergent validity indices, as shown by examining correlations with similar but not identical constructs (CERAD-NP verbal subscales), were medium-high, while the divergent validity index (constructional praxis) was relatively low. The relationship to peer-rating remained nonsignificant. Criterion validity was investigated in groups of patients in accordance with their cognitive status. As expected, verbal communication abilities deteriorate faster than the relationship aspects of communication as the disease progresses. In summary, CODEM amb is a reliable and valid instrument that can be used to collect important information with the ultimate aim of supporting communication with people with dementia.

Documentation Resources on the ESIP Wiki

NASA Technical Reports Server (NTRS)

Habermann, Ted; Kozimor, John; Gordon, Sean

2017-01-01

The ESIP community includes data providers and users that communicate with one another through datasets and metadata that describe them. Improving this communication depends on consistent high-quality metadata. The ESIP Documentation Cluster and the wiki play an important central role in facilitating this communication. We will describe and demonstrate sections of the wiki that provide information about metadata concept definitions, metadata recommendation, metadata dialects, and guidance pages. We will also describe and demonstrate the ISO Explorer, a tool that the community is developing to help metadata creators.

Patient-clinician communication about end-of-life care for Dutch and US patients with COPD.

PubMed

Janssen, D J A; Curtis, J R; Au, D H; Spruit, M A; Downey, L; Schols, J M G A; Wouters, E F M; Engelberg, R A

2011-08-01

Improving patient-clinician communication about end-of-life care is important in order to enhance quality of care for patients with chronic obstructive pulmonary disease (COPD). Our objective was to compare quality of patient-clinician communication about end-of-life care, and endorsement of barriers and facilitators to this communication in the Netherlands and the USA. The present study was an analysis of survey data from 122 Dutch and 391 US outpatients with COPD. We compared quality of patient-clinician communication about end-of-life care (Quality of Communication questionnaire) and barriers and facilitators to communication about end-of-life care (Barriers and Facilitators Questionnaire) between the Netherlands and the USA, controlling for patients' demographic and illness characteristics. Although Dutch patients in this study had worse lung function and disease-specific health status than US patients, Dutch patients reported lower quality of communication about end-of-life care (median score 0.0 (interquartile range 0.0-2.0) versus 1.4 (0.0-3.6); adjusted p<0.005). Clinicians in both countries rarely discussed life-sustaining treatment preferences, prognoses, dying processes or spiritual issues. Quality of communication about end-of-life care needs to improve in the Netherlands and the USA. Future studies to improve this communication should be designed to take into account international differences and patient-specific barriers and facilitators to communication about end-of-life care.

Measuring verbal and non-verbal communication in aphasia: reliability, validity, and sensitivity to change of the Scenario Test.

PubMed

van der Meulen, Ineke; van de Sandt-Koenderman, W Mieke E; Duivenvoorden, Hugo J; Ribbers, Gerard M

2010-01-01

This study explores the psychometric qualities of the Scenario Test, a new test to assess daily-life communication in severe aphasia. The test is innovative in that it: (1) examines the effectiveness of verbal and non-verbal communication; and (2) assesses patients' communication in an interactive setting, with a supportive communication partner. To determine the reliability, validity, and sensitivity to change of the Scenario Test and discuss its clinical value. The Scenario Test was administered to 122 persons with aphasia after stroke and to 25 non-aphasic controls. Analyses were performed for the entire group of persons with aphasia, as well as for a subgroup of persons unable to communicate verbally (n = 43). Reliability (internal consistency, test-retest reliability, inter-judge, and intra-judge reliability) and validity (internal validity, convergent validity, known-groups validity) and sensitivity to change were examined using standard psychometric methods. The Scenario Test showed high levels of reliability. Internal consistency (Cronbach's alpha = 0.96; item-rest correlations = 0.58-0.82) and test-retest reliability (ICC = 0.98) were high. Agreement between judges in total scores was good, as indicated by the high inter- and intra-judge reliability (ICC = 0.86-1.00). Agreement in scores on the individual items was also good (square-weighted kappa values 0.61-0.92). The test demonstrated good levels of validity. A principal component analysis for categorical data identified two dimensions, interpreted as general communication and communicative creativity. Correlations with three other instruments measuring communication in aphasia, that is, Spontaneous Speech interview from the Aachen Aphasia Test (AAT), Amsterdam-Nijmegen Everyday Language Test (ANELT), and Communicative Effectiveness Index (CETI), were moderate to strong (0.50-0.85) suggesting good convergent validity. Group differences were observed between persons with aphasia and non-aphasic controls, as well as between persons with aphasia unable to use speech to convey information and those able to communicate verbally; this indicates good known-groups validity. The test was sensitive to changes in performance, measured over a period of 6 months. The data support the reliability and validity of the Scenario Test as an instrument for examining daily-life communication in aphasia. The test focuses on multimodal communication; its psychometric qualities enable future studies on the effect of Alternative and Augmentative Communication (AAC) training in aphasia.

Positioning Open Access Journals in a LIS Journal Ranking

ERIC Educational Resources Information Center

Xia, Jingfeng

2012-01-01

This research uses the h-index to rank the quality of library and information science journals between 2004 and 2008. Selected open access (OA) journals are included in the ranking to assess current OA development in support of scholarly communication. It is found that OA journals have gained momentum supporting high-quality research and…

Communication Quality Predicts Psychological Well-Being and Satisfaction in Family Surrogates of Hospitalized Older Adults: An Observational Study.

PubMed

Torke, Alexia M; Callahan, Christopher M; Sachs, Greg A; Wocial, Lucia D; Helft, Paul R; Monahan, Patrick O; Slaven, James E; Montz, Kianna; Burke, Emily S; Inger, Lev

2018-03-01

Many hospitalized older adults require family surrogates to make decisions, but surrogates may perceive that the quality of medical decisions is low and may have poor psychological outcomes after the patient's hospitalization. To determine the relationship between communication quality and high-quality medical decisions, psychological well-being, and satisfaction for surrogates of hospitalized older adults. Observational study at three hospitals in a Midwest metropolitan area. Hospitalized older adults (65+ years) admitted to medicine and medical intensive care units who were unable to make medical decisions, and their family surrogates. Among 799 eligible dyads, 364 (45.6%) completed the study. Communication was assessed during hospitalization using the information and emotional support subscales of the Family Inpatient Communication Survey. Decision quality was assessed with the Decisional Conflict Scale. Outcomes assessed at baseline and 4-6 weeks post-discharge included anxiety (Generalized Anxiety Disorder-7), depression (Patient Health Questionnaire-9), post-traumatic stress (Impact of Event Scale-Revised), and satisfaction (Hospital Consumer Assessment of Healthcare Providers and Systems). The mean patient age was 81.9 years (SD 8.32); 62% were women, and 28% African American. Among surrogates, 67% were adult children. Six to eight weeks post-discharge, 22.6% of surrogates reported anxiety (11.3% moderate-severe anxiety); 29% reported depression, (14.0% moderate-severe), and 14.6% had high levels of post-traumatic stress. Emotional support was associated with lower odds of anxiety (adjusted odds ratio [AOR] = 0.65, 95% CI 0.50, 0.85) and depression (AOR = 0.80, 95% CI 0.65, 0.99) at follow-up. In multivariable linear regression, emotional support was associated with lower post-traumatic stress (β = -0.30, p = 0.003) and higher decision quality (β = -0.44, p < 0.0001). Information was associated with higher post-traumatic stress (β = 0.23, p = 0.022) but also higher satisfaction (β = 0.61, p < 0.001). Emotional support of hospital surrogates is consistently associated with better psychological outcomes and decision quality, suggesting an opportunity to improve decision making and well-being.

Perils and positives of science journalism in Australia.

PubMed

McKinnon, Merryn; Howes, Johanna; Leach, Andrew; Prokop, Natasha

2017-03-01

Scientists, science communicators and science journalists interact to deliver science news to the public. Yet the value of interactions between the groups in delivering high-quality science stories is poorly understood within Australia. A recent study in New Zealand on the perspectives of the three groups on the challenges facing science journalism is replicated here in the context of New South Wales and the Australian Capital Territory. While all three groups perceived the quality of science journalism as generally high, the limitations of non-specialists and public relation materials were causes for concern. The results indicate that science communicators are considered to play a valuable role as facilitators of information flow to journalists and support for scientists. Future studies on the influence and implications of interactions between these three groups are required.

Internet Communication versus Face-to-Face Interaction in Quality of Life

ERIC Educational Resources Information Center

Lee, Paul S. N.; Leung, Louis; Lo, Venhwei; Xiong, Chengyu; Wu, Tingjun

2011-01-01

This study seeks to understand the role of the Internet in quality of life (QoL). Specifically, it examines the question of whether Internet communication serves, like face-to-face interactions, to enhance quality of life. It is hypothesized that the use of the Internet for interpersonal communication can improve quality of life among Internet…

Mode of Communication, Perceived Level of Understanding, and Perceived Quality of Life in Youth Who Are Deaf or Hard of Hearing

PubMed Central

Kushalnagar, P.; Topolski, T. D.; Schick, B.; Edwards, T. C.; Skalicky, A. M.; Patrick, D. L.

2011-01-01

Given the important role of parent–youth communication in adolescent well-being and quality of life, we sought to examine the relationship between specific communication variables and youth perceived quality of life in general and as a deaf or hard-of-hearing (DHH) individual. A convenience sample of 230 youth (mean age = 14.1, standard deviation = 2.2; 24% used sign only, 40% speech only, and 36% sign + speech) was surveyed on communication-related issues, generic and DHH-specific quality of life, and depression symptoms. Higher youth perception of their ability to understand parents’ communication was significantly correlated with perceived quality of life as well as lower reported depressive symptoms and lower perceived stigma. Youth who use speech as their single mode of communication were more likely to report greater stigma associated with being DHH than youth who used both speech and sign. These findings demonstrate the importance of youths’ perceptions of communication with their parents on generic and DHH-specific youth quality of life. PMID:21536686

Communication Tools for End-of-Life Decision-Making in Ambulatory Care Settings: A Systematic Review and Meta-Analysis.

PubMed

Oczkowski, Simon J; Chung, Han-Oh; Hanvey, Louise; Mbuagbaw, Lawrence; You, John J

2016-01-01

Patients with serious illness, and their families, state that better communication and decision-making with healthcare providers is a high priority to improve the quality of end-of-life care. Numerous communication tools to assist patients, family members, and clinicians in end-of-life decision-making have been published, but their effectiveness remains unclear. To determine, amongst adults in ambulatory care settings, the effect of structured communication tools for end-of-life decision-making on completion of advance care planning. We searched for relevant randomized controlled trials (RCTs) or non-randomized intervention studies in MEDLINE, EMBASE, CINAHL, ERIC, and the Cochrane Database of Randomized Controlled Trials from database inception until July 2014. Two reviewers independently screened articles for eligibility, extracted data, and assessed risk of bias. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to evaluate the quality of evidence for each of the primary and secondary outcomes. Sixty-seven studies, including 46 RCTs, were found. The majority evaluated communication tools in older patients (age >50) with no specific medical condition, but many specifically evaluated populations with cancer, lung, heart, neurologic, or renal disease. Most studies compared the use of communication tools against usual care, but several compared the tools to less-intensive advance care planning tools. The use of structured communication tools increased: the frequency of advance care planning discussions/discussions about advance directives (RR 2.31, 95% CI 1.25-4.26, p = 0.007, low quality evidence) and the completion of advance directives (ADs) (RR 1.92, 95% CI 1.43-2.59, p<0.001, low quality evidence); concordance between AD preferences and subsequent medical orders for use or non-use of life supporting treatment (RR 1.19, 95% CI 1.01-1.39, p = 0.028, very low quality evidence, 1 observational study); and concordance between the care desired and care received by patients (RR 1.17, 95% CI 1.05-1.30, p = 0.004, low quality evidence, 2 RCTs). The use of structured communication tools may increase the frequency of discussions about and completion of advance directives, and concordance between the care desired and the care received by patients. The use of structured communication tools rather than an ad-hoc approach to end-of-life decision-making should be considered, and the selection and implementation of such tools should be tailored to address local needs and context. PROSPERO CRD42014012913.

Communication Tools for End-of-Life Decision-Making in Ambulatory Care Settings: A Systematic Review and Meta-Analysis

PubMed Central

Chung, Han-Oh; Hanvey, Louise; Mbuagbaw, Lawrence; You, John J.

2016-01-01

Background Patients with serious illness, and their families, state that better communication and decision-making with healthcare providers is a high priority to improve the quality of end-of-life care. Numerous communication tools to assist patients, family members, and clinicians in end-of-life decision-making have been published, but their effectiveness remains unclear. Objectives To determine, amongst adults in ambulatory care settings, the effect of structured communication tools for end-of-life decision-making on completion of advance care planning. Methods We searched for relevant randomized controlled trials (RCTs) or non-randomized intervention studies in MEDLINE, EMBASE, CINAHL, ERIC, and the Cochrane Database of Randomized Controlled Trials from database inception until July 2014. Two reviewers independently screened articles for eligibility, extracted data, and assessed risk of bias. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to evaluate the quality of evidence for each of the primary and secondary outcomes. Results Sixty-seven studies, including 46 RCTs, were found. The majority evaluated communication tools in older patients (age >50) with no specific medical condition, but many specifically evaluated populations with cancer, lung, heart, neurologic, or renal disease. Most studies compared the use of communication tools against usual care, but several compared the tools to less-intensive advance care planning tools. The use of structured communication tools increased: the frequency of advance care planning discussions/discussions about advance directives (RR 2.31, 95% CI 1.25–4.26, p = 0.007, low quality evidence) and the completion of advance directives (ADs) (RR 1.92, 95% CI 1.43–2.59, p<0.001, low quality evidence); concordance between AD preferences and subsequent medical orders for use or non-use of life supporting treatment (RR 1.19, 95% CI 1.01–1.39, p = 0.028, very low quality evidence, 1 observational study); and concordance between the care desired and care received by patients (RR 1.17, 95% CI 1.05–1.30, p = 0.004, low quality evidence, 2 RCTs). Conclusions The use of structured communication tools may increase the frequency of discussions about and completion of advance directives, and concordance between the care desired and the care received by patients. The use of structured communication tools rather than an ad-hoc approach to end-of-life decision-making should be considered, and the selection and implementation of such tools should be tailored to address local needs and context. Registration PROSPERO CRD42014012913 PMID:27119571

Examination of Communication Delays on Team Performance: Utilizing the International Space Station (ISS) as a Test Bed for Analog Research

NASA Technical Reports Server (NTRS)

Keeton, K. E.; Slack, K, J.; Schmidt, L. L.; Ploutz-Snyder, R.; Baskin, P.; Leveton, L. B.

2011-01-01

Operational conjectures about space exploration missions of the future indicate that space crews will need to be more autonomous from mission control and operate independently. This is in part due to the expectation that communication quality between the ground and exploration crews will be more limited and delayed. Because of potential adverse effects on communication quality, both researchers and operational training and engineering experts have suggested that communication delays and the impact these delays have on the quality of communications to the crew will create performance decrements if crews are not given adequate training and tools to support more autonomous operations. This presentation will provide an overview of a research study led by the Behavioral Health and Performance Element (BHP) of the NASA Human Research Program that examines the impact of implementing a communication delay on ISS on individual and team factors and outcomes, including performance and related perceptions of autonomy. The methodological design, data collection efforts, and initial results of this study to date will be discussed . The results will focus on completed missions, DRATS and NEEMO15. Lessons learned from implementing this study within analog environments will also be discussed. One lesson learned is that the complexities of garnishing a successful data collection campaign from these high fidelity analogs requires perseverance and a strong relationship with operational experts. Results of this study will provide a preliminary understanding of the impact of communication delays on individual and team performance as well as an insight into how teams perform and interact in a space-like environment . This will help prepare for implementation of communication delay tests on the ISS, targeted for Increment 35/36.

Real-time visual communication to aid disaster recovery in a multi-segment hybrid wireless networking system

NASA Astrophysics Data System (ADS)

Al Hadhrami, Tawfik; Wang, Qi; Grecos, Christos

2012-06-01

When natural disasters or other large-scale incidents occur, obtaining accurate and timely information on the developing situation is vital to effective disaster recovery operations. High-quality video streams and high-resolution images, if available in real time, would provide an invaluable source of current situation reports to the incident management team. Meanwhile, a disaster often causes significant damage to the communications infrastructure. Therefore, another essential requirement for disaster management is the ability to rapidly deploy a flexible incident area communication network. Such a network would facilitate the transmission of real-time video streams and still images from the disrupted area to remote command and control locations. In this paper, a comprehensive end-to-end video/image transmission system between an incident area and a remote control centre is proposed and implemented, and its performance is experimentally investigated. In this study a hybrid multi-segment communication network is designed that seamlessly integrates terrestrial wireless mesh networks (WMNs), distributed wireless visual sensor networks, an airborne platform with video camera balloons, and a Digital Video Broadcasting- Satellite (DVB-S) system. By carefully integrating all of these rapidly deployable, interworking and collaborative networking technologies, we can fully exploit the joint benefits provided by WMNs, WSNs, balloon camera networks and DVB-S for real-time video streaming and image delivery in emergency situations among the disaster hit area, the remote control centre and the rescue teams in the field. The whole proposed system is implemented in a proven simulator. Through extensive simulations, the real-time visual communication performance of this integrated system has been numerically evaluated, towards a more in-depth understanding in supporting high-quality visual communications in such a demanding context.

Competition in collaborative clothing: a qualitative case study of influences on collaborative quality improvement in the ICU.

PubMed

Dainty, Katie N; Scales, Damon C; Sinuff, Tasnim; Zwarenstein, Merrick

2013-04-01

Multiorganisational quality improvement (QI) collaborative networks are promoted for improving quality within healthcare. Recently, several large-scale QI initiatives have been conducted in the intensive care unit (ICU) environment with successful quantitative results. However, the mechanisms through which such networks lead to QI success remain uncertain. We aim to understand ICU staff perspectives on collaborative QI based on involvement in a multiorganisational improvement network and hypothesise about theoretical constructs that might explain the effect of collaboration in such networks. Qualitative study using a modified grounded theory approach. Key informant interviews were conducted with staff from 12 community hospital ICUs that participated in a cluster randomized control trial (RCT) of a QI intervention using a collaborative approach between 2006 and 2008. Data analysis followed the standard procedure for grounded theory using constant comparative methodology. The collaborative network was perceived to promote increased intrateam cooperation over interorganisational cooperation, but friendly competition with other ICUs appeared to be a prominent driver of behaviour change. Bedsides, clinicians reported that belonging to a collaborative network provided recognition for the high-quality patient care that they already provided. However, the existing communication structure was perceived to be ineffective for staff engagement since it was based on a hierarchical approach to knowledge transfer and project awareness. QI collaborative networks may promote behaviour change by improving intrateam communication, fostering competition with other institutions, and increasing recognition for providing high-quality care. Other commonly held assumptions about their potential impact, for instance, increasing interorganisational legitimisation, communication and collaboration, may be less important.

Relating Communications Mode Choice and Teamwork Quality: Conversational versus Textual Communication in IT System and Software Development Teams

ERIC Educational Resources Information Center

Smith, James Robert

2012-01-01

This cross-sectional study explored how IT system and software development team members communicated in the workplace and whether teams that used more verbal communication (and less text-based communication) experienced higher levels of collaboration as measured using the Teamwork Quality (TWQ) scale. Although computer-mediated communication tools…

A clinical review of communication training for haematologists and haemato-oncologists: a case of art versus science.

PubMed

Christie, Deborah; Glew, Sarah

2017-07-01

The art of communication at times seems at odds with the science of medicine. Poor communication is associated with risks for patient and physician. Communication skills are highly relevant for haematologists and are associated with increased physician and patient satisfaction, positive psychosocial outcomes and possible health outcomes. Medical communication training has recently become widespread but is largely restricted to junior medical professionals. In haematology, the proliferation of high quality communication skills is low and there are few interventions catering for the required skillset. A review identified five applicable interventions for haematologists. There is variation in intervention length and structure, and most studies measure targeted skill fidelity rather than patient outcomes. Work on motivation and empowerment holds potential for haematological conditions, but is largely absent from care. This review highlights the need for new interventions for haematologists which focus on producing and maintaining positive patient outcomes. © 2017 John Wiley & Sons Ltd.

Strategies for improved French-language health services: Perspectives of family physicians in northeastern Ontario.

PubMed

Gauthier, Alain P; Timony, Patrick E; Serresse, Suzanne; Goodale, Natalie; Prpic, Jason

2015-08-01

To identify strategies to improve the quality of health services for Francophone patients. A series of semistructured key informant interviews. Northeastern Ontario. Participants A total of 18 physicians were interviewed. Ten physicians were interviewed in French, 7 physicians were women, and 10 physicians were located in urban communities. Purposive and snowball sampling strategies were used to conduct a series of semistructured key informant interviews with family physicians practising in communities with a large Francophone population. Principles of grounded theory were applied, guided by a framework for patient-professional communication. Results were inductively derived following an iterative data collection–data analysis process and were analyzed using a detailed thematic approach. Respondents identified several strategies for providing high-quality French-language health services. Some were unique to non–French-speaking physicians (eg, using appropriate interpreter services), some were unique to French-speaking physicians (eg, using a flexible dialect), and some strategies were common to all physicians serving French populations (eg, hiring bilingual staff or having pamphlets and posters in both French and English). Physicians interviewed for this study provided high-quality health care by attributing substantial importance to effective communication. While linguistic patient-to-physician concordance is ideal, it might not always be possible. Thus, conscious efforts to attenuate communication barriers are necessary, and several effective strategies exist.

Staying Connected: Computer-Mediated and Face-to-Face Communication in College Students' Dating Relationships.

PubMed

Boyle, Andrea M; O'Sullivan, Lucia F

2016-05-01

Little is known about the features, depth, and quality of communication in heterosexual dating relationships that include computer-mediated communication (CMC). This study examined these features as well as CMC's potential to facilitate self-disclosure and information-seeking. It also evaluated whether partner CMC interactions play a role in partner intimacy and communication quality. Young adults (N = 359; 18-24) attending postsecondary education institutions completed an online survey about their CMC use. To be included in the study, all participants were in established dating relationships at the time of the study and reported daily communication with their partner. CMC was linked to partners' disclosure of nonintimate information. This personal self-disclosure was linked positively to relationship intimacy and communication quality, beyond contributions from face-to-face interactions. Breadth (not depth) of self-disclosure and positively valenced interactions, in particular, proved key to understanding greater levels of intimacy in dating relationships and better communication quality as a function of CMC. CMC provides opportunities for partners to stay connected and to improve the overall quality of their intimacy and communication.

Effective communication about the use of complementary and integrative medicine in cancer care.

PubMed

Frenkel, Moshe; Cohen, Lorenzo

2014-01-01

Complementary and integrative medicine (CIM) is becoming an increasingly popular and visible component of oncology care. Many patients affected by cancer and their family members are looking for informed advice and desire communication with their physicians about CIM use. Patients affected by cancer come to discuss CIM use with intense emotions and are experiencing an existential crisis that cannot be ignored. Effective communication is crucial in establishing trust with these patients and their families. Communication is now recognized as a core clinical skill in medicine, including cancer care, and is important to the delivery of high-quality care. The quality of communication affects patient satisfaction, decision-making, patient distress and well-being, compliance, and even malpractice litigation. The communication process about CIM use requires a very sensitive approach that depends on effective communication skills, such as experience in listening, encouraging hope, and ability to convey empathy and compassion. This process can be divided into two parts: the "how" and the "what". The "how" relates to the change in clinician attitude, the process of gathering information, addressing patients' unmet needs and emotions, and dealing with uncertainty. The "what" relates to the process of information exchange while assisting patients in decisions about CIM use by using reliable information sources, leading to informed decision-making.

[The Health Department of Sicily "Regional recommendations for hospital discharge and communication with patients after admission due to a cardiologic event" decree].

PubMed

Abrignani, Maurizio Giuseppe; De Luca, Giovanni; Gabriele, Michele; Tourkmani, Nidal

2014-06-01

Mortality and rehospitalizations still remain high after discharge for an acute cardiologic event. In this context, hospital discharge represents a potential pitfall for heart disease patients. In the setting of care transitions, the discharge letter is the main instrument of communication between hospital and primary care. Communication, besides, is an integral part of high-quality, patient-centered interventions aimed at improving the discharge process. Inadequate information at discharge significantly affects the quality of treatment compliance and the adoption of lifestyle modifications for an effective secondary prevention. The Health Department of Sicily, in 2013, established a task force with the aim to elaborate "Regional recommendations for hospital discharge and communication with patients after admission due to a cardiologic event", inviting to participate GICR-IACPR and many other scientific societies of cardiology and primary care, as discharge letter and communication are fundamental junctions of care transitions in cardiology. These recommendations have been published as a specific decree and contain: a structured model of discharge letter, which includes all of the parameters characterizing patients at high clinical risk, high thrombotic risk and low risk according to the Consensus document ANMCO/GICR-IACPR/GISE; is thus possible to identify these patients, choosing consequently the most appropriate follow-up pathways. A particular attention has been given to the "Medication Reconciliation" and to the identification of therapeutic targets; an educational Kit, with different forms on cardiac diseases, risk factors, drugs and lifestyle; a check-list about information given to the patient and caregivers. The "Recommendations" represent, in conclusion, the practical realization of the fruitful cooperation between scientific societies and political-administrative institutions that has been realized in Sicily in the last years.

IoT real time data acquisition using MQTT protocol

NASA Astrophysics Data System (ADS)

Atmoko, R. A.; Riantini, R.; Hasin, M. K.

2017-05-01

The Internet of Things (IoT) provides ease to monitor and to gain sensor data through the Internet [1]. The need of high quality data is increasing to the extent that data monitoring and acquisition system in real time is required, such as smart city or telediagnostic in medical areas [2]. Therefore, an appropriate communication protocol is required to resolve these problems. Lately, researchers have developed a lot of communication protocols for IoT, of which each has advantages and disadvantages. This study proposes the utilization of MQTT as a communication protocol, which is one of data communication protocols for IoT. This study used temperature and humidity sensors because the physical parameters are often needed as parameters of environment condition [3]. Data acquisition was done in real-time and stored in MySQL database. This study is also completed by interface web-based and mobile for online monitoring. This result of this study is the enhancement of data quality and reliability using MQTT protocol.

Coparenting profiles in the context of Mexican-origin teen pregnancy: links to mother-daughter relationship quality and adjustment.

PubMed

Perez-Brena, Norma J; Updegraff, Kimberly A; Umaña-Taylor, Adriana J; Jahromi, Laudan; Guimond, Amy

2015-06-01

The current study explored the multifaceted nature of the mother-adolescent coparental relationship with data from 167 Mexican-origin adolescent mothers and their own mothers at 10 months post childbirth. Profiles of mother-adolescent coparenting were created with latent profile analysis using adolescents' reports of three dimensions of coparenting (communication, involvement, and conflict). Four profiles were identified: (a) Harmonious Coparents (equal involvement, high communication, low conflict); (b) Harmonious-Adolescent Primary (adolescent is more involved than mother, high communication, low conflict); (c) Conflictual Coparents (equal involvement, high communication, high conflict); and (d) Conflictual-Adolescent Primary (adolescent is more involved than mother, moderate communication, high conflict). Families characterized by high mother-daughter conflict and psychological control prior to childbirth were more likely to belong in the Conflictual Coparents profile. In addition, adolescents' and mothers' depressive symptoms and parenting efficacy after childbirth were linked to profile membership, such that the Harmonious-Adolescent Primary profile reported the most positive adjustment patterns, whereas profiles with high coparental conflict (i.e., Conflictual Coparenting and Conflictual-Adolescent Primary profiles) showed the least positive adjustment patterns. Discussion considers the applied implications of identifying precursors to healthy and problematic mother-daughter coparenting for families of adolescent mothers in the early years of parenting. © 2014 Family Process Institute.

Coparenting Profiles in the Context of Mexican-Origin Teen Pregnancy: Links to Mother-Daughter Relationship Quality and Adjustment

PubMed Central

Perez-Brena, Norma J.; Updegraff, Kimberly A.; Umaña-Taylor, Adriana J.; Jahromi, Laudan; Guimond, Amy

2015-01-01

The current study explored the multifaceted nature of the mother-adolescent coparental relationship with data from 167 Mexican-origin adolescent mothers and their own mothers at ten months post-childbirth. Profiles of mother-adolescent coparenting were created with latent profile analysis using adolescents’ reports of three dimensions of coparenting (communication, involvement and conflict). Four profiles were identified: (a) Harmonious Coparents (equal involvement, high communication, low conflict); (b) Harmonious-Adolescent Primary (adolescent is more involved than mother, high communication, low conflict); (c) Conflictual Coparents (equal involvement, high communication, high conflict); and (d) Conflictual-Adolescent Primary (adolescent is more involved than mother, moderate communication, high conflict). Families characterized by high mother-daughter conflict and psychological control prior to childbirth were more likely to belong in the Conflictual Coparents profile. In addition, adolescents’ and mothers’ depressive symptoms and parenting efficacy after childbirth were linked to profile membership, such that the Harmonious-Adolescent Primary profile reported the most positive adjustment patterns, whereas profiles with high coparental conflict (i.e., Conflictual Coparenting and Conflictual-Adolescent Primary profiles) showed the least positive adjustment patterns. Discussion considers the applied implications of identifying precursors to healthy and problematic mother-daughter coparenting for families of adolescent mothers in the early years of parenting. PMID:25438748

Stochastic Packet Loss Model to Evaluate QoE Impairments

NASA Astrophysics Data System (ADS)

Hohlfeld, Oliver

With provisioning of broadband access for mass market—even in wireless and mobile networks—multimedia content, especially real-time streaming of high-quality audio and video, is extensively viewed and exchanged over the Internet. Quality of Experience (QoE) aspects, describing the service quality perceived by the user, is a vital factor in ensuring customer satisfaction in today's communication networks. Frameworks for accessing quality degradations in streamed video currently are investigated as a complex multi-layered research topic, involving network traffic load, codec functions and measures of user perception of video quality.

Quality of pharmaceutical care at the pharmacy counter: patients' experiences versus video observation.

PubMed

Koster, Ellen S; Blom, Lyda; Overbeeke, Marloes R; Philbert, Daphne; Vervloet, Marcia; Koopman, Laura; van Dijk, Liset

2016-01-01

Consumer Quality Index questionnaires are used to assess quality of care from patients' experiences. To provide insight into the agreement about quality of pharmaceutical care, measured both by a patient questionnaire and video observations. Pharmaceutical encounters in four pharmacies were video-recorded. Patients completed a questionnaire based upon the Consumer Quality Index Pharmaceutical Care after the encounter containing questions about patients' experiences regarding information provision, medication counseling, and pharmacy staff's communication style. An observation protocol was used to code the recorded encounters. Agreement between video observation and patients' experiences was calculated. In total, 109 encounters were included for analysis. For the domains "medication counseling" and "communication style", agreement between patients' experiences and observations was very high (>90%). Less agreement (45%) was found for "information provision", which was rated more positive by patients compared to the observations, especially for the topic, encouragement of patients' questioning behavior. A questionnaire is useful to assess the quality of medication counseling and pharmacy staff's communication style, but might be less suitable to evaluate information provision and pharmacy staff's encouragement of patients' questioning behavior. Although patients may believe that they have received all necessary information to use their new medicine, some information on specific instructions was not addressed during the encounter. When using questionnaires to get insight into information provision, observations of encounters are very informative to validate the patient questionnaires and make necessary adjustments.

Managing Diversity: A Key to Building a Quality Work Force. Research and Development Series No. 271.

ERIC Educational Resources Information Center

Maxson, Judith; Hair, Billy

Economic changes create stress as U.S. businesses progress toward building a high quality work force for the year 2000. Skills such as critical literacy, communication, writing, math, and interpersonal competence are desired. Critical literacy involves the higher order thinking skills: the ability to analyze, evaluate, and synthesize. In addition,…

The Motivation Impact of Open Educational Resources Utilization on Physics Learning Using Quipper School App

ERIC Educational Resources Information Center

Sulisworo, Dwi; Sulistyo, Eko Nur; Akhsan, Rifai Nur

2017-01-01

The distribution of the education quality in Indonesia is relatively uneven. This affects the quality of secondary school graduates. On the other hand, the national growth of Information Communication Technology usage in Indonesia is very high, including the use of mobile technology. This is an opportunity for the application of OER (Open…

Illinois High School Principals' Perceptions of Alternative Learning Environments

ERIC Educational Resources Information Center

Carlton, Lawrence W.

2009-01-01

This study examined Illinois high school principals' perceptions of the growth, quality, advantages and disadvantages of alternative learning environments. In this study, alternative learning environments involved the use of both synchronous and asynchronous modes of communication for course delivery. Synchronous modes of instructional delivery…

Improving metacognitive skills in geosciences to preserve the quality of divulged information

NASA Astrophysics Data System (ADS)

Arattano, Massimo; Gatti, Albertina

2017-04-01

The commitment to communicate and divulge the knowledge acquired and/or produced during the course of his professional activity, has certainly always been one of the ethical duties of the geologist and/or the geoscientist. Nowadays this duty must be pursued paying also great attention to the quality with which the information is expressed, both orally and in written form, given the much greater spreading that it usually undergoes through the Internet. Thus it has become part of the ethical duties of the geologist to take care of the quality of the information and knowledge he produces. Consequently, it has become crucial for Universities and teaching Institutions to devote some efforts to improve the metacognitive skills of all those who work and are involved in the broad field of the earth sciences. Metacognitive skills are in fact essential to reach a high quality of communication. Metacognition can be defined as the process of thinking about thinking and developing self-awareness and the ability to self-assess. It is contemplation about one's education and learning - past, present, and future - which implies knowledge and control of one's learning processes. During experimental classes devoted to improve metacognitive skills, it was often discovered that people who have higher-order thinking abilities, lack the communication skills needed to relay them adequately. It may also be difficult for them to convey some of the more abstract or complex ideas. The reason that has been found for this situation is a lack of training in communication and a too poor mastery of lexicon, which becomes a severe shortcoming in an era of great proliferation of our dictionary due to the strong undergoing technological development of our society. A specific research carried out within the IRPI Institute to improve this scenario, has led to the creation of a specific training and to the development of specific exercises devoted to the enhancement of communication and expressive abilities, through the improvement of metacognitive skills. This particular training has been recently proposed to the engineers of the Order of Engineers in Turin, as part of the offer for their permanent education. The program was intended to improve the ability of participants to both understand and learn with ease any kind of written text or oral talk and also to improve the quality of their expressive and communication capacities. The results obtained and the feedbacks received have been extremely positive. People with a very high level of education have in fact discovered, nevertheless, that their metacognitive and communication skills could be noticeably improved. The goal has been reached in a relatively short time (about 30 hours of lessons). The training has been already proposed to five different groups of engineers, during the course of 2015 and 2016, reaching more than one hundred people. The participants have reported an increased awareness of their thought processes and a significant improvement of their communication abilities. This has allowed to envision the possibility of a general improvement of the communication skills and of the quality of the available information in the entire field of geosciences.

Assessing Communication Skills of Medical Students in Objective Structured Clinical Examinations (OSCE) - A Systematic Review of Rating Scales

PubMed Central

Cömert, Musa; Zill, Jördis Maria; Christalle, Eva; Dirmaier, Jörg; Härter, Martin; Scholl, Isabelle

2016-01-01

Background Teaching and assessment of communication skills have become essential in medical education. The Objective Structured Clinical Examination (OSCE) has been found as an appropriate means to assess communication skills within medical education. Studies have demonstrated the importance of a valid assessment of medical students’ communication skills. Yet, the validity of the performance scores depends fundamentally on the quality of the rating scales used in an OSCE. Thus, this systematic review aimed at providing an overview of existing rating scales, describing their underlying definition of communication skills, determining the methodological quality of psychometric studies and the quality of psychometric properties of the identified rating scales. Methods We conducted a systematic review to identify psychometrically tested rating scales, which have been applied in OSCE settings to assess communication skills of medical students. Our search strategy comprised three databases (EMBASE, PsycINFO, and PubMed), reference tracking and consultation of experts. We included studies that reported psychometric properties of communication skills assessment rating scales used in OSCEs by examiners only. The methodological quality of included studies was assessed using the COnsensus based Standards for the selection of health status Measurement INstruments (COSMIN) checklist. The quality of psychometric properties was evaluated using the quality criteria of Terwee and colleagues. Results Data of twelve studies reporting on eight rating scales on communication skills assessment in OSCEs were included. Five of eight rating scales were explicitly developed based on a specific definition of communication skills. The methodological quality of studies was mainly poor. The psychometric quality of the eight rating scales was mainly intermediate. Discussion Our results reveal that future psychometric evaluation studies focusing on improving the methodological quality are needed in order to yield psychometrically sound results of the OSCEs assessing communication skills. This is especially important given that most OSCE rating scales are used for summative assessment, and thus have an impact on medical students’ academic success. PMID:27031506

Assessing Communication Skills of Medical Students in Objective Structured Clinical Examinations (OSCE)--A Systematic Review of Rating Scales.

PubMed

Cömert, Musa; Zill, Jördis Maria; Christalle, Eva; Dirmaier, Jörg; Härter, Martin; Scholl, Isabelle

2016-01-01

Teaching and assessment of communication skills have become essential in medical education. The Objective Structured Clinical Examination (OSCE) has been found as an appropriate means to assess communication skills within medical education. Studies have demonstrated the importance of a valid assessment of medical students' communication skills. Yet, the validity of the performance scores depends fundamentally on the quality of the rating scales used in an OSCE. Thus, this systematic review aimed at providing an overview of existing rating scales, describing their underlying definition of communication skills, determining the methodological quality of psychometric studies and the quality of psychometric properties of the identified rating scales. We conducted a systematic review to identify psychometrically tested rating scales, which have been applied in OSCE settings to assess communication skills of medical students. Our search strategy comprised three databases (EMBASE, PsycINFO, and PubMed), reference tracking and consultation of experts. We included studies that reported psychometric properties of communication skills assessment rating scales used in OSCEs by examiners only. The methodological quality of included studies was assessed using the COnsensus based Standards for the selection of health status Measurement INstruments (COSMIN) checklist. The quality of psychometric properties was evaluated using the quality criteria of Terwee and colleagues. Data of twelve studies reporting on eight rating scales on communication skills assessment in OSCEs were included. Five of eight rating scales were explicitly developed based on a specific definition of communication skills. The methodological quality of studies was mainly poor. The psychometric quality of the eight rating scales was mainly intermediate. Our results reveal that future psychometric evaluation studies focusing on improving the methodological quality are needed in order to yield psychometrically sound results of the OSCEs assessing communication skills. This is especially important given that most OSCE rating scales are used for summative assessment, and thus have an impact on medical students' academic success.

Healthcare users' experiences of communicating with healthcare professionals about children who have life-limiting conditions: a qualitative systematic review protocol.

PubMed

Ekberg, Stuart; Bradford, Natalie; Herbert, Anthony; Danby, Susan; Yates, Patsy

2015-11-01

The objective of this review is to identify and synthesize the best international qualitative evidence on healthcare users' experiences of communication with healthcare professionals about children who have life-limiting conditions. For the purposes of this review, "healthcare users" will be taken to include children who have life-limiting conditions and their families. The question to be addressed is:What are healthcare users' experiences of communicating with healthcare professionals about children who have life-limiting conditions? The prospect of the death of a child from an incurable medical condition is harrowing, yet finding a way to discuss this prospect is crucial to maximize the quality of life for such children and their families. High-quality communication is well recognized as a core skill health care professionals need to maximize the quality of care they provide. This skill is valued by service users, who consistently rate it as one of the highest priorities for the care they receive. Evidence suggests, however, that healthcare professionals can feel ill-equipped or uncomfortable communicating with and about such children. Therefore, it is important to understand what represents high-quality communication and what is involved in accomplishing this within pediatric palliative care.In recent decades there has been an increased focus on providing palliative care for children who have life-limiting conditions. These are conditions for which no cure is available and for which the probable outcome is premature death. Palliative care may also be appropriate for children who have life-threatening conditions; these are conditions where there is not only a high probability of premature death but also a chance of long-term survival into adulthood Although pediatric palliative care is underpinned by the same philosophy as adult palliative care, children who have life-limiting conditions and their families have particular needs that distinguish them from users of adult palliative care. For example, at a physical level children are more likely than adults to have non-malignant conditions that follow trajectories in which children oscillate between feeling relatively well and acutely unwell. The social dynamic of their care is also radically different, particularly given the role of parents or guardians in making surrogate decisions about their child's care. Such factors warrant considering pediatric palliative care as distinct from palliative care more generally.Although the particular circumstances of children who have life-limiting conditions have led to development of pediatric palliative care, the particular provisions of this care differs among countries. One aspect of variation is the age range of patients. Pediatric palliative care is usually provided to neonates, infants, children, adolescents and young adults, but international variations in the definitions of these age ranges, particularly for adolescents and young adults, means pediatric palliative care is provided to different age groups in different countries. This review therefore adopts a pragmatic rather than an age-based definition of a pediatric palliative care, considering all studies relating to service users who are being cared for by pediatric rather than adult healthcare services.In catering for the unique needs of children who have life-limiting conditions and their families, pediatric palliative care aims to achieve pain and symptom management, enhanced dignity and quality of life, and psychosocial and spiritual care. It also seeks to incorporate care for patients' broader families and facilitating access to appropriate services and support. High-quality communication is crucial for achieving these aims. It enables healthcare users and providers to make decisions that underpin the care that is provided and the quality of the life that is possible for patients and their families.Although both users and providers recognize the value of high-quality communication with and about children who have life-limiting conditions, this does not mean that these stakeholders necessarily share the same perspective of what constitutes high-quality communication and the best way of accomplishing this. Focusing on healthcare users' experiences of communication with healthcare professionals about children who have life-limiting conditions, the present review will explore the subjective impact of professionals' communication on the people for whom they provide care.It may be necessary to consider a range of contextual factors to understand healthcare users' experiences of communicating with healthcare professionals about children who have life-limiting conditions. For instance, age, developmental stage, cognitive capacity, emotional and social strengths, and family dynamics can influence a child's level of involvement in discussions about their condition and care. Although there are factors that appear more consistent across the range of pediatric palliative care users, such as parents' preferences for being treated by healthcare professionals as partners in making decisions about the care of their child, there is not always such consistency. Nor is it clear whether such findings can be generalized across different cultural contexts. In appraising existing research, this systematic review will therefore consider the relationship between the context of individual studies and their reported findings.The primary aim of this review is to identify, appraise and synthesize existing qualitative evidence of healthcare users' experiences of communicating with healthcare professionals about children who have life-limiting conditions. The review will consider relevant details of these findings, particularly whether factors like age are relevant for understanding particular experiences of communication. An outcome of this review will be the identification of best available qualitative evidence that can be used to inform professional practice, as well as an identification of priorities for future research in pediatric palliative care.A preliminary search in MEDLINE and CINAHL found primary studies exploring healthcare users' experiences of aspects of communicating with healthcare professionals about children who have life-limiting conditions. A search was also conducted for existing systematic reviews in PubMed, CINAHL, EMBASE, PsycINFO, the Cochrane Database of Systematic Reviews, the JBI Database of Systematic Reviews and Implementation Reports, and PROSPERO. No systematic reviews on this topic were found.

Quality control and improvement of cancer care: what is needed? 4th European Roundtable Meeting (ERTM) May 5th, 2017, Berlin, Germany.

PubMed

Ortmann, Olaf; Helbig, Ulrike; Torode, Julie; Schreck, Stefan; Karjalainen, Sakari; Bettio, Manola; Ringborg, Ulrik; Klinkhammer-Schalke, Monika; Bray, Freddy

2018-06-01

National Cancer Control Plans (NCCPs) often describe structural requirements for high quality cancer care. During the fourth European Roundtable Meeting (ERTM) participants shared learnings from their own national setting to formulate best practice in optimizing communication strategies between parties involved in clinical cancer registries, cancer centers and guideline groups. A decentralized model of data collection close to the patient and caregiver enhances timely completion and the quality of the data captured. Nevertheless, central coordination is necessary to define datasets, indicators, standard settings, education, training and quality control to maintain standards across the network. In particular, interaction of parties in cancer care network has to be established and maintained on a regular basis. After establishing the structural requirements of cancer care networks, communication between the different components and parties is required to analyze outcome data, provide regular reporting to all and develop strategies for continuous improvement of quality across the network.

Trends in NASA communication satellites.

NASA Technical Reports Server (NTRS)

Sivo, J. N.; Robbins, W. H.; Stretchberry, D. M.

1972-01-01

Discussion of the potential applications of satellite communications technology in meeting the national needs in education, health care, culture, and data transfer techniques. Experiments with the NASA ATS 1, 3 and 5 spacecraft, which are conducted in an attempt to satisfy such needs, are reviewed. The future needs are also considered, covering the requirements of multiple region coverage, communications between regions, large numbers of ground terminals, multichannel capability and high quality TV pictures. The ATS F and CTS spacecraft are expected to be available in the near future to expand experiments in this field.

POSNA Quality Safety Value Initiative: From Vision to Implementation to Early Results.

PubMed

Waters, Peter M; Flynn, John M

2015-01-01

The POSNA Quality, Safety and Value Initiative (QSVI) formally started with POSNA board approval in early 2011. The initial vision statement was: "To lead in defining our members' value based clinical care. To partner with hospital based and orthopedic organizational efforts to guarantee safe, high quality outcomes for our patients. To communicate our initiatives and results cooperatively with payer, credentialing, and compliance organizations to improve pediatric orthopedic care in North America."

MedRapid--medical community & business intelligence system.

PubMed

Finkeissen, E; Fuchs, H; Jakob, T; Wetter, T

2002-01-01

currently, it takes at least 6 months for researchers to communicate their results. This delay is caused (a) by partial lacks of machine support for both representation as well as communication and (b) by media breaks during the communication process. To make an integrated communication between researchers and practitioners possible, a general structure for medical content representation has been set up. The procedure for data entry and quality management has been generalized and implemented in a web-based authoring system. The MedRapid-system supports the medical experts in entering their knowledge into a database. Here, the level of detail is still below that of current medical guidelines representation. However, the symmetric structure for an area-wide medical knowledge representation is highly retrievable and thus can quickly be communicated into daily routine for the improvement of the treatment quality. In addition, other sources like journal articles and medical guidelines can be references within the MedRapid-system and thus be communicated into daily routine. The fundamental system for the representation of medical reference knowledge (from reference works/books) itself is not sufficient for the friction-less communication amongst medical staff. Rather, the process of (a) representing medical knowledge, (b) refereeing the represented knowledge, (c) communicating the represented knowledge, and (d) retrieving the represented knowledge has to be unified. MedRapid will soon support the whole process on one server system.

Climate uniformity: its influence on team communication quality, task conflict, and team performance.

PubMed

González-Romá, Vicente; Hernández, Ana

2014-11-01

We investigated whether climate uniformity (the pattern of climate perceptions of organizational support within the team) is related to task conflict, team communication quality, and team performance. We used a sample composed of 141 bank branches and collected data at 3 time points. The results obtained showed that, after controlling for aggregate team climate, climate strength, and their interaction, a type of nonuniform climate pattern (weak dissimilarity) was directly related to task conflict and team communication quality. Teams with weak dissimilarity nonuniform patterns tended to show higher levels of task conflict and lower levels of team communication quality than teams with uniform climate patterns. The relationship between weak dissimilarity patterns and team performance was fully mediated by team communication quality. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Geritalk: communication skills training for geriatric and palliative medicine fellows.

PubMed

Kelley, Amy S; Back, Anthony L; Arnold, Robert M; Goldberg, Gabrielle R; Lim, Betty B; Litrivis, Evgenia; Smith, Cardinale B; O'Neill, Lynn B

2012-02-01

Expert communication is essential to high-quality care for older patients with serious illness. Although the importance of communication skills is widely recognized, formal curricula for teaching communication skills to geriatric and palliative medicine fellows is often inadequate or unavailable. The current study drew upon the educational principles and format of an evidence-based, interactive teaching method to develop an intensive communication skills training course designed specifically to address the common communication challenges that geriatric and palliative medicine fellows face. The 2-day retreat, held away from the hospital environment, included large-group overview presentations, small-group communication skills practice, and development of future skills practice commitment. Faculty received in-depth training in small-group facilitation techniques before the course. Geriatric and palliative medicine fellows were recruited to participate in the course and 100% (n = 18) enrolled. Overall satisfaction with the course was very high (mean 4.8 on a 5-point scale). After the course, fellows reported an increase in self-assessed preparedness for specific communication challenges (mean increase 1.4 on 5-point scale, P < .001). Two months after the course, fellows reported a high level of sustained skills practice (mean 4.3 on 5-point scale). In sum, the intensive communication skills program, customized for the specific needs of geriatric and palliative medicine fellows, improved fellows' self-assessed preparedness for challenging communication tasks and provided a model for ongoing deliberate practice of communication skills. © 2012, Copyright the Authors Journal compilation © 2011, The American Geriatrics Society.

Geritalk: Communication Skills Training for Geriatrics and Palliative Medicine Fellows

PubMed Central

Kelley, Amy S.; Back, Anthony L.; Arnold, Robert M.; Goldberg, Gabrielle R.; Lim, Betty B.; Litrivis, Evgenia; Smith, Cardinale B.; O’Neill, Lynn B.

2011-01-01

Expert communication is essential to high quality care for older patients with serious illness. While the importance of communication skills is widely recognized, formal curricula for teaching communication skills to geriatrics and palliative medicine fellows is often inadequate or unavailable. We drew upon the educational principles and format of an evidence-based, interactive teaching method, to develop an intensive communication skills training course designed specifically to address the common communication challenges faced by geriatrics and palliative medicine fellows. The 2-day retreat, held away from the hospital environment, included large-group overview presentations, small-group communication skills practice, and development of future skills practice commitment. Faculty received in-depth training in small-group facilitation techniques prior to the course. Geriatrics and palliative medicine fellows were recruited to participate in the course and 100% (n=18) enrolled. Overall satisfaction with the course was very high (mean 4.8 on 5-point scale). Compared to before the course, fellows reported an increase in self-assessed preparedness for specific communication challenges (mean increase 1.4 on 5-point scale, p<0.01). Two months after the course, fellows reported a high level of sustained skills practice (mean 4.3 on 5-point scale). In sum, the intensive communication skills program, tailored to the specific needs of geriatrics and palliative medicine fellows, improved fellows’ self-assessed preparedness for challenging communication tasks and provided a model for ongoing deliberate practice of communication skills. PMID:22211768

Exploratory investigation of communication management in residential-aged care: a comparison of staff knowledge, documentation and observed resident-staff communication.

PubMed

Bennett, Michelle K; Ward, Elizabeth C; Scarinci, Nerina A

2016-05-01

There is a high prevalence of communication difficulty among older people living in residential-aged care. Such functional deficits can have a negative impact on resident quality of life, staff workplace satisfaction and the provision of quality care. Systematic research investigating the nature of communication management in residential-aged care and factors impacting optimal communication management is lacking. To use data triangulation across multiple sources to describe resident-staff communication and communication management in residential-aged care. Participants included a sample of 14 residents and 29 staff directly involved in communication interactions with residents. Data were obtained from: (1) resident file review (n = 14), (2) observation of resident-staff communication (n = 14), (3) resident surveys (n = 14) and (4) staff surveys (n = 29). Data from each source were examined separately then triangulated. All residents had limited opportunity for meaningful communication with staff. Documentation of residents' communication needs and strategies to facilitate resident-staff communication was insufficient to provide individualized recommendations. Although staff were observed to use various strategies to facilitate communication with residents, staff agreement about the applicability of these strategies to individual residents was inconsistent. Differences in resident-staff communication for residents who experience nil/mild versus moderate/severe communication difficulty were also found. Resident-staff communication and communication management in residential-aged care is limited in scope and challenged in meeting residents' individual communication needs. Improvements in both documentation and staff knowledge of residents' communication needs are necessary. Strategies to facilitate communication with individual residents must be tailored, evidence based, documented in care plans and delivered to staff through ongoing education. Increased involvement of specialist providers such as speech pathologists to support better communication management in residential-aged care may provide one way of facilitating such change. © 2015 Royal College of Speech and Language Therapists.

Testing the Implementation of the Veder Contact Method: A Theatre-Based Communication method in Dementia Care.

PubMed

Boersma, Petra; van Weert, Julia C M; Lissenberg-Witte, Birgit I; van Meijel, Berno; Dröes, Rose-Marie

2018-01-08

There is a lack of research on implementation of person-centered care in nursing home care. The purpose of this study was to assess the implementation of the Veder contact method (VCM), a new person-centered method using theatrical, poetic and musical communication for application in 24-hr care. Caregivers (n = 136) and residents (n = 141) participated in a 1-year quasi-experimental study. Foundation Theater Veder implemented VCM on six experimental wards and rated implementation quality. Six control wards delivered care-as-usual. Before and after implementation, caregiver behavior was assessed during observations using the Veder-observation list and Quality of Caregivers' Behavior-list. Caregiver attitude was rated with the Approaches to Dementia Questionnaire. Quality of life, behavior, and mood of the residents were measured with QUALIDEM, INTERACT and FACE. Residents' care plans were examined for person-centered background information. Significant improvements in caregivers' communicative behavior (i.e., the ability to apply VCM, establishing positive interactions) and some aspects of residents' behavior and quality of life (i.e., positive affect, social relations) were found on the experimental wards with a high implementation score, as compared to the experimental wards with a low implementation score, and the control wards. No significant differences were found between the groups in caregivers' attitudes, residents' care plans, or mood. The positive changes in caregivers' behavior and residents' well-being on the high implementation score wards confirm the partly successful VCM implementation. Distinguishing between wards with a high and low implementation score provided insight into factors which are crucial for successful implementation. © The Author(s) 2018. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The National Diabetes Education Program at 20 Years: Lessons Learned and Plans for the Future.

PubMed

Siminerio, Linda M; Albright, Ann; Fradkin, Judith; Gallivan, Joanne; McDivitt, Jude; Rodríguez, Betsy; Tuncer, Diane; Wong, Faye

2018-02-01

The National Diabetes Education Program (NDEP) was established to translate findings from diabetes research studies into clinical and public health practice. Over 20 years, NDEP has built a program with partnership engagement that includes science-based resources for multiple population and stakeholder audiences. Throughout its history, NDEP has developed strategies and messages based on communication research and relied on established behavior change models from health education, communication, and social marketing. The program's success in continuing to engage diverse partners after 20 years has led to time-proven and high-quality resources that have been sustained. Today, NDEP maintains a national repository of diabetes education tools and resources that are high quality, science- and audience-based, culturally and linguistically appropriate, and available free of charge to a wide variety of audiences. This review looks back and describes NDEP's evolution in transforming and communicating diabetes management and type 2 diabetes prevention strategies through partnerships, campaigns, educational resources, and tools and identifies future opportunities and plans. © 2018 by the American Diabetes Association.

One size fits all? Challenges faced by physicians during shift handovers in a hospital with high sender/recipient ratio

PubMed Central

Yang, Xi Jessie; Park, Taezoon; Siah, Tien Ho Kewin; Ang, Bee Leng Sophia; Donchin, Yoel

2015-01-01

INTRODUCTION The aim of the present study was to investigate the challenges faced by physicians during shift handovers in a university hospital that has a high handover sender/recipient ratio. METHODS We adopted a multifaceted approach, comprising recording and analysis of handover information, rating of handover quality, and shadowing of handover recipients. Data was collected at the general medical ward of a university hospital in Singapore for a period of three months. Handover information transfer (i.e. senders’ and recipients’ verbal communication, and recipients’ handwritten notes) and handover environmental factors were analysed. The relationship between ‘to-do’ tasks and information transfer, handover quality and handover duration was examined using analysis of variance. RESULTS Verbal handovers for 152 patients were observed. Handwritten notes on 102 (67.1%) patients and handover quality ratings for 98 (64.5%) patients were collected. Although there was good task prioritisation (information transfer: p < 0.005, handover duration: p < 0.01), incomplete information transfer and poor implementation of non-modifiable identifiers were observed. The high sender/recipient ratio of the hospital made face-to-face and/or bedside handover difficult to implement. Although the current handover method (i.e. use of telephone communication) allowed for interactive communication, it resulted in systemic information loss due to the lack of written information. The handover environment was chaotic in the high sender/recipient ratio setting, and the physicians had no designated handover time or location. CONCLUSION Handovers in high sender/recipient ratio settings are challenging. Efforts should be made to improve the handover processes in such situations, so that patient care is not compromised. PMID:25532519

Leader emergence through interpersonal neural synchronization

PubMed Central

Jiang, Jing; Chen, Chuansheng; Dai, Bohan; Shi, Guang; Ding, Guosheng; Liu, Li; Lu, Chunming

2015-01-01

The neural mechanism of leader emergence is not well understood. This study investigated (i) whether interpersonal neural synchronization (INS) plays an important role in leader emergence, and (ii) whether INS and leader emergence are associated with the frequency or the quality of communications. Eleven three-member groups were asked to perform a leaderless group discussion (LGD) task, and their brain activities were recorded via functional near infrared spectroscopy (fNIRS)-based hyperscanning. Video recordings of the discussions were coded for leadership and communication. Results showed that the INS for the leader–follower (LF) pairs was higher than that for the follower–follower (FF) pairs in the left temporo-parietal junction (TPJ), an area important for social mentalizing. Although communication frequency was higher for the LF pairs than for the FF pairs, the frequency of leader-initiated and follower-initiated communication did not differ significantly. Moreover, INS for the LF pairs was significantly higher during leader-initiated communication than during follower-initiated communications. In addition, INS for the LF pairs during leader-initiated communication was significantly correlated with the leaders’ communication skills and competence, but not their communication frequency. Finally, leadership could be successfully predicted based on INS as well as communication frequency early during the LGD (before half a minute into the task). In sum, this study found that leader emergence was characterized by high-level neural synchronization between the leader and followers and that the quality, rather than the frequency, of communications was associated with synchronization. These results suggest that leaders emerge because they are able to say the right things at the right time. PMID:25831535

Leader emergence through interpersonal neural synchronization.

PubMed

Jiang, Jing; Chen, Chuansheng; Dai, Bohan; Shi, Guang; Ding, Guosheng; Liu, Li; Lu, Chunming

2015-04-07

The neural mechanism of leader emergence is not well understood. This study investigated (i) whether interpersonal neural synchronization (INS) plays an important role in leader emergence, and (ii) whether INS and leader emergence are associated with the frequency or the quality of communications. Eleven three-member groups were asked to perform a leaderless group discussion (LGD) task, and their brain activities were recorded via functional near infrared spectroscopy (fNIRS)-based hyperscanning. Video recordings of the discussions were coded for leadership and communication. Results showed that the INS for the leader-follower (LF) pairs was higher than that for the follower-follower (FF) pairs in the left temporo-parietal junction (TPJ), an area important for social mentalizing. Although communication frequency was higher for the LF pairs than for the FF pairs, the frequency of leader-initiated and follower-initiated communication did not differ significantly. Moreover, INS for the LF pairs was significantly higher during leader-initiated communication than during follower-initiated communications. In addition, INS for the LF pairs during leader-initiated communication was significantly correlated with the leaders' communication skills and competence, but not their communication frequency. Finally, leadership could be successfully predicted based on INS as well as communication frequency early during the LGD (before half a minute into the task). In sum, this study found that leader emergence was characterized by high-level neural synchronization between the leader and followers and that the quality, rather than the frequency, of communications was associated with synchronization. These results suggest that leaders emerge because they are able to say the right things at the right time.

Development and testing of emergency department patient transfer communication measures.

PubMed

Klingner, Jill; Moscovice, Ira

2012-01-01

Communication problems are a major contributing factor to adverse events in hospitals.(1) The contextual environment in small rural hospitals increases the importance of emergency department (ED) patient transfer communication quality. This study addresses the communication problems through the development and testing of ED quality measurement of interfacility patient transfer communication. Input from existing measures, measurement and health care delivery experts, as well as hospital frontline staff was used to design and modify ED quality measures. Three field tests were conducted to determine the feasibility of data collection and the effectiveness of different training methods and types of partnerships. Measures were evaluated based on their prevalence, ease of data collection, and usefulness for internal and external improvement. It is feasible to collect ED quality measure data. Different data sources, data collection, and data entry methods, training and partners can be used to examine hospital ED quality. There is significant room for improvement in the communication of patient information between health care facilities. Current health care reform efforts highlight the importance of clear communication between organizations held accountable for patient safety and outcomes. The patient transfer communication measures have been tested in a wide range of rural settings and have been vetted nationally. They have been endorsed by the National Quality Forum, are included in the National Quality Measurement Clearinghouse supported by the Agency for Health Care Research and Quality (AHRQ), and are under consideration by the Centers for Medicare and Medicaid Services for future payment determinations beginning in calendar year 2013. © 2011 National Rural Health Association.

Examining the Role of Communication on Sibling Relationship Quality and Interaction for Sibling Pairs with and without a Developmental Disability

ERIC Educational Resources Information Center

Smith, Ashlyn L.; Romski, MaryAnn; Sevcik, Rose A.

2013-01-01

This study examined communication interaction patterns when one sibling had a developmental disability as well as the role of communication skills in sibling relationship quality. Thirty sibling dyads were categorized into one of three communication status groups: emerging, context-dependent, and independent communicators. Independent…

A software communication tool for the tele-ICU.

PubMed

Pimintel, Denise M; Wei, Shang Heng; Odor, Alberto

2013-01-01

The Tele Intensive Care Unit (tele-ICU) supports a high volume, high acuity population of patients. There is a high-volume of incoming and outgoing calls, especially during the evening and night hours, through the tele-ICU hubs. The tele-ICU clinicians must be able to communicate effectively to team members in order to support the care of complex and critically ill patients while supporting and maintaining a standard to improve time to intervention. This study describes a software communication tool that will improve the time to intervention, over the paper-driven communication format presently used in the tele-ICU. The software provides a multi-relational database of message instances to mine information for evaluation and quality improvement for all entities that touch the tele-ICU. The software design incorporates years of critical care and software design experience combined with new skills acquired in an applied Health Informatics program. This software tool will function in the tele-ICU environment and perform as a front-end application that gathers, routes, and displays internal communication messages for intervention by priority and provider.

High-technology augmentative and alternative communication for individuals with intellectual and developmental disabilities and complex communication needs: a meta-analysis.

PubMed

Ganz, Jennifer B; Morin, Kristi L; Foster, Margaret J; Vannest, Kimberly J; Genç Tosun, Derya; Gregori, Emily V; Gerow, Stephanie L

2017-12-01

The use of mobile technology is ubiquitous in modern society and is rapidly increasing in novel use. The use of mobile devices and software applications ("apps") as augmentative and alternative communication (AAC) is rapidly expanding in the community, and this is also reflected in the research literature. This article reports the social-communication outcome results of a meta-analysis of single-case experimental research on the use of high-tech AAC, including mobile devices, by individuals with intellectual and developmental disabilities, including autism spectrum disorder. Following inclusion determination, and excluding studies with poor design quality, raw data from 24 publications were extracted and included 89 A-B phase contrasts. Tau-U nonparametric, non-overlap effect size was used to aggregate the results across all studies for an omnibus and moderator analyses. Kendall's S was calculated for confidence intervals, p-values, and standard error. The omnibus analysis indicated overall low to moderate positive effects on social-communication outcomes for high-tech AAC use by individuals with intellectual and developmental disabilities.

The experience of educational quality in undergraduate nursing students: a phenomenological study.

PubMed

Macale, Loreana; Vellone, Ercole; Scialò, Gennaro; Iossa, Mauro; Cristofori, Elena; Alvaro, Rosaria

2016-01-01

The evaluation of academic education has become crucial in the European Union since the Bologna Process encouraged all European universities to reach high quality standards in education. Although several studies have been conducted on the quality of undergraduate nursing education, few studies have explored this topic from the students' perspective. The purpose of this study was to describe the experience of educational quality in undergraduate nursing students. The phenomenological method was used to study 55 students (mean age 24 years; 73% female) pursuing a baccalaureate degree in nursing in three universities in central Italy. The following five themes emerged from the phenomenological analysis: 1) quality of faculties: teaching skills, preparation, sensitivity to students, self-discipline; 2) theory-practice integration and communication between teaching and clinical area; 3) general management and organization of the programme; 4) quality of infrastructures: libraries, classrooms, information technology, services, administration, and communication; and 5) clinical tutorship: humanity, relationships and ability of the clinical tutor to guide and support. This study's novel finding was a deeper understanding of the educational quality's meanings among undergraduate nursing students. Students thought educational quality consisted of the faculty members' sensitivity towards their problems and the clinical tutors' humanity, interpersonal skills, guidance and support.

Communication and transportation as quality of life determinants based on cities in Central Java Province and Special Region of Yogyakarta

NASA Astrophysics Data System (ADS)

Subanti, S.; Hartatik; Hakim, A. R.; Daerobi, A.; Setiawan, R. R.

2018-03-01

The quality of life become a concern for individuals and communities seeking to find their sustainable life. Some people in industry, consumer groups, academics, and policy makers have sought to better understand how communication and transportation contributes on quality of life. Thus, this paper aimed to calculate quality of life based on transportation and communication. Indicator of transportation such as road surface condition and the availability of public of transportation; while indicator of communication such as the availability of television signal, post services, cable phone, and internet cafes. Cities involved in this study were Magelang, Surakarta, Salatiga, Semarang, Pekalongan, Tegal,and Yogyakarta. This paper used national socio-economic survey data and the potential of village data. Estimation techniques using multiple regression method. The findings of this paper, (1) transportation and communication were linked to Quality of Life; (2) the highest quality of life obtained by the city of Magelang, while the lowest was occupied by the City of Pekalongan. Suggestion from this paper, local government should have to prioritize infrastructure development such as transportation and communication because it can improve the quality of life whose lived in the city.

Improving the quality of physician communication with rapid-throughput analysis and report cards.

PubMed

Farrell, Michael H; Christopher, Stephanie A; La Pean Kirschner, Alison; Roedl, Sara J; O'Tool, Faith O; Ahmad, Nadia Y; Farrell, Philip M

2014-11-01

Problems with clinician-patient communication negatively impact newborn screening, genetics, and all of healthcare. Training programs teach communication, but educational methods are not feasible for entire populations of clinicians. To address this healthcare quality gap, we developed a Communication Quality Assurance intervention. Child health providers volunteered for a randomized controlled trial of assessment and a report card. Participants provided telephone counseling to a standardized parent regarding a newborn screening result showing heterozygous status for cystic fibrosis or sickle cell disease. Our rapid-throughput timeline allows individualized feedback within a week. Two encounters were recorded (baseline and after a random sample received the report card) and abstracted for four groups of communication quality indicators. 92 participants finished both counseling encounters within our rapid-throughput time limits. Participants randomized to receive the report card improved communication behaviors more than controls, including request for teach-back (p<0.01), opening behaviors (p=0.01), anticipate/validate emotion (p<0.001) and the ratio of explained to unexplained jargon words (p<0.03). The rapid-throughput report card is effective at improving specific communication behaviors. Communication can be taught, but this project shows how healthcare organizations can assure communication quality everywhere. Further implementation could improve newborn screening, genetics, and healthcare in general. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Using Organization Risk Analyzer (ORA) to Explore the Relationship of Nursing Unit Communication to Patient Safety and Quality Outcomes

PubMed Central

Effken, Judith A.; Carley, Kathleen M.; Gephart, Sheila; Verran, Joyce A.; Bianchi, Denise; Reminga, Jeff; Brewer, Barbara

2011-01-01

Purpose We used Organization Risk Analyzer (ORA), a dynamic network analysis tool, to identify patient care unit communication patterns associated with patient safety and quality outcomes. Although ORA had previously had limited use in healthcare, we felt it could effectively model communication on patient care units. Methods Using a survey methodology, we collected communication network data from nursing staff on seven patient care units on two different days. Patient outcome data were collected via a separate survey. Results of the staff survey were used to represent the communication networks for each unit in ORA. We then used ORA's analysis capability to generate communication metrics for each unit. ORA's visualization capability was used to better understand the metrics. Results We identified communication patterns that correlated with two safety (falls and medication errors) and five quality (e.g., symptom management, complex self care, and patient satisfaction) outcome measures. Communication patterns differed substantially by shift. Conclusion The results demonstrate the utility of ORA for healthcare research and the relationship of nursing unit communication patterns to patient safety and quality outcomes. PMID:21536492

A M-Health Platform for Supporting Clinical Data Integration and Service Delivery: An Example from Augmentative and Alternative Communication Intervention

ERIC Educational Resources Information Center

Wang, Erh-Hsuan

2016-01-01

Improving the quality of healthcare while simultaneously reducing its overall costs remains a challenge. One of the recommended approaches for achieving this goal is to build high quality data collection and reporting systems to facilitate evidence-based practice (EBP), which emphasizes the importance of using the solid evidence available to make…

Information bias in contingent valuation: effects of personal relevance, quality of information, and motivational orientation

Treesearch

Icek Ajzen; Thomas C. Brown; Lori H. Rosenthal

1996-01-01

A laboratory experiment examined the potential for information bias in contingent valuation (CV). Consistent with the view that information about a public or private good can function as a persuasive communication, willingness to pay (WTP) was found to increase with the quality of arguments used to describe the good, especially under conditions of high personal...

An Energy-Efficient and High-Quality Video Transmission Architecture in Wireless Video-Based Sensor Networks.

PubMed

Aghdasi, Hadi S; Abbaspour, Maghsoud; Moghadam, Mohsen Ebrahimi; Samei, Yasaman

2008-08-04

Technological progress in the fields of Micro Electro-Mechanical Systems (MEMS) and wireless communications and also the availability of CMOS cameras, microphones and small-scale array sensors, which may ubiquitously capture multimedia content from the field, have fostered the development of low-cost limited resources Wireless Video-based Sensor Networks (WVSN). With regards to the constraints of videobased sensor nodes and wireless sensor networks, a supporting video stream is not easy to implement with the present sensor network protocols. In this paper, a thorough architecture is presented for video transmission over WVSN called Energy-efficient and high-Quality Video transmission Architecture (EQV-Architecture). This architecture influences three layers of communication protocol stack and considers wireless video sensor nodes constraints like limited process and energy resources while video quality is preserved in the receiver side. Application, transport, and network layers are the layers in which the compression protocol, transport protocol, and routing protocol are proposed respectively, also a dropping scheme is presented in network layer. Simulation results over various environments with dissimilar conditions revealed the effectiveness of the architecture in improving the lifetime of the network as well as preserving the video quality.

Power adaptive multi-filter carrierless amplitude and phase access scheme for visible light communication network

NASA Astrophysics Data System (ADS)

Li, Wei; Huang, Zhitong; Li, Haoyue; Ji, Yuefeng

2018-04-01

Visible light communication (VLC) is a promising candidate for short-range broadband access due to its integration of advantages for both optical communication and wireless communication, whereas multi-user access is a key problem because of the intra-cell and inter-cell interferences. In addition, the non-flat channel effect results in higher losses for users in high frequency bands, which leads to unfair qualities. To solve those issues, we propose a power adaptive multi-filter carrierless amplitude and phase access (PA-MF-CAPA) scheme, and in the first step of this scheme, the MF-CAPA scheme utilizing multiple filters as different CAP dimensions is used to realize multi-user access. The character of orthogonality among the filters in different dimensions can mitigate the effect of intra-cell and inter-cell interferences. Moreover, the MF-CAPA scheme provides different channels modulated on the same frequency bands, which further increases the transmission rate. Then, the power adaptive procedure based on MF-CAPA scheme is presented to realize quality fairness. As demonstrated in our experiments, the MF-CAPA scheme yields an improved throughput compared with multi-band CAP access scheme, and the PA-MF-CAPA scheme enhances the quality fairness and further improves the throughput compared with the MF-CAPA scheme.

The effect of communication skills training on quality of care, self-efficacy, job satisfaction and communication skills rate of nurses in hospitals of tabriz, iran.

PubMed

Khodadadi, Esmail; Ebrahimi, Hossein; Moghaddasian, Sima; Babapour, Jalil

2013-03-01

Having an effective relationship with the patient in the process of treatment is essential. Nurses must have communication skills in order to establish effective relationships with the patients. This study evaluated the impact of communication skills training on quality of care, self-efficacy, job satisfaction and communication skills of nurses. This is an experimental study with a control group that has been done in 2012. The study sample consisted of 73 nurses who work in hospitals of Tabriz; they were selected by proportional randomizing method. The intervention was only conducted on the experimental group. In order to measure the quality of care 160 patients, who had received care by nurses, participated in this study. The Data were analyzed by SPSS (ver.13). Comparing the mean scores of communication skills showed a statistically significant difference between control and experimental groups after intervention. The paired t-test showed a statistically significant difference in the experimental group before and after the intervention. Independent t-test showed a statistically significant difference between the rate of quality of care in patients of control and experimental groups after the intervention. The results showed that the training of communication skills can increase the nurse's rate of communication skills and cause elevation in quality of nursing care. Therefore, in order to improve the quality of nursing care it is recommended that communication skills be established and taught as a separate course in nursing education.

Drivers of Successful Bond and Operating Levies...Q4C at the Foundation.

ERIC Educational Resources Information Center

Lifto, Don E. Morris; Morris, William D.

2000-01-01

Improving a school's Q4C quotient (quality control, customer commitment, and communications) during election planning hinges on district mission, a culture of high expectations, basic skills mastery, commitment to customers, continuous feedback, healthy working relationships, broad community involvement, high- level strategic planning and…

Clinical Decision Support System to Enhance Quality Control of Spirometry Using Information and Communication Technologies

PubMed Central

2014-01-01

Background We recently demonstrated that quality of spirometry in primary care could markedly improve with remote offline support from specialized professionals. It is hypothesized that implementation of automatic online assessment of quality of spirometry using information and communication technologies may significantly enhance the potential for extensive deployment of a high quality spirometry program in integrated care settings. Objective The objective of the study was to elaborate and validate a Clinical Decision Support System (CDSS) for automatic online quality assessment of spirometry. Methods The CDSS was done through a three step process including: (1) identification of optimal sampling frequency; (2) iterations to build-up an initial version using the 24 standard spirometry curves recommended by the American Thoracic Society; and (3) iterations to refine the CDSS using 270 curves from 90 patients. In each of these steps the results were checked against one expert. Finally, 778 spirometry curves from 291 patients were analyzed for validation purposes. Results The CDSS generated appropriate online classification and certification in 685/778 (88.1%) of spirometry testing, with 96% sensitivity and 95% specificity. Conclusions Consequently, only 93/778 (11.9%) of spirometry testing required offline remote classification by an expert, indicating a potential positive role of the CDSS in the deployment of a high quality spirometry program in an integrated care setting. PMID:25600957

Communication Barriers in Quality Process: Sakarya University Sample

ERIC Educational Resources Information Center

Yalcin, Mehmet Ali

2012-01-01

Communication has an important role in life and especially in education. Nowadays, lots of people generally use technology for communication. When technology uses in education and other activities, there may be some communication barriers. And also, quality process has an important role in higher education institutes. If a higher education…

Strengthening the quality of longitudinal research into cognitive-communication recovery after traumatic brain injury: A systematic review.

PubMed

Elbourn, Elise; Togher, Leanne; Kenny, Belinda; Power, Emma

2017-02-01

(i) To systematically review longitudinal and prognostic studies relating to the trajectory of cognitive-communication recovery after TBI and (ii) to provide recommendations to strengthen future research. Thirteen health literature databases were accessed up until July 2014. Articles were screened systematically against pre-determined inclusion and exclusion criteria. Quality reviews were performed on the selected articles using a modified Downs & Black Rating Scale. Two independent reviewers performed the reviews. Sixteen longitudinal and prognostic articles met the inclusion criteria. There was evidence of either maintenance or improvement of cognitive-communication skills during the first 3 years post-injury. However, the studies did not provide detailed recovery trajectories, by failing to evaluate numerous data points over time. No studies evaluated recovery beyond 3 years post-injury. Injury severity, lesion location, brain volume loss and conversation skills may predict specific cognitive-communication outcomes. There was high variability in study characteristics and measures. There is currently scarce evidence regarding cognitive-communication recovery and prognosis. People with TBI may recover or maintain pre-morbid cognitive-communication skills during the early rehabilitation stage. Further research detailing the recovery trajectory with a view to evaluating predictive factors is strongly indicated. Guidelines for future research are provided.

Exclusion of Residents From Surgery-Intensive Care Team Communication: A Qualitative Study.

PubMed

Gotlib Conn, Lesley; Haas, Barbara; Rubenfeld, Gordon D; Scales, Damon C; Amaral, Andre C; Ferguson, Niall D; Nathens, Avery B

2016-01-01

Communication competency is an important aspect of postgraduate training and patient care delivery in all specialties and clinical domains. This study explored staff surgeon and intensivist perceptions of and experiences with residents' communication with a view toward fostering high quality interspecialty team communication in the surgical intensive care unit. A qualitative study using semistructured interviews. Data were analyzed iteratively and inductively as per standard qualitative thematic approach. University of Toronto, Toronto, Canada. A total of 15 staff surgeons and intensivists who collaborate in patient care in the surgical intensive care unit. The phenomenon of "resident bypass" emerged, resulting from staff surgeon and intensivist perceptions that residents threaten the quality of interspecialty team communication. Clear patterns and preferences for resident exclusion from this communication were present. A total of 5 interrelated drivers of resident bypass were discovered: lack of trust, lack of specialized knowledge, poor system design, need for timely communication, and residents' inadequate contribution to decision-making. Surgical and intensive care staff were dissatisfied with the structure of residents' roles in interspecialty team communication. Concerns about communication gaps, patient care continuity, and patient safety were expressed. Surgical and intensive care staff exclude residents from interspecialty team communication for the benefit of patient safety and care continuity, but this limits opportunities for residents to develop communication skill and competence. Efforts are needed to effectively integrate surgery and intensive care residents in interspecialty attending-resident communication in ways that are meaningful for both patient care and postgraduate training. The implications for medical education are discussed. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Communication in cancer care: psycho-social, interactional, and cultural issues. A general overview and the example of India.

PubMed

Chaturvedi, Santosh K; Strohschein, Fay J; Saraf, Gayatri; Loiselle, Carmen G

2014-01-01

Communication is a core aspect of psycho-oncology care. This article examines key psychosocial, cultural, and technological factors that affect this communication. Drawing from advances in clinical work and accumulating bodies of empirical evidence, the authors identify determining factors for high quality, efficient, and sensitive communication and support for those affected by cancer. Cancer care in India is highlighted as a salient example. Cultural factors affecting cancer communication in India include beliefs about health and illness, societal values, integration of spiritual care, family roles, and expectations concerning disclosure of cancer information, and rituals around death and dying. The rapidly emerging area of e-health significantly impacts cancer communication and support globally. In view of current globalization, understanding these multidimensional psychosocial, and cultural factors that shape communication are essential for providing comprehensive, appropriate, and sensitive cancer care.

Experiences with ATM in a multivendor pilot system at Forschungszentrum Julich

NASA Astrophysics Data System (ADS)

Kleines, H.; Ziemons, K.; Zwoll, K.

1998-08-01

The ATM technology for high speed serial transmission provides a new quality of communication by introducing novel features in a LAN environment, especially support of real time communication, of both LAN and WAN communication and of multimedia streams. In order to evaluate ATM for future DAQ systems and remote control systems as well as for a high speed picture archiving and communications system for medical images, Forschungszentrum Julich has build up a pilot system for the evaluation of ATM and standard low cost multimedia systems. It is a heterogeneous multivendor system containing a variety of switches and desktop solutions, employing different protocol options of ATM. The tests conducted in the pilot system revealed major difficulties regarding stability, interoperability and performance. The paper presents motivations, layout and results of the pilot system. Discussion of results concentrates on performance issues relevant for realistic applications, e.g., connection to a RAID system via NFS over ATM.

Visual Communications And Image Processing

NASA Astrophysics Data System (ADS)

Hsing, T. Russell; Tzou, Kou-Hu

1989-07-01

This special issue on Visual Communications and Image Processing contains 14 papers that cover a wide spectrum in this fast growing area. For the past few decades, researchers and scientists have devoted their efforts to these fields. Through this long-lasting devotion, we witness today the growing popularity of low-bit-rate video as a convenient tool for visual communication. We also see the integration of high-quality video into broadband digital networks. Today, with more sophisticated processing, clearer and sharper pictures are being restored from blurring and noise. Also, thanks to the advances in digital image processing, even a PC-based system can be built to recognize highly complicated Chinese characters at the speed of 300 characters per minute. This special issue can be viewed as a milestone of visual communications and image processing on its journey to eternity. It presents some overviews on advanced topics as well as some new development in specific subjects.

Patient Communication, Satisfaction, and Trust Before and After Use of a Standardized Birth Plan.

PubMed

Anderson, Clare-Marie; Monardo, Rosie; Soon, Reni; Lum, Jennifer; Tschann, Mary; Kaneshiro, Bliss

2017-11-01

The birth plan was developed as a way for pregnant women to communicate their desires and expectations for labor and delivery. Standardized birth plans have been used by some birth facilities as a communication tool. In this quality improvement project, we sought to describe communication, trust, and satisfaction scores after delivery in a group of patients who used a standardized birth plan. All pregnant women at 24 or more weeks of gestation were asked to complete a short, standardized birth plan. Communication, trust, and satisfaction were assessed before and after delivery. Descriptive analyses showed that communication, trust, and satisfaction scores were high following delivery. Scores for all three factors increased significantly following delivery though increases were modest. Most patients (84%) indicated they would use a birth plan with a subsequent delivery.

Quality of pharmaceutical care at the pharmacy counter: patients’ experiences versus video observation

PubMed Central

Koster, Ellen S; Blom, Lyda; Overbeeke, Marloes R; Philbert, Daphne; Vervloet, Marcia; Koopman, Laura; van Dijk, Liset

2016-01-01

Introduction Consumer Quality Index questionnaires are used to assess quality of care from patients’ experiences. Objective To provide insight into the agreement about quality of pharmaceutical care, measured both by a patient questionnaire and video observations. Methods Pharmaceutical encounters in four pharmacies were video-recorded. Patients completed a questionnaire based upon the Consumer Quality Index Pharmaceutical Care after the encounter containing questions about patients’ experiences regarding information provision, medication counseling, and pharmacy staff’s communication style. An observation protocol was used to code the recorded encounters. Agreement between video observation and patients’ experiences was calculated. Results In total, 109 encounters were included for analysis. For the domains “medication counseling” and “communication style”, agreement between patients’ experiences and observations was very high (>90%). Less agreement (45%) was found for “information provision”, which was rated more positive by patients compared to the observations, especially for the topic, encouragement of patients’ questioning behavior. Conclusion A questionnaire is useful to assess the quality of medication counseling and pharmacy staff’s communication style, but might be less suitable to evaluate information provision and pharmacy staff’s encouragement of patients’ questioning behavior. Although patients may believe that they have received all necessary information to use their new medicine, some information on specific instructions was not addressed during the encounter. When using questionnaires to get insight into information provision, observations of encounters are very informative to validate the patient questionnaires and make necessary adjustments. PMID:27042025

Strategies for improved French-language health services

PubMed Central

Gauthier, Alain P.; Timony, Patrick E.; Serresse, Suzanne; Goodale, Natalie; Prpic, Jason

2015-01-01

Abstract Objective To identify strategies to improve the quality of health services for Francophone patients. Design A series of semistructured key informant interviews. Setting Northeastern Ontario. Participants A total of 18 physicians were interviewed. Ten physicians were interviewed in French, 7 physicians were women, and 10 physicians were located in urban communities. Methods Purposive and snowball sampling strategies were used to conduct a series of semistructured key informant interviews with family physicians practising in communities with a large Francophone population. Principles of grounded theory were applied, guided by a framework for patient-professional communication. Results were inductively derived following an iterative data collection–data analysis process and were analyzed using a detailed thematic approach. Main findings Respondents identified several strategies for providing high-quality French-language health services. Some were unique to non–French-speaking physicians (eg, using appropriate interpreter services), some were unique to French-speaking physicians (eg, using a flexible dialect), and some strategies were common to all physicians serving French populations (eg, hiring bilingual staff or having pamphlets and posters in both French and English). Conclusion Physicians interviewed for this study provided high-quality health care by attributing substantial importance to effective communication. While linguistic patient-to-physician concordance is ideal, it might not always be possible. Thus, conscious efforts to attenuate communication barriers are necessary, and several effective strategies exist. PMID:26505060

Risk Communication of Groundwater Quality in Northern Malawi, Africa

NASA Astrophysics Data System (ADS)

Holm, R.

2011-12-01

Malawi lies in Africa's Great Rift Valley. Its western border is defined by Lake Malawi, the third largest lake in Africa. Over 80% of Malawians live in rural areas and 90% of the labor force is associated with agriculture. More than half of the population lives below the poverty line. Area characteristics indicate a high likelihood of nitrate and total coliform in community drinking water. Infants exposed to high nitrate are at risk of developing methemoglobinemia. In addition, diarrheal diseases from unsafe drinking water are one of the top causes of mortality in children under five. Without sufficient and sustainable supplies of clean water, these challenges will continue to threaten Malawi's ability to overcome the devastating impact of diarrheal diseases on its population. Therefore, Malawi remains highly dependent on outside assistance and influence to reduce or eliminate the threat posed by unsafe drinking water. This research presents a literature review of nitrate and total coliform groundwater quality and a proposed risk communication plan for drinking water in northern Malawi.

Low-Latency Telerobotics from Mars Orbit: The Case for Synergy Between Science and Human Exploration

NASA Technical Reports Server (NTRS)

Valinia, A.; Garvin, J. B.; Vondrak, R.; Thronson, H.; Lester, D.; Schmidt, G.; Fong, T.; Wilcox, B.; Sellers, P.; White, N.

2012-01-01

Initial, science-directed human exploration of Mars will benefit from capabilities in which human explorers remain in orbit to control telerobotic systems on the surface (Figure 1). Low-latency, high-bandwidth telerobotics (LLT) from Mars orbit offers opportunities for what the terrestrial robotics community considers to be high-quality telepresence. Such telepresence would provide high quality sensory perception and situation awareness, and even capabilities for dexterous manipulation as required for adaptive, informed selection of scientific samples [1]. Astronauts on orbit in close communication proximity to a surface exploration site (in order to minimize communication latency) represent a capability that would extend human cognition to Mars (and potentially for other bodies such as asteroids, Venus, the Moon, etc.) without the challenges, expense, and risk of putting those humans on hazardous surfaces or within deep gravity wells. Such a strategy may be consistent with goals for a human space flight program that, are currently being developed within NASA.

Ocean Wireless Networking and Real Time Data Management

NASA Astrophysics Data System (ADS)

Berger, J.; Orcutt, J. A.; Vernon, F. L.; Braun, H. W.; Rajasekar, A.

2001-12-01

Recent advances in technology have enabled the exploitation of satellite communications for high-speed (> 64 kbps) duplex communications with oceanographic ships at sea. Furthermore, decreasing costs for high-speed communications have made possible continuous connectivity to the global Internet for delivery of data ashore and communications with scientists and engineers on the ship. Through support from the Office of Naval Research, we have planned a series of tests using the R/V Revelle for real time data delivery of large quantities of underway data (e.g. continuous multibeam profiling) to shore for quality control, archiving, and real-time data availability. The Cecil H. and Ida M. Green Institute of Geophysics and Planetary Physics (IGPP) and the San Diego Supercomputer Center (SDSC) were funded by the NSF Information Technology Research (ITR) Program, the California Institute for Telecommunications and Information Technology [Cal-(IT)2] and the Scripps Institution of Oceanography for research entitled: "Exploring the Environment in Time: Wireless Networks & Real-Time Management." We will describe the technology to be used for the real-time seagoing experiment and the planned expansion of the project through support from the ITR grant. The short-term goal is to exercise the communications system aboard ship in various weather conditions and sea states while testing and developing the real-time data quality control and archiving methodology. The long-term goal is to enable continuous observations in the ocean, specifically supporting the goals of the DEOS (Dynamics of Earth and Ocean Systems) observatory program supported through a NSF Major Research Equipment (MRE) program - a permanent presence in the oceans. The impact on scientific work aboard ships, however, is likely to be fundamental. It will be possible to go to sea in the future with limited engineering capability for scientific operations by allowing shore-based quality control of data collected and videoconferencing for problem resolution. Costs for shipboard measurements will be reduced significantly while, at the same time, the quality of data collected will increase and ex-post-facto data archiving will no longer be necessary.

Analysis of Station Quality Issues from EarthScope's Transportable Array

NASA Astrophysics Data System (ADS)

Pfeifer, C.; Barstow, N.; Busby, R.; Hafner, K.

2008-12-01

160 of the first 400 Earthscope USARRY transportable array (TA) stations have completed their first two-year deployment and are being moved to their next locations. Over the past 4 years the majority of stations have run with few interruptions in the transfer of real time data to the Array Network Facility (ANF) at the Univ of CA San Diego and near real time data to the IRIS Data Management System (DMS). The combination of telemetered data and dedicated people reviewing the waveforms and state of health data have revealed several conditions that can affect the data quality or cause loss of data. The data problems fall into three broad categories; station power, equipment malfunction, and communication failures. Station power issues have been implicated in several types of noise seen in the seismic data (as well as causing station failures and resultant data gaps). The most common type of equipment problem that has been found to degrade data quality is caused by sensor problems, and has affected all 3 types of sensors used in the TA to varying degrees. While communication problems can cause real time data loss, they do not cause a degradation of the quality of the data, and any gaps in the real time data due solely to communications problems are filled in later with the continuous data recorded to disk at each TA station. Over the past 4 years the TA team has recognized a number of noise sources and have made several design changes to minimize the effects on data quality. Design/procedural changes include: stopping water incursion into the stations, power conditioning, changing mass re-center voltage thresholds. Figures that demonstrate examples are provided. Changes have created better data quality and improved the station performance. Vigilance and deployment of service teams to reestablish communications, replace noisy sensors, and troubleshoot problems is also key to maintaining the high-quality TA network.

Verification techniques for x-ray and mammography applications

NASA Astrophysics Data System (ADS)

Kotsopoulos, Stavros A.; Lymberopoulos, Dimitris C.

1993-07-01

The integration of Medical Information Environment demands the study and development of high speed data communication systems with special designed 'endsystems' (MWS, etc.) for flexible and reliable data transmission/reception, handling and manipulation. An important parameter which affects the overall system's performance is the 'quality factor' of the communicated medical data produced by a wide range of modern modalities. The present paper describes a set of tests, done in a medical communication network based on a teleworking platform, in order to optimize the sensitivity parameters of the modalities by remote fine re-adjustments guided by experts.

Radio speech communication problems reported in a survey of military pilots.

PubMed

Lahtinen, Taija M M; Huttunen, Kerttu H; Kuronen, Pentti O; Sorri, Martti J; Leino, Tuomo K

2010-12-01

Despite technological advances in conveying information, speech communication is still a key safety factor in aviation. Effective radio communication is necessary, for example, in building and maintaining good team situation awareness. However, little has been reported concerning the prevalence and nature of radio communication problems in everyday working environments in military aviation. We surveyed Finnish Defense Forces pilots regarding the prevalence of radio speech communication problems. Of the 225 pilots contacted, 75% replied to our survey. Altogether 138 of the respondents were fixed-wing pilots and 31 were helicopter pilots. Problems in radio communication occurred, on average, during 14% of flight time. The most prevalent problems were multiple speakers on the same radio frequency band causing overlapping speech, missing acknowledgments, high background noise especially during helicopter operations, and technical problems. Of the respondents, 18% (31 pilots) reported having encountered at least one potentially dangerous event caused by problems in radio communication during their military aviation career. If the employer were to offer extra hearing protection, such as custom-made ear plugs, 93% of the pilots indicated that they would use it. Communication can be a flight safety factor especially during intense air combat exercises and other information-loaded flights. During these situations, communication should be clear and focused on the most essential information. So, training and technical improvements are necessary for better communication. High quality radio speech communication also improves operational effectiveness in military aviation.

Architecture of distributed picture archiving and communication systems for storing and processing high resolution medical images

NASA Astrophysics Data System (ADS)

Tokareva, Victoria

2018-04-01

New generation medicine demands a better quality of analysis increasing the amount of data collected during checkups, and simultaneously decreasing the invasiveness of a procedure. Thus it becomes urgent not only to develop advanced modern hardware, but also to implement special software infrastructure for using it in everyday clinical practice, so-called Picture Archiving and Communication Systems (PACS). Developing distributed PACS is a challenging task for nowadays medical informatics. The paper discusses the architecture of distributed PACS server for processing large high-quality medical images, with respect to technical specifications of modern medical imaging hardware, as well as international standards in medical imaging software. The MapReduce paradigm is proposed for image reconstruction by server, and the details of utilizing the Hadoop framework for this task are being discussed in order to provide the design of distributed PACS as ergonomic and adapted to the needs of end users as possible.

Long-term persistence of quality improvements for an intensive care unit communication initiative using the VALUE strategy.

PubMed

Wysham, Nicholas G; Mularski, Richard A; Schmidt, David M; Nord, Shirley C; Louis, Deborah L; Shuster, Elizabeth; Curtis, J Randall; Mosen, David M

2014-06-01

Communication in the intensive care unit (ICU) is an important component of quality ICU care. In this report, we evaluate the long-term effects of a quality improvement (QI) initiative, based on the VALUE communication strategy, designed to improve communication with family members of critically ill patients. We implemented a multifaceted intervention to improve communication in the ICU and measured processes of care. Quality improvement components included posted VALUE placards, templated progress note inclusive of communication documentation, and a daily rounding checklist prompt. We evaluated care for all patients cared for by the intensivists during three separate 3 week periods, pre, post, and 3 years following the initial intervention. Care delivery was assessed in 38 patients and their families in the pre-intervention sample, 27 in the post-intervention period, and 41 in follow-up. Process measures of communication showed improvement across the evaluation periods, for example, daily updates increased from pre 62% to post 76% to current 84% of opportunities. Our evaluation of this quality improvement project suggests persistence and continued improvements in the delivery of measured aspects of ICU family communication. Maintenance with point-of-care-tools may account for some of the persistence and continued improvements. Copyright © 2014 Elsevier Inc. All rights reserved.

Risk communication in the hyperacute setting of stroke thrombolysis: an interview study of clinicians.

PubMed

Lie, M L S; Murtagh, M J; Watson, D Burges; Jenkings, K N; Mackintosh, J; Ford, G A; Thomson, R G

2015-05-01

Communicating treatment risks and benefits to patients and their carers is central to clinical practice in modern healthcare. We investigated the challenges of risk communication by clinicians offering thrombolytic therapy for hyperacute stroke where treatment must be administered rapidly to maximise benefit. Semistructured interviews with 13 clinicians from three acute stroke units involved in decision making and/or information provision about thrombolysis. We report on clinicians' accounts of communicating risks and benefits to patients and carers. Framework analysis was employed. We identified the major challenges facing clinicians in communicating risk in this context that is, disease complexity, patients' capacity and time constraints, and communicating quality of life after stroke. We found significant variation in the data on risks and benefits that clinicians provide, and ways these were communicated to patients. Clinicians' communication strategies varied and included practices such as: a phased approach to communicating information, being responsive to the patient and family and documenting information they gave to patients. Risk communication about thrombolysis involves complex uncertainties. We elucidate the challenges of effective risk communication in a hyperacute setting and identify the issues regarding variation in risk communication and the use of less effective formats for the communication of numerical risks and benefits. The paper identifies good practice, such as the phased transfer of information over the care pathway, and ways in which clinicians might be supported to overcome challenges. This includes standardised risk and benefit information alongside appropriate personalisation of risk communication. Effective risk communication in emergency settings requires presentation of high-quality data which is amenable to tailoring to individual patients' circumstances. It necessitates clinical skills development supported by personalised risk communication tools. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Shaking up the system: the role of change in maternal-adolescent communication quality and adolescent weight loss.

PubMed

Hadley, Wendy; McCullough, Mary Beth; Rancourt, Diana; Barker, David; Jelalian, Elissa

2015-01-01

The association between directly observed mother-adolescent weight-related communication quality and adolescent percent overweight within the context of an adolescent weight control study was examined. As part of a larger study examining the impact of a behavioral weight control intervention that included attention to parent-adolescent communication (Standard Behavioral Treatment + Enhanced Parenting, SBT + EP) compared with an efficacious Standard Behavioral Treatment (SBT), 38 mother-adolescent dyads participated in a weight-related videotaped discussion. Discussions were taped and collected pre- and postintervention. No significant differences emerged in the quality of mother-adolescent communication between SBT (n = 19) and SBT + EP (n = 19) participants, nor was baseline mother-adolescent communication quality associated with adolescents' weight loss in either condition. However, a decline in communication quality was associated with better outcomes for adolescents participating in the SBT group. This study provides preliminary evidence that a change in mother-adolescent communication is associated with successful weight loss among adolescents. © The Author 2014. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The Effect of Communication Skills Training on Quality of Care, Self-Efficacy, Job Satisfaction and Communication Skills Rate of Nurses in Hospitals of Tabriz, Iran

PubMed Central

Khodadadi, Esmail; Ebrahimi, Hossein; Moghaddasian, Sima; Babapour, Jalil

2013-01-01

Introduction: Having an effective relationship with the patient in the process of treatment is essential. Nurses must have communication skills in order to establish effective relationships with the patients. This study evaluated the impact of communication skills training on quality of care, self-efficacy, job satisfaction and communication skills of nurses. Methods: This is an experimental study with a control group that has been done in 2012. The study sample consisted of 73 nurses who work in hospitals of Tabriz; they were selected by proportional randomizing method. The intervention was only conducted on the experimental group. In order to measure the quality of care 160 patients, who had received care by nurses, participated in this study. The Data were analyzed by SPSS (ver.13). Results: Comparing the mean scores of communication skills showed a statistically significant difference between control and experimental groups after intervention. The paired t-test showed a statistically significant difference in the experimental group before and after the intervention. Independent t-test showed a statistically significant difference between the rate of quality of care in patients of control and experimental groups after the intervention. Conclusion: The results showed that the training of communication skills can increase the nurse's rate of communication skills and cause elevation in quality of nursing care. Therefore, in order to improve the quality of nursing care it is recommended that communication skills be established and taught as a separate course in nursing education. PMID:25276707

The Experience of Hospital Death: Assessing the Quality of Care at an Academic Medical Center.

PubMed

Carey, Elise C; Dose, Ann M; Humeniuk, Katherine M; Kuan, Yichen C; Hicks, Ashley D; Ottenberg, Abigale L; Tilburt, Jon C; Koenig, Barbara

2018-02-01

The quality of perimortem care received by patients who died at our hospitals was unknown. To describe the quality of hospital care experienced in the last week of life, as perceived by decedents' families. Telephone survey that included established measures and investigator-developed content. Large, tertiary care center known for high-quality, cost-effective care. Family members of 104 patients who died in-hospital (10% of annual deaths) over the course of 1 year. None. Participant perceptions of the decedent's care, including symptom management, personal care, communication, and care coordination. Decedents were mostly male (64%), white (96%), married (73%), and Christian (91%). Most survey participants were spouses of the decedent (68%); they were predominately white (98%), female (70%), and Christian (90%) and had a median age of 70 years (range, 35-91 years). Overall satisfaction was high. Pain, dyspnea, and anxiety or sadness were highly prevalent among decedents (73%, 73%, and 55%, respectively) but largely well managed. Most participants believed that decedents were treated respectfully and kindly by staff (87%) and that sufficient help was available to assist with medications and dressing changes (97%). Opportunities for improvement included management of decedents' anxiety or sadness (29%) and personal care (25%), emotional support of the family (57%), communication regarding decedents' illness (29%), and receiving contradictory or confusing information (33%). Despite high satisfaction with care overall, we identified important unmet needs. Addressing these gaps will improve the care of dying patients.

Communication Among Team Members Within the Patient-centered Medical Home and Patient Satisfaction With Providers: The Mediating Role of Patient-Provider Communication.

PubMed

Stockdale, Susan E; Rose, Danielle; Darling, Jill E; Meredith, Lisa S; Helfrich, Christian D; Dresselhaus, Timothy R; Roos, Philip; Rubenstein, Lisa V

2018-06-01

The Patient-centered Medical Home (PCMH) uses team-based care to improve patient outcomes, including satisfaction. The quality of patients' communication with their primary care providers (PCPs) is a key determinant of patient satisfaction. A shift to team-based care could disrupt the therapeutic relationship between patients and their PCPs and reduce patient satisfaction if communication and coordination among primary care team members is poor. Little is known about the relationship between intrateam communication within a PCMH and patient satisfaction with PCPs, and whether patient-provider communication might mediate this relationship. To examine the relationship between intrateam communication in a PCMH and patients' satisfaction with assigned PCPs, and whether patient-provider communication mediates this relationship. Cross-sectional surveys of Veterans Health Administration PCPs (2011-2012, n=149) matched with their assigned patients' surveys (n=3329). Mediation analyses using a nested data structure, controlling for patient and provider characteristics. Patient satisfaction with PCPs, patient-reported patient-provider communication, and PCP-reported intrateam communication within the PCMH. Intrateam communication and patient-provider communication were independently associated with patients' satisfaction with their PCPs. Patient-provider communication mediated 56% of the association between intrateam communication and patient satisfaction. Better intrateam communication combined with better patient-provider communication predicted high satisfaction (81%), compared with poor intrateam communication and poor patient-provider communication (22%). PCMH environments with better communication among team members are likely to experience better patient-provider communication and high patient satisfaction. PCMH practices with low ratings of patient satisfaction may need to look beyond individual PCPs to communication within and across teams.

Delivering effective science communication: advice from a professional science communicator.

PubMed

Illingworth, Sam

2017-10-01

Science communication is becoming ever more prevalent, with more and more scientists expected to not only communicate their research to a wider public, but to do so in an innovative and engaging manner. Given the other commitments that researchers and academics are required to fulfil as part of their workload models, it is unfair to be expect them to also instantly produce effective science communication events and activities. However, by thinking carefully about what it is that needs to be communicated, and why this is being done, it is possible to develop high-quality activities that are of benefit to both the audience and the communicator(s). In this paper, I present some practical advice for developing, delivering and evaluating effective science communication initiatives, based on over a decade of experience as being a professional science communicator. I provide advice regarding event logistics, suggestions on how to successfully market and advertise your science communication initiatives, and recommendations for establishing effective branding and legacy. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Analyzing communication errors in an air medical transport service.

PubMed

Dalto, Joseph D; Weir, Charlene; Thomas, Frank

2013-01-01

Poor communication can result in adverse events. Presently, no standards exist for classifying and analyzing air medical communication errors. This study sought to determine the frequency and types of communication errors reported within an air medical quality and safety assurance reporting system. Of 825 quality assurance reports submitted in 2009, 278 were randomly selected and analyzed for communication errors. Each communication error was classified and mapped to Clark's communication level hierarchy (ie, levels 1-4). Descriptive statistics were performed, and comparisons were evaluated using chi-square analysis. Sixty-four communication errors were identified in 58 reports (21% of 278). Of the 64 identified communication errors, only 18 (28%) were classified by the staff to be communication errors. Communication errors occurred most often at level 1 (n = 42/64, 66%) followed by level 4 (21/64, 33%). Level 2 and 3 communication failures were rare (, 1%). Communication errors were found in a fifth of quality and safety assurance reports. The reporting staff identified less than a third of these errors. Nearly all communication errors (99%) occurred at either the lowest level of communication (level 1, 66%) or the highest level (level 4, 33%). An air medical communication ontology is necessary to improve the recognition and analysis of communication errors. Copyright © 2013 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.

Communication after laryngectomy: an assessment of quality of life.

PubMed

Carr, M M; Schmidbauer, J A; Majaess, L; Smith, R L

2000-01-01

The purpose of this study was to examine quality of life in laryngectomees using different methods of communication. A survey was mailed to all the living laryngectomees in Nova Scotia. Patients were asked to rate their ability to communicate in a number of common situations, to rate their difficulty with several communication problems, and to complete the EORTC QLQ-C30 quality-of-life assessment tool. Sixty-two patients responded (return rate of 84%); 57% were using electrolaryngeal speech, 19% esophageal speech, and 8.5% tracheoesophageal speech. These groups were comparable with respect to age, sex, first language, education level, and years since laryngectomy. There were very few differences between these groups in ability to communicate in social situations and no difference in overall quality of life as measured by these scales. The most commonly cited problem was difficulty being heard in a noisy environment. Despite the fact that tracheoesophageal speech is objectively most intelligible, there does not seem to be a measurable improvement in quality of life or ability to communicate in everyday situations over electrolaryngeal or esophageal speakers.

Aggregative Learning Method and Its Application for Communication Quality Evaluation

NASA Astrophysics Data System (ADS)

Akhmetov, Dauren F.; Kotaki, Minoru

2007-12-01

In this paper, so-called Aggregative Learning Method (ALM) is proposed to improve and simplify the learning and classification abilities of different data processing systems. It provides a universal basis for design and analysis of mathematical models of wide class. A procedure was elaborated for time series model reconstruction and analysis for linear and nonlinear cases. Data approximation accuracy (during learning phase) and data classification quality (during recall phase) are estimated from introduced statistic parameters. The validity and efficiency of the proposed approach have been demonstrated through its application for monitoring of wireless communication quality, namely, for Fixed Wireless Access (FWA) system. Low memory and computation resources were shown to be needed for the procedure realization, especially for data classification (recall) stage. Characterized with high computational efficiency and simple decision making procedure, the derived approaches can be useful for simple and reliable real-time surveillance and control system design.

On the influence of latency estimation on dynamic group communication using overlays

NASA Astrophysics Data System (ADS)

Vik, Knut-Helge; Griwodz, Carsten; Halvorsen, Pål

2009-01-01

Distributed interactive applications tend to have stringent latency requirements and some may have high bandwidth demands. Many of them have also very dynamic user groups for which all-to-all communication is needed. In online multiplayer games, for example, such groups are determined through region-of-interest management in the application. We have investigated a variety of group management approaches for overlay networks in earlier work and shown that several useful tree heuristics exist. However, these heuristics require full knowledge of all overlay link latencies. Since this is not scalable, we investigate the effects that latency estimation techqniues have ton the quality of overlay tree constructions. We do this by evaluating one example of our group management approaches in Planetlab and examing how latency estimation techqniues influence their quality. Specifically, we investigate how two well-known latency estimation techniques, Vivaldi and Netvigator, affect the quality of tree building.

A Reliable Wireless Control System for Tomato Hydroponics

PubMed Central

Ibayashi, Hirofumi; Kaneda, Yukimasa; Imahara, Jungo; Oishi, Naoki; Kuroda, Masahiro; Mineno, Hiroshi

2016-01-01

Agricultural systems using advanced information and communication (ICT) technology can produce high-quality crops in a stable environment while decreasing the need for manual labor. The system collects a wide variety of environmental data and provides the precise cultivation control needed to produce high value-added crops; however, there are the problems of packet transmission errors in wireless sensor networks or system failure due to having the equipment in a hot and humid environment. In this paper, we propose a reliable wireless control system for hydroponic tomato cultivation using the 400 MHz wireless band and the IEEE 802.15.6 standard. The 400 MHz band, which is lower than the 2.4 GHz band, has good obstacle diffraction, and zero-data-loss communication is realized using the guaranteed time-slot method supported by the IEEE 802.15.6 standard. In addition, this system has fault tolerance and a self-healing function to recover from faults such as packet transmission failures due to deterioration of the wireless communication quality. In our basic experiments, the 400 MHz band wireless communication was not affected by the plants’ growth, and the packet error rate was less than that of the 2.4 GHz band. In summary, we achieved a real-time hydroponic liquid supply control with no data loss by applying a 400 MHz band WSN to hydroponic tomato cultivation. PMID:27164105

A Reliable Wireless Control System for Tomato Hydroponics.

PubMed

Ibayashi, Hirofumi; Kaneda, Yukimasa; Imahara, Jungo; Oishi, Naoki; Kuroda, Masahiro; Mineno, Hiroshi

2016-05-05

Agricultural systems using advanced information and communication (ICT) technology can produce high-quality crops in a stable environment while decreasing the need for manual labor. The system collects a wide variety of environmental data and provides the precise cultivation control needed to produce high value-added crops; however, there are the problems of packet transmission errors in wireless sensor networks or system failure due to having the equipment in a hot and humid environment. In this paper, we propose a reliable wireless control system for hydroponic tomato cultivation using the 400 MHz wireless band and the IEEE 802.15.6 standard. The 400 MHz band, which is lower than the 2.4 GHz band, has good obstacle diffraction, and zero-data-loss communication is realized using the guaranteed time-slot method supported by the IEEE 802.15.6 standard. In addition, this system has fault tolerance and a self-healing function to recover from faults such as packet transmission failures due to deterioration of the wireless communication quality. In our basic experiments, the 400 MHz band wireless communication was not affected by the plants' growth, and the packet error rate was less than that of the 2.4 GHz band. In summary, we achieved a real-time hydroponic liquid supply control with no data loss by applying a 400 MHz band WSN to hydroponic tomato cultivation.

Quality of Parent-Adolescent Conversations About Sex and Adolescent Sexual Behavior: An Observational Study.

PubMed

Rogers, Adam A; Ha, Thao; Stormshak, Elizabeth A; Dishion, Thomas J

2015-08-01

Studies suggest that the quality of parent-adolescent communication about sex uniquely predicts adolescent sexual behavior. Previous studies have relied predominantly on self-report data. Observational methods, which are not susceptible to self-report biases, may be useful in examining the associations between the quality of parent-adolescent communication about sex and adolescent sexual behavior more objectively. With a sample of adolescents (N = 55, 58% male, 44% white, Mage = 15.8) and their parents, we used hierarchical logistic regression analyses to examine the associations between the observed quality of parent-adolescent communication about dating and sex and the likelihood of adolescents' sexual intercourse. The quality of parent-adolescent communication about dating and sex predicted sexual behavior. Specifically, lecturing was associated with a higher likelihood of adolescents having had sexual intercourse. The quality of parent-adolescent communication about sex is a unique correlate of adolescent sexual behavior and warrants further investigation. Thus, it serves as a potential target of preventive interventions that aim to foster adolescent sexual health behaviors. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Quality of Parent-Adolescent Conversations about Sex and Adolescent Sexual Behavior: An Observational Study

PubMed Central

Rogers, Adam A.; Ha, Thao; Stormshak, Elizabeth A.; Dishion, Thomas J.

2015-01-01

PURPOSE Studies suggest that the quality of parent-adolescent communication about sex uniquely predicts adolescent sexual behavior. Previous studies have relied predominantly on self-report data. Observational methods, which are not susceptible to self-report biases, may be useful in examining the associations between the quality of parent-adolescent communication about sex and adolescent sexual behavior more objectively. METHOD With a sample of adolescents (N = 55, 58% male, 44% White, Mage = 15.8) and their parents, we used hierarchical logistic regression analyses to examine the associations between the observed quality of parent-adolescent communication about dating and sex and the likelihood of adolescents’ sexual intercourse. RESULTS The quality of parent-adolescent communication about dating and sex predicted sexual behavior. Specifically, lecturing was associated with a higher likelihood of adolescents having had sexual intercourse. CONCLUSIONS The quality of parent-adolescent communication about sex is a unique correlate of adolescent sexual behavior and warrants further investigation. Thus, it serves as a potential target of preventive interventions that aim to foster adolescent sexual health behaviors. PMID:26206438

Low-quality birds do not display high-quality signals: The cysteine-pheomelanin mechanism of honesty

PubMed Central

Galván, Ismael; Wakamatsu, Kazumasa; Camarero, Pablo R; Mateo, Rafael; Alonso-Alvarez, Carlos

2015-01-01

The mechanisms that make that the costs of producing high-quality signals are unaffordable to low-quality signalers are a current issue in animal communication. The size of the melanin-based bib of male house sparrows Passer domesticus honestly signals quality. We induced the development of new bibs while treating males with buthionine-sulfoximine (BSO), a substance that depletes the levels of the antioxidant glutathione (GSH) and the amino acid cysteine, two elements that switch melanogenesis from eumelanin to pheomelanin. Final bib size is negatively related to pheomelanin levels in the bib feathers. BSO reduced cysteine and GSH levels in all birds, but improved phenotypes (bibs larger than controls) were only expressed by high-quality birds (BSO birds with largest bibs initially). Negative associations between final bib size and cysteine levels in erythrocytes, and between pheomelanin and cysteine levels, were observed in high-quality birds only. These findings suggest that a mechanism uncoupling pheomelanin and cysteine levels may have evolved in low-quality birds to avoid producing bibs of size not corresponding to their quality and greater relative costs. Indeed, greater oxidative stress in cells was not observed in low-quality birds. This may represent the first mechanism maintaining signal honesty without producing greater relative costs on low-quality signalers. PMID:25330349

77 FR 59024 - Excepted Service

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-25

... (Communications). Quality. Council on Special Assistant EQ120006 7/6/2012 Environmental Public Engagement. Quality.... Strategic Communications. Office of the Public Affairs and DM120151 7/30/2012 Assistant Strategic Secretary for Communications Public Affairs. Assistant. Office of the Under Special Assistant.. DM120155 7/30...

Using a Teaching Intervention and Calibrated Peer Review™ Diagnostics to Improve Visual Communication Skills.

PubMed

Saterbak, Ann; Moturu, Anoosha; Volz, Tracy

2018-03-01

Rice University's bioengineering department incorporates written, oral, and visual communication instruction into its undergraduate curriculum to aid student learning and to prepare students to communicate their knowledge and discoveries precisely and persuasively. In a tissue culture lab course, we used a self- and peer-review tool called Calibrated Peer Review™ (CPR) to diagnose student learning gaps in visual communication skills on a poster assignment. We then designed an active learning intervention that required students to practice the visual communication skills that needed improvement and used CPR to measure the changes. After the intervention, we observed that students performed significantly better in their ability to develop high quality graphs and tables that represent experimental data. Based on these outcomes, we conclude that guided task practice, collaborative learning, and calibrated peer review can be used to improve engineering students' visual communication skills.

Wireless communication link for capsule endoscope at 600 MHz.

PubMed

Khaleghi, A; Balasingham, I

2015-01-01

Simulation of a wireless communication link for a capsule endoscopy is presented for monitoring of small intestine in humans. The realized communication link includes the transmitting capsule antenna, the outside body receiving antenna and the model of the human body. The capsule antenna is designed for operating at the frequency band of 600 MHz with an impedance bandwidth of 10 MHz and omnidirectional radiation pattern. The quality of the communication link is improved by using directive antenna outside body inside matching layer for electromagnetic wave tuning to the body. The outside body antenna has circular polarization that guaranteeing the communication link for different orientations of the capsule inside intestine. It is shown that the path loss for the capsule in 60 mm from the abdomen surface varies between 37-47 dB in relation to the antenna orientation. This link can establish high data rate wireless communications for capsule endoscopy.

Creating a Highly Reliable Neonatal Intensive Care Unit Through Safer Systems of Care.

PubMed

Panagos, Patoula G; Pearlman, Stephen A

2017-09-01

Neonates requiring intensive care are at high risk for medical errors due to their unique characteristics and high acuity. Designing a safer work environment begins with safe processes. Creating a culture of safety demands the involvement of all organizational levels and an interdisciplinary approach. Adverse events can result from suboptimal communication and lack of a shared mental model. This chapter describes tools to promote better patient safety in the NICU through monitoring adverse events, improving communication and using information technology. Unplanned extubation is an example of a neonatal safety concern that can be reduced by employing quality improvement methodology. Copyright © 2017 Elsevier Inc. All rights reserved.

Automated ground-water monitoring with Robowell: case studies and potential applications

NASA Astrophysics Data System (ADS)

Granato, Gregory E.; Smith, Kirk P.

2002-02-01

Robowell is an automated system and method for monitoring ground-water quality. Robowell meets accepted manual- sampling protocols without high labor and laboratory costs. Robowell periodically monitors and records water-quality properties and constituents in ground water by pumping a well or multilevel sampler until one or more purge criteria have been met. A record of frequent water-quality measurements from a monitoring site can indicate changes in ground-water quality and can provide a context for the interpretation of laboratory data from discrete samples. Robowell also can communicate data and system performance through a remote communication link. Remote access to ground-water data enables the user to monitor conditions and optimize manual sampling efforts. Six Robowell prototypes have successfully monitored ground-water quality during all four seasons of the year under different hydrogeologic conditions, well designs, and geochemical environments. The U.S. Geological Survey is seeking partners for research with robust and economical water-quality monitoring instruments designed to measure contaminants of concern in conjunction with the application and commercialization of the Robowell technology. Project publications and information about technology transfer opportunities are available on the Internet at URL http://ma.water.usgs.gov/automon/

Automated ground-water monitoring with robowell-Case studies and potential applications

USGS Publications Warehouse

Granato, G.E.; Smith, K.P.; ,

2001-01-01

Robowell is an automated system and method for monitoring ground-water quality. Robowell meets accepted manual-sampling protocols without high labor and laboratory costs. Robowell periodically monitors and records water-quality properties and constituents in ground water by pumping a well or multilevel sampler until one or more purge criteria have been met. A record of frequent water-quality measurements from a monitoring site can indicate changes in ground-water quality and can provide a context for the interpretation of laboratory data from discrete samples. Robowell also can communicate data and system performance through a remote communication link. Remote access to ground-water data enables the user to monitor conditions and optimize manual sampling efforts. Six Robowell prototypes have successfully monitored ground-water quality during all four seasons of the year under different hydrogeologic conditions, well designs, and geochemical environments. The U.S. Geological Survey is seeking partners for research with robust and economical water-quality monitoring instruments designed to measure contaminants of concern in conjunction with the application and commercialization of the Robowell technology. Project publications and information about technology transfer opportunities are available on the Internet at URL http://ma.water.usgs.gov/automon/.

Development and evaluation of an interprofessional communication intervention to improve family outcomes in the ICU.

PubMed

Curtis, J Randall; Ciechanowski, Paul S; Downey, Lois; Gold, Julia; Nielsen, Elizabeth L; Shannon, Sarah E; Treece, Patsy D; Young, Jessica P; Engelberg, Ruth A

2012-11-01

The intensive care unit (ICU), where death is common and even survivors of an ICU stay face the risk of long-term morbidity and re-admissions to the ICU, represents an important setting for improving communication about palliative and end-of-life care. Communication about the goals of care in this setting should be a high priority since studies suggest that the current quality of ICU communication is often poor and is associated with psychological distress among family members of critically ill patients. This paper describes the development and evaluation of an intervention designed to improve the quality of care in the ICU by improving communication among the ICU team and with family members of critically ill patients. We developed a multi-faceted, interprofessional intervention based on self-efficacy theory. The intervention involves a "communication facilitator" - a nurse or social worker - trained to facilitate communication among the interprofessional ICU team and with the critically ill patient's family. The facilitators are trained using three specific content areas: a) evidence-based approaches to improving clinician-family communication in the ICU, b) attachment theory allowing clinicians to adapt communication to meet individual family member's communication needs, and c) mediation to facilitate identification and resolution of conflict including clinician-family, clinician-clinician, and intra-family conflict. The outcomes assessed in this randomized trial focus on psychological distress among family members including anxiety, depression, and post-traumatic stress disorder at 3 and 6 months after the ICU stay. This manuscript also reports some of the lessons that we have learned early in this study. Copyright © 2012 Elsevier Inc. All rights reserved.

Development and evaluation of an interprofessional communication intervention to improve family outcomes in the ICU☆, ☆☆

PubMed Central

Curtis, J. Randall; Ciechanowski, Paul S.; Downey, Lois; Gold, Julia; Nielsen, Elizabeth L.; Shannon, Sarah E.; Treece, Patsy D.; Young, Jessica P.; Engelberg, Ruth A.

2013-01-01

The intensive care unit (ICU), where death is common and even survivors of an ICU stay face the risk of long-term morbidity and re-admissions to the ICU, represents an important setting for improving communication about palliative and end-of-life care. Communication about the goals of care in this setting should be a high priority since studies suggest that the current quality of ICU communication is often poor and is associated with psychological distress among family members of critically ill patients. This paper describes the development and evaluation of an intervention designed to improve the quality of care in the ICU by improving communication among the ICU team and with family members of critically ill patients. We developed a multi-faceted, interprofessional intervention based on self-efficacy theory. The intervention involves a “communication facilitator” – a nurse or social worker – trained to facilitate communication among the interprofessional ICU team and with the critically ill patient’s family. The facilitators are trained using three specific content areas: a) evidence-based approaches to improving clinician–family communication in the ICU, b) attachment theory allowing clinicians to adapt communication to meet individual family member’s communication needs, and c) mediation to facilitate identification and resolution of conflict including clinician–family, clinician–clinician, and intra-family conflict. The outcomes assessed in this randomized trial focus on psychological distress among family members including anxiety, depression, and post-traumatic stress disorder at 3 and 6 months after the ICU stay. This manuscript also reports some of the lessons that we have learned early in this study. PMID:22772089

Studies of Physician-Patient Communication with Older Patients: How Often is Hearing Loss Considered? A Systematic Literature Review.

PubMed

Cohen, Jamie M; Blustein, Jan; Weinstein, Barbara E; Dischinger, Hannah; Sherman, Scott; Grudzen, Corita; Chodosh, Joshua

2017-08-01

Hearing loss is remarkably prevalent in the geriatric population: one-quarter of adults aged 60-69 and 80% of adults aged 80 years and older have bilateral disabling loss. Only about one in five adults with hearing loss wears a hearing aid, leaving many vulnerable to poor communication with healthcare providers. We quantified the extent to which hearing loss is mentioned in studies of physician-patient communication with older patients, and the degree to which hearing loss is incorporated into analyses and findings. We conducted a structured literature search within PubMed for original studies of physician-patient communication with older patients that were published since 2000, using the natural language phrase "older patient physician communication." We identified 409 papers in the initial search, and included 67 in this systematic review. Of the 67 papers, only 16 studies (23.9%) included any mention of hearing loss. In six of the 16 studies, hearing loss was mentioned only; in four studies, hearing loss was used as an exclusion criterion; and in two studies, the extent of hearing loss was measured and reported for the sample, with no further analysis. Three studies examined or reported on an association between hearing loss and the quality of physician-patient communication. One study included an intervention to temporarily mitigate hearing loss to improve communication. Less than one-quarter of studies of physician-elderly patient communication even mention that hearing loss may affect communication. Methodologically, this means that many studies may have omitted an important potential confounder. Perhaps more importantly, research in this field has largely overlooked a highly prevalent, important, and remediable influence on the quality of communication. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Implementation of Patient Decision Support Interventions in Primary Care: The Role of Relational Coordination.

PubMed

Tietbohl, Caroline K; Rendle, Katharine A S; Halley, Meghan C; May, Suepattra G; Lin, Grace A; Frosch, Dominick L

2015-11-01

The benefits of patient decision support interventions (DESIs) have been well documented. However, DESIs remain difficult to incorporate into clinical practice. Relational coordination (RC) has been shown to improve performance and quality of care in health care settings. This study aims to demonstrate how applying RC theory to DESI implementation could elucidate underlying issues limiting widespread uptake. Five primary care clinics in Northern California participated in a DESI implementation project. We used a deductive thematic approach guided by behaviors outlined in RC theory to analyze qualitative data collected from ethnographic field notes documenting the implementation process and focus groups with health care professionals. We then systematically compared the qualitative findings with quantitative DESI distribution data. Based on DESI distribution rates, clinics were placed into 3 performance categories: high, middle, and low. Qualitative data illustrated how each clinic's performance related to RC behaviors. Consistent with RC theory, the high-performing clinic exhibited frequent, timely, and accurate communication and positive working relationships. The 3 middle-performing clinics exhibited high-quality communication within physician-staff teams but limited communication regarding DESI implementation across the clinic. The lowest-performing clinic was characterized by contentious relationships and inadequate communication. Limitations of the study include nonrandom selection of clinics and limited geographic diversity. In addition, ethnographic data collected documented only DESI implementation practices and not larger staff interactions contributing to RC. These findings suggest that a high level of RC within clinical settings may be a key component and facilitator of successful DESI implementation. Future attempts to integrate DESIs into clinical practice should consider incorporating interventions designed to increase positive RC behaviors as a potential means to improve uptake. © The Author(s) 2015.

Sexual communication, sexual satisfaction, and relationship quality in people with multiple sclerosis.

PubMed

Valvano, Abbey K; Rollock, Michael J D; Hudson, William H; Goodworth, Marie-Christine Rutter; Lopez, Eliot; Stepleman, Lara

2018-05-01

This study sought to explore relationships between sexual satisfaction, sexual communication and relationship satisfaction in people living with multiple sclerosis (MS). Specifically, sexual satisfaction was evaluated as a moderator between sexual communication and relationship satisfaction. Individuals diagnosed with MS and being treated in a hospital-based MS clinic in the southeastern United States (n = 58) completed measures of sexual satisfaction, sexual communication, sexual dysfunction, relationship quality, depression, level of disability, and frequency of sex-related communication and behaviors in a cross-sectional survey design. Sexual satisfaction moderated the relationship between quality of sexual communication and relationship quality, controlling for depression and frequency of sexual behavior and sexual communication. Directionality was examined in a 2nd regression analysis, in which the predictor and outcome variables were switched, which was also significant. Additionally, depression most strongly predicted relationship dissatisfaction. Findings help to establish sexual satisfaction as a moderator between sexual communication and relationship satisfaction, although directionality cannot be supported. Results also highlight the role of depression in overall relationship functioning and support the biopsychosocial model of care for treatment of sexual dysfunction in people living with MS. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Mode of Communication, Perceived Level of Understanding, and Perceived Quality of Life in Youth Who Are Deaf or Hard of Hearing

ERIC Educational Resources Information Center

Kushalnagar, P.; Topolski, T. D.; Schick, B.; Edwards, T. C.; Skalicky, A. M.; Patrick, D. L.

2011-01-01

Given the important role of parent-youth communication in adolescent well-being and quality of life, we sought to examine the relationship between specific communication variables and youth perceived quality of life in general and as a deaf or hard-of-hearing (DHH) individual. A convenience sample of 230 youth (mean age = 14.1, standard deviation…

Measurement of laser spot quality

NASA Technical Reports Server (NTRS)

Milster, T. D.; Treptau, J. P.

1991-01-01

Several ways of measuring spot quality are compared. We examine in detail various figures of merit such as full width at half maximum (FWHM), full width at 1/(e exp 2) maximum, Strehl ratio, and encircled energy. Our application is optical data storage, but results can be applied to other areas like space communications and high energy lasers. We found that the optimum figure of merit in many cases is Strehl ratio.

Daily communication, conflict resolution, and marital quality in Chinese marriage: A three-wave, cross-lagged analysis.

PubMed

Li, Xiaomin; Cao, Hongjian; Zhou, Nan; Ju, Xiaoyan; Lan, Jing; Zhu, Qinyi; Fang, Xiaoyi

2018-05-17

Based on three annual waves of data obtained from 268 Chinese couples in the early years of marriage and using a three-wave, cross-lagged approach, the present study examined the associations among daily marital communication, marital conflict resolution, and marital quality. Results indicated unidirectional associations linking daily marital communication or marital conflict resolution to marital quality (instead of reciprocal associations); and when considered simultaneously in a single model, daily marital communication and marital conflict resolution explained variance in marital quality above and beyond each other. Furthermore, the authors also found a significant longitudinal, indirect association linking husbands' daily marital communication at Wave 1 to husbands' marital quality at Wave 3 via husbands' marital conflict resolution at Wave 2. Taken altogether, the current study adds to an emerging body of research aimed at clarifying: (a) the directionality of the associations between couple interactive processes and marital well-being; (b) the unique roles of daily marital communication and marital conflict resolution in predicting marital outcomes; and (c) how daily marital communication and marital conflict resolution may operate in conjunction with each other to shape the development of couple relationship well-being. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

High-performing trauma teams: frequency of behavioral markers of a shared mental model displayed by team leaders and quality of medical performance.

PubMed

Johnsen, Bjørn Helge; Westli, Heidi Kristina; Espevik, Roar; Wisborg, Torben; Brattebø, Guttorm

2017-11-10

High quality team leadership is important for the outcome of medical emergencies. However, the behavioral marker of leadership are not well defined. The present study investigated frequency of behavioral markers of shared mental models (SMM) on quality of medical management. Training video recordings of 27 trauma teams simulating emergencies were analyzed according to team -leader's frequency of shared mental model behavioral markers. The results showed a positive correlation of quality of medical management with leaders sharing information without an explicit demand for the information ("push" of information) and with leaders communicating their situational awareness (SA) and demonstrating implicit supporting behavior. When separating the sample into higher versus lower performing teams, the higher performing teams had leaders who displayed a greater frequency of "push" of information and communication of SA and supportive behavior. No difference was found for the behavioral marker of team initiative, measured as bringing up suggestions to other teammembers. The results of this study emphasize the team leader's role in initiating and updating a team's shared mental model. Team leaders should also set expectations for acceptable interaction patterns (e.g., promoting information exchange) and create a team climate that encourages behaviors, such as mutual performance monitoring, backup behavior, and adaptability to enhance SMM.

47 CFR 1.7000 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false Purpose. 1.7000 Section 1.7000 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Implementation of Section 706 of... telecommunications capability that enables users to originate and receive high-quality voice, data, graphics, and...

Limits on quality of life in communication after total laryngectomy

PubMed Central

Chaves, Adriana Di Donato; Pernambuco, Leandro de Araújo; Balata, Patrícia Maria Mendes; Santos, Veridiana da Silva; de Lima, Leilane Maria; de Souza, Síntia Ribeiro; da Silva, Hilton Justino

2012-01-01

Summary Introduction: Among people affected by cancer, the impairment of quality of life of people affected by cancer can cause have devastating effects. The self-image of patients after post-laryngectomyzed patients may be find themselves compromised, affecting the quality of life in this population. Objective: To characterize quality of life in related to communication in people who have undergone went total laryngectomy surgery. Methods: This is an observational study, with a cross-sectional and descriptive series. Design of series study. The sample were comprised 15 patients interviewed the period from January to February of 2011. We used the Quality Protocol for Life Communication in Post-laryngectomy adapted from Bertocello (2004); which this questionnaire contains 55 questions. The protocol was organized from the nature of using responses classified as positive and negative aspects, proposals in with respect to five 5 communication domains: family relationships, social relationships, personal analysis; morphofunctional aspect, and use of writing. To promote and guarantee the autonomy of the respondents, was examiners made use of used assistive technology with the Visual Response Scale. Results: The responses that total laryngectomy compromises the quality of life in communication amounted to 463 occurrences (65.7%), and that who responses suggesting good quality of life were represented with amounted to 242 occurrences (34.3%), from a total of 705 occurrencesresponses. From Among the five 5 Communication domains, four 4 had percentages of above 63% for occurrences of negative content for impact on communication. Appearance Morphofunctional appearance gave the had the highest percentage of negative content, amounting to 77.3% of cases. Conclusions: The results showed important limitations of a personal and social nature due to poor communication with their peers. Thus, there is a need for multidisciplinary interventions that aim to minimize the entrapment of negative impact on these people communication among these patients. PMID:25991977

Limits on quality of life in communication after total laryngectomy.

PubMed

Chaves, Adriana Di Donato; Pernambuco, Leandro de Araújo; Balata, Patrícia Maria Mendes; Santos, Veridiana da Silva; de Lima, Leilane Maria; de Souza, Síntia Ribeiro; da Silva, Hilton Justino

2012-10-01

 Among people affected by cancer, the impairment of quality of life of people affected by cancer can cause have devastating effects. The self-image of patients after post-laryngectomyzed patients may be find themselves compromised, affecting the quality of life in this population.  To characterize quality of life in related to communication in people who have undergone went total laryngectomy surgery.  This is an observational study, with a cross-sectional and descriptive series. Design of series study. The sample were comprised 15 patients interviewed the period from January to February of 2011. We used the Quality Protocol for Life Communication in Post-laryngectomy adapted from Bertocello (2004); which this questionnaire contains 55 questions. The protocol was organized from the nature of using responses classified as positive and negative aspects, proposals in with respect to five 5 communication domains: family relationships, social relationships, personal analysis; morphofunctional aspect, and use of writing. To promote and guarantee the autonomy of the respondents, was examiners made use of used assistive technology with the Visual Response Scale.  The responses that total laryngectomy compromises the quality of life in communication amounted to 463 occurrences (65.7%), and that who responses suggesting good quality of life were represented with amounted to 242 occurrences (34.3%), from a total of 705 occurrencesresponses. From Among the five 5 Communication domains, four 4 had percentages of above 63% for occurrences of negative content for impact on communication. Appearance Morphofunctional appearance gave the had the highest percentage of negative content, amounting to 77.3% of cases.  The results showed important limitations of a personal and social nature due to poor communication with their peers. Thus, there is a need for multidisciplinary interventions that aim to minimize the entrapment of negative impact on these people communication among these patients.

Effect of Promoting High-Quality Staff Interactions on Fall Prevention in Nursing Homes: A Cluster-Randomized Trial.

PubMed

Colón-Emeric, Cathleen S; Corazzini, Kirsten; McConnell, Eleanor S; Pan, Wei; Toles, Mark; Hall, Rasheeda; Cary, Michael P; Batchelor-Murphy, Melissa; Yap, Tracey; Anderson, Amber L; Burd, Andrew; Amarasekara, Sathya; Anderson, Ruth A

2017-11-01

New approaches are needed to enhance implementation of complex interventions for geriatric syndromes such as falls. To test whether a complexity science-based staff training intervention (CONNECT) promoting high-quality staff interactions improves the impact of an evidence-based falls quality improvement program (FALLS). Cluster-randomized trial in 24 nursing homes receiving either CONNECT followed by FALLS (intervention), or FALLS alone (control). Nursing home staff in all positions were asked to complete surveys at baseline, 3, 6, and 9 months. Medical records of residents with at least 1 fall in the 6-month pre- and postintervention windows (n = 1794) were abstracted for fall risk reduction measures, falls, and injurious falls. CONNECT taught staff to improve their connections with coworkers, increase information flow, and use cognitive diversity in problem solving. Intervention components included 2 classroom sessions, relationship mapping, and self-monitoring. FALLS provided instruction in the Agency for Healthcare Research and Quality's Falls Management Program. Primary outcomes were (1) mean number of fall risk reduction activities documented within 30 days of falls and (2) median fall rates among residents with at least 1 fall during the study period. In addition, validated scales measured staff communication quality, frequency, timeliness, and safety climate. Surveys were completed by 1545 staff members, representing 734 (37%) and 811 (44%) of eligible staff in intervention and control facilities, respectively; 511 (33%) respondents were hands-on care workers. Neither the CONNECT nor the FALLS-only facilities improved the mean count of fall risk reduction activities following FALLS (3.3 [1.6] vs 3.2 [1.5] of 10); furthermore, adjusted median recurrent fall rates did not differ between the groups (4.06 [interquartile range {IQR}, 2.03-8.11] vs 4.06 [IQR, 2.04-8.11] falls/resident/y). A modest improvement in staff communication measures was observed overall (mean, 0.03 [SE, 0.01] points on a 5-point scale; P = .03) and for communication timeliness (mean, 0.8 [SE, 0.03] points on a 5-point scale; P = .02). There was wide variation across facilities in intervention penetration. An intervention targeting gaps in staff communication and coordination did not improve the impact of a falls quality improvement program. New approaches to implementing evidence-based care for complex conditions in the nursing home are urgently needed. clinicaltrials.gov Identifier: NCT00636675.

Validation of a model of family caregiver communication types and related caregiver outcomes.

PubMed

Wittenberg, Elaine; Kravits, Kate; Goldsmith, Joy; Ferrell, Betty; Fujinami, Rebecca

2017-02-01

Caring for the family is included as one of the eight domains of quality palliative care, calling attention to the importance of the family system and family communications about cancer during care and treatment of the disease. Previously, a model of family caregiver communication defined four caregiver communication types-Manager, Carrier, Partner, Lone-each with a unique communication pattern. The purpose of the present study was to extend the model of family caregiver communication in cancer care to further understand the impact of family communication burden on caregiving outcomes. This mixed-method study employed fieldnotes from a family caregiver intervention focused on quality of life and self-reported caregiver communication items to identify a specific family caregiver type. Caregiver types were then analyzed using outcome measures on psychological distress, skills preparedness, family inventory of needs, and quality-of-life domains. Corroboration between fieldnotes and self-reported communication for caregivers (n = 21, 16 women, mean age of 53 years) revealed a definitive classification of the four caregiver types (Manager = 6, Carrier = 5, Partner = 6, Lone = 4). Mean scores on self-reported communication items documented different communication patterns congruent with the theoretical framework of the model. Variation in caregiver outcomes measures confirmed the model of family caregiver communication types. Partner and Lone caregivers reported the lowest psychological distress, with Carrier caregivers feeling least prepared and Manager caregivers reporting the lowest physical quality of life. This study illustrates the impact of family communication on caregiving and increases our knowledge and understanding about the role of communication in caregiver burden. The research provides the first evidence-based validation for a family caregiver communication typology and its relationship to caregiver outcomes. Future research is needed to develop and test interventions that target specific caregiver types.

Communication tools for end-of-life decision-making in the intensive care unit: a systematic review and meta-analysis.

PubMed

Oczkowski, Simon J W; Chung, Han-Oh; Hanvey, Louise; Mbuagbaw, Lawrence; You, John J

2016-04-09

For many patients admitted to the intensive care unit (ICU), preferences for end-of-life care are unknown, and clinicians and substitute decision-makers are required to make decisions about the goals of care on their behalf. We conducted a systematic review to determine the effect of structured communication tools for end-of-life decision-making, compared to usual care, upon the number of documented goals of care discussions, documented code status, and decisions to withdraw life-sustaining treatments, in adult patients admitted to the ICU. We searched multiple databases including MEDLINE, Embase, CINAHL, ERIC, and Cochrane from database inception until July 2014. Two reviewers independently screened articles, assessed eligibility, verified data extraction, and assessed risk of bias using the tool described by the Cochrane Collaboration and the Newcastle Ottawa Scale. Pooled estimates of effect (relative risk, standardized mean difference, or mean difference), were calculated where sufficient data existed. GRADE was used to evaluate the overall quality of evidence for each outcome. We screened 5785 abstracts and reviewed the full text of 424 articles, finding 168 eligible articles, including 19 studies in the ICU setting. The use of communication tools increased documentation of goals-of-care discussions (RR 3.47, 95% CI 1.55, 7.75, p = 0.020, very low-quality evidence), but did not have an effect on code status documentation (RR 1.03, 95% CI 0.96, 1.10, p = 0.540, low-quality evidence) or decisions to withdraw or withhold life-sustaining treatments (RR 0.98, 95% CI 0.89, 1.08, p = 0.70, low-quality evidence). The use of such tools was associated with a decrease in multiple measures of health care resource utilization, including duration of mechanical ventilation (MD -1.9 days, 95% CI -3.26, -0.54, p = 0.006, very low-quality evidence), length of ICU stay (MD -1.11 days, 95% CI -2.18, -0.03, p = 0.04, very low-quality evidence), and health care costs (SMD -0.32, 95% CI -0.5, -0.15, p < 0.001, very low-quality evidence). Structured communication tools may improve documentation of EOL decision making and may result in lower resource use. The supporting evidence is low to very low in quality. Further high-quality randomized studies of simple communication interventions are needed to determine whether structured, rather than ad hoc, approaches to end-of-life decision-making improve patient-level, family-level, and system-level outcomes. PROSPERO CRD42014012913.

Health literacy and communication quality in health care organizations.

PubMed

Wynia, Matthew K; Osborn, Chandra Y

2010-01-01

The relationship between limited health literacy and poor health may be due, in part, to poor communication quality within health care delivery organizations. We explored the relationship between health literacy status and receiving patient-centered communication in clinics and hospitals serving communication-vulnerable patient populations. Thirteen health care organizations nationwide distributed a survey to 5929 patients. All patients completed seven items assessing patient-centered communication. One third also completed three items assessing health literacy. The majority of patients had self-reported health literacy challenges, reporting problems learning about their medical condition because of difficulty understanding written information (53%), a lack of confidence in completing medical forms by themselves (61%), and needing someone to help them read hospital/clinic materials (57%). Logistic regression models showed that, after adjustment for patient demographic characteristics and health care organization type, patients with limited health literacy were 28% to 79% less likely than those with adequate health literacy to report their health care organization "always" provides patient-centered communication across seven communication items. Using a scaled composite of these items, limited health literacy remained associated with lower reported communication quality. These results suggest that improving communication quality in health care organizations might help to address the challenges facing patients with limited health literacy. They also highlight that efforts to address the needs of patients with limited health literacy should be sensitive to the range of communication challenges confronting these patients and their caregivers.

Understanding couples' relationship quality and contraceptive use in Kumasi, Ghana.

PubMed

Cox, Carie Muntifering; Hindin, Michelle J; Otupiri, Easmo; Larsen-Reindorf, Roderick

2013-12-01

A wealth of data exist on knowledge, attitudes and practice related to contraceptive use; however, emotional aspects of relationships that may influence reproductive decision making are often overlooked. Data from the 2010 Family Health and Wealth Survey were used in bivariate and multinomial logistic regression analyses to identify associations between relationship quality and current contraceptive use among 698 married or cohabiting couples in Kumasi, Ghana. Four scales measuring commitment, trust, constructive communication and destructive communication, as well as a question about relationship satisfaction, were the indicators of relationship quality. Current contraceptive use was divided into three categories: no use, reliance on a method that can be used without the partner's awareness (the injectable, pill, IUD, implant and diaphragm) and use of a method that both partners are typically aware of (periodic abstinence, withdrawal, condoms and spermicide). Overall contraceptive use was low--22% of women said they were currently using any method. In general, respondents reported high levels of relationship quality. Women's relationship satisfaction scores were positively associated with use of awareness methods rather than nonuse (relative risk ratio, 1.2). Men's trust scores were positively associated with use of nonawareness methods rather than nonuse (1.1), and men's constructive communication scores were associated with use of both types of method rather than nonuse (1.1 for each). Couples' relationship quality appears to be an important element in their decision making regarding contraceptive use, and should be taken into consideration in the design and implementation of family planning programs and policy.

Communicating Instantaneous Air Quality Data: Pilot Project

EPA Pesticide Factsheets

Communicating Instantaneous Air Quality Data: Pilot ProjectEPA is launching a pilot project to test a new tool for making instantaneous outdoor air quality data useful for the public. The new “sensor scale” is designed to be used with sensors

Can All Doctors Be Like This? Seven Stories of Communication Transformation Told by Physicians Rated Highest by Patients.

PubMed

Janisse, Tom; Tallman, Karen

2017-01-01

The top predictors of patient satisfaction with clinical visits are the quality of the physician-patient relationship and the communications contributing to their relationship. How do physicians improve their communication, and what effect does it have on them? This article presents the verbatim stories of seven high-performing physicians describing their transformative change in the areas of communication, connection, and well-being. Data for this study are based on interviews from a previous study in which a 6-question set was posed, in semistructured 60-minute interviews, to 77 of the highest-performing Permanente Medical Group physicians in 4 Regions on the "Art of Medicine" patient survey. Transformation stories emerged spontaneously during the interviews, and so it was an incidental finding when some physicians identified that they were not always high performing in their communication with patients. Seven different modes of transformation in communication were described by these physicians: a listening tool, an awareness course, finding new meaning in clinical practice, a technologic tool, a sudden insight, a mentor observation, and a physician-as-patient experience. These stories illustrate how communication skills can be learned through various activities and experiences that transform physicians into those who are highly successful communicators. All modes result in a change of state-a new way of seeing, of being-and are not just a new tool or a new practice, but a change in state of mind. This state resulted in a marked change of behavior, and a substantial improvement of communication and relationship.

Recommendations for Best Communication Practices to Facilitate Goal-concordant Care for Seriously Ill Older Patients With Emergency Surgical Conditions.

PubMed

Cooper, Zara; Koritsanszky, Luca A; Cauley, Christy E; Frydman, Julia L; Bernacki, Rachelle E; Mosenthal, Anne C; Gawande, Atul A; Block, Susan D

2016-01-01

To address the need for improved communication practices to facilitate goal-concordant care in seriously ill, older patients with surgical emergencies. Improved communication is increasingly recognized as a central element in providing goal-concordant care and reducing health care utilization and costs among seriously ill older patients. Given high rates of surgery in the last weeks of life, high risk of poor outcomes after emergency operations in these patients, and barriers to quality communication in the acute setting, we sought to create a framework to support surgeons in communicating with seriously ill, older patients with surgical emergencies. An interdisciplinary panel of 23 national leaders was convened for a 1-day conference at Harvard Medical School to provide input on concept, content, format, and usability of a communication framework. A prototype framework was created. Participants supported the concept of a structured approach to communication in these scenarios, and delineated 9 key elements of a framework: (1) formulating prognosis, (2) creating a personal connection, (3) disclosing information regarding the acute problem in the context of the underlying illness, (4) establishing a shared understanding of the patient's condition, (5) allowing silence and dealing with emotion, (6) describing surgical and palliative treatment options, (7) eliciting patient's goals and priorities, (8) making a treatment recommendation, and (9) affirming ongoing support for the patient and family. Communication with seriously ill patients in the acute setting is difficult. The proposed communication framework may assist surgeons in delivering goal-concordant care for high-risk patients.

Patients' perception of chemotherapy side effects: Expectations, doctor-patient communication and impact on quality of life - An Italian survey.

PubMed

Lorusso, Domenica; Bria, Emilio; Costantini, Anna; Di Maio, Massimo; Rosti, Giovanni; Mancuso, Annamaria

2017-03-01

Chemotherapy side effects (CSE) have a strong impact on patients' quality of life (QOL). To assess patient perceptions of CSE, their impact on QOL and doctor-patient communication regarding these aspects, a survey was conducted among Italian cancer patients. Patients at least 18 years of age, who received chemotherapy, were administered a dedicated questionnaire to assess their point of view on five domains: expectations about CSE and impact on QOL; doctor-patient communication about CSE; treatments to reduce the impact of CSE; sexual life; family relationships/activities and employment. A total of 761 patients participated. CSE had a considerable impact on patient QOL. Nausea/vomiting was the most feared adverse effect before initiating chemotherapy and the one most commonly experienced during treatment. Patients generally reported good doctor-patient communication regarding information about CSE. In almost all cases, the oncologists prescribed an antiemetic treatment, but the incidence of nausea/vomiting was high. Cancer and CSE severely affected sexual life, daily activities and employment. CSE had a strong negative impact on QOL. Good doctor-patient communication is essential. Improving antiemetic strategies may improve QOL. Doctors' ability to inform patients about delicate issues, such as the impact of CSE on sexual life, needs to be improved. © 2016 John Wiley & Sons Ltd.

Culture and nonverbal expressions of empathy in clinical settings: A systematic review.

PubMed

Lorié, Áine; Reinero, Diego A; Phillips, Margot; Zhang, Linda; Riess, Helen

2017-03-01

To conduct a systematic review of studies examining how culture mediates nonverbal expressions of empathy with the aim to improve clinician cross-cultural competency. We searched three databases for studies of nonverbal expressions of empathy and communication in cross-cultural clinical settings, yielding 16,143 articles. We examined peer-reviewed, experimental or observational articles. Sixteen studies met inclusion criteria. Nonverbal expressions of empathy varied across cultural groups and impacted the quality of communication and care. Some nonverbal behaviors appeared universally desired and others, culturally specific. Findings revealed the impact of nonverbal communication on patient satisfaction, affective tone, information exchange, visit length, and expression decoding during cross-cultural clinical encounters. Racial discordance, patients' perception of physician racism, and physician implicit bias are among factors that appear to influence information exchange in clinical encounters. Culture-based norms impact expectations for specific nonverbal expressions within patient-clinician dyads. Nonverbal communication plays a significant role in fostering trusting provider-patient relationships, and is critical to high quality care. Medical education should include training in interpretation of nonverbal behavior to optimize empathic cross-cultural communication and training efforts should accommodate norms of local patient populations. These efforts should reduce implicit biases in providers and perceived prejudice in patients. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The Use of Interactive Methods in the Educational Process of the Higher Education Institution

ERIC Educational Resources Information Center

Kutbiddinova, Rimma A.; Eromasova, Aleksandr? A.; Romanova, Marina A.

2016-01-01

The modernization of higher education and the transition to the new Federal Education Standards require a higher quality training of the graduates. The training of highly qualified specialists must meet strict requirements: a high level of professional competence, the developed communication skills, the ability to predict the results of one's own…

Consumer Awareness and Willingness to Pay for High-Pressure Processing of Ready-to-Eat Food

ERIC Educational Resources Information Center

Hicks, Doris T.; Pivarnik, Lori F.; McDermott, Ryan; Richard, Nicole; Hoover, Dallas G.; Kniel, Kalmia E.

2009-01-01

Commercial, nonthermal processing of food, such as high hydrostatic-pressure processing (HPP), has increased. The safety and quality of foods produced by HPP has not been well communicated to the public. An online, nationwide consumer survey was implemented to assess awareness of alternative food processing technologies, consumer food safety…

COOP 3D ARPA Experiment 109 National Center for Atmospheric Research

NASA Technical Reports Server (NTRS)

1998-01-01

Coupled atmospheric and hydrodynamic forecast models were executed on the supercomputing resources of the National Center for Atmospheric Research (NCAR) in Boulder, Colorado and the Ohio Supercomputing Center (OSC)in Columbus, Ohio. respectively. The interoperation of the forecast models on these geographically diverse, high performance Cray platforms required the transfer of large three dimensional data sets at very high information rates. High capacity, terrestrial fiber optic transmission system technologies were integrated with those of an experimental high speed communications satellite in Geosynchronous Earth Orbit (GEO) to test the integration of the two systems. Operation over a spacecraft in GEO orbit required modification of the standard configuration of legacy data communications protocols to facilitate their ability to perform efficiently in the changing environment characteristic of a hybrid network. The success of this performance tuning enabled the use of such an architecture to facilitate high data rate, fiber optic quality data communications between high performance systems not accessible to standard terrestrial fiber transmission systems. Thus obviating the performance degradation often found in contemporary earth/satellite hybrids.

Microbial water quality communication: public and practitioner insights from British Columbia, Canada.

PubMed

Dunn, G; Henrich, N; Holmes, B; Harris, L; Prystajecky, N

2014-09-01

This work examines the communication interactions of water suppliers and health authorities with the general public regarding microbial source water quality for recreational and drinking water. We compare current approaches to risk communication observable in British Columbia (BC), Canada, with best practices derived from the communications literature, finding significant gaps between theory and practice. By considering public views and government practices together, we identify key disconnects, leading to the conclusion that at present, neither the public's needs nor public health officials' goals are being met. We find: (1) there is a general lack of awareness and poor understanding by the public of microbial threats to water and the associated health implications; (2) the public often does not know where to find water quality information; (3) public information needs are not identified or met; (4) information sharing by authorities is predominantly one-way and reactive (crisis-oriented); and (5) the effectiveness of communications is not evaluated. There is a need for both improved public understanding of water quality-related risks, and new approaches to ensure information related to water quality reaches audiences. Overall, greater attention should be given to planning and goal setting related to microbial water risk communication.

High quality factor surface Fabry-Perot cavity of acoustic waves

NASA Astrophysics Data System (ADS)

Xu, Yuntao; Fu, Wei; Zou, Chang-ling; Shen, Zhen; Tang, Hong X.

2018-02-01

Surface acoustic wave (SAW) resonators are critical components in wireless communications and many sensing applications. They have also recently emerged as a subject of study in quantum acoustics at the single phonon level. Acoustic loss reduction and mode confinement are key performance factors in SAW resonators. Here, we report the design and experimental realization of high quality factor Fabry-Perot SAW resonators formed in between the tapered phononic crystal mirrors patterned on a GaN-on-sapphire material platform. The fabricated SAW resonators are characterized by both an electrical network analyzer and an optical heterodyne vibrometer. We observed standing Rayleigh waves inside the cavity, with an intrinsic quality factor exceeding 1.3 × 104 at ambient conditions.

Primary care team communication networks, team climate, quality of care, and medical costs for patients with diabetes: A cross-sectional study.

PubMed

Mundt, Marlon P; Agneessens, Filip; Tuan, Wen-Jan; Zakletskaia, Larissa I; Kamnetz, Sandra A; Gilchrist, Valerie J

2016-06-01

Primary care teams play an important role in providing the best quality of care to patients with diabetes. Little evidence is available on how team communication networks and team climate contribute to high quality diabetes care. To determine whether primary care team communication and team climate are associated with health outcomes, health care utilization, and associated costs for patients with diabetes. A cross-sectional survey of primary care team members collected information on frequency of communication with other care team members about patient care and on team climate. Patient outcomes (glycemic, cholesterol, and blood pressure control, urgent care visits, emergency department visits, hospital visit days, medical costs) in the past 12 months for team diabetes patient panels were extracted from the electronic health record. The data were analyzed using nested (clinic/team/patient) generalized linear mixed modeling. 155 health professionals at 6 U.S. primary care clinics participated from May through December 2013. Primary care teams with a greater number of daily face-to-face communication ties among team members were associated with 52% (rate ratio=0.48, 95% CI: 0.22, 0.94) fewer hospital days and US$1220 (95% CI: -US$2416, -US$24) lower health-care costs per team diabetes patient in the past 12 months. In contrast, for each additional registered nurse (RN) who reported frequent daily face-to-face communication about patient care with the primary care practitioner (PCP), team diabetes patients had less-controlled HbA1c (Odds ratio=0.83, 95% CI: 0.66, 0.99), increased hospital days (RR=1.57, 95% CI: 1.10, 2.03), and higher healthcare costs (β=US$877, 95% CI: US$42, US$1713). Shared team vision, a measure of team climate, significantly mediated the relationship between team communication and patient outcomes. Primary care teams which relied on frequent daily face-to-face communication among more team members, and had a single RN communicating patient care information to the PCP, had greater shared team vision, better patient outcomes, and lower medical costs for their diabetes patient panels. Copyright © 2016 Elsevier Ltd. All rights reserved.

Primary care team communication networks, team climate, quality of care, and medical costs for patients with diabetes: A cross-sectional study

PubMed Central

Mundt, Marlon P.; Agneessens, Filip; Tuan, Wen-Jan; Zakletskaia, Larissa I.; Kamnetz, Sandra A.; Gilchrist, Valerie J.

2016-01-01

Background Primary care teams play an important role in providing the best quality of care to patients with diabetes. Little evidence is available on how team communication networks and team climate contribute to high quality diabetes care. Objective To determine whether primary care team communication and team climate are associated with health outcomes, health care utilization, and associated costs for patients with diabetes. Methods A cross-sectional survey of primary care team members collected information on frequency of communication with other care team members about patient care and on team climate. Patient outcomes (glycemic, cholesterol, and blood pressure control, urgent care visits, emergency department visits, hospital visit days, medical costs) in the past 12 months for team diabetes patient panels were extracted from the electronic health record. The data were analyzed using nested (clinic/team/patient) generalized linear mixed modeling. Participants 155 health professionals at 6 U.S. primary care clinics participated from May through December 2013. Results Primary care teams with a greater number of daily face-to-face communication ties among team members were associated with 52% (Rate Ratio=0.48, 95% CI: 0.22, 0.94) fewer hospital days and US$1220 (95% CI: -US$2416, -US$24) lower health-care costs per team diabetes patient in the past 12 months. In contrast, for each additional registered nurse (RN) who reported frequent daily face-to-face communication about patient care with the primary care practitioner (PCP), team diabetes patients had less-controlled HbA1c (Odds Ratio=0.83, 95% CI: 0.66, 0.99), increased hospital days (RR=1.57, 95% CI: 1.10, 2.03), and higher healthcare costs (β=US$877, 95% CI: US$42, US$1713). Shared team vision, a measure of team climate, significantly mediated the relationship between team communication and patient outcomes. Conclusions Primary care teams which relied on frequent daily face-to-face communication among more team members, and had a single RN communicating patient care information to the PCP, had greater shared team vision, better patient outcomes, and lower medical costs for their diabetes patient panels. PMID:27087293

Critical differences between elective and emergency surgery: identifying domains for quality improvement in emergency general surgery.

PubMed

Columbus, Alexandra B; Morris, Megan A; Lilley, Elizabeth J; Harlow, Alyssa F; Haider, Adil H; Salim, Ali; Havens, Joaquim M

2018-04-01

The objective of our study was to characterize providers' impressions of factors contributing to disproportionate rates of morbidity and mortality in emergency general surgery to identify targets for care quality improvement. Emergency general surgery is characterized by a high-cost burden and disproportionate morbidity and mortality. Factors contributing to these observed disparities are not comprehensively understood and targets for quality improvement have not been formally developed. Using a grounded theory approach, emergency general surgery providers were recruited through purposive-criterion-based sampling to participate in semi-structured interviews and focus groups. Participants were asked to identify contributors to emergency general surgery outcomes, to define effective care for EGS patients, and to describe operating room team structure. Interviews were performed to thematic saturation. Transcripts were iteratively coded and analyzed within and across cases to identify emergent themes. Member checking was performed to establish credibility of the findings. A total of 40 participants from 5 academic hospitals participated in either individual interviews (n = 25 [9 anesthesia, 12 surgery, 4 nursing]) or focus groups (n = 2 [15 nursing]). Emergency general surgery was characterized by an exceptionally high level of variability, which can be subcategorized as patient-variability (acute physiology and comorbidities) and system-variability (operating room resources and workforce). Multidisciplinary communication is identified as a modifier to variability in emergency general surgery; however, nursing is often left out of early communication exchanges. Critical variability in emergency general surgery may impact outcomes. Patient-variability and system-variability, with focus on multidisciplinary communication, represent potential domains for quality improvement in this field. Copyright © 2017 Elsevier Inc. All rights reserved.

10Gbps 2D MGC OCDMA Code over FSO Communication System

NASA Astrophysics Data System (ADS)

Professor Urmila Bhanja, Associate, Dr.; Khuntia, Arpita; Alamasety Swati, (Student

2017-08-01

Currently, wide bandwidth signal dissemination along with low latency is a leading requisite in various applications. Free space optical wireless communication has introduced as a realistic technology for bridging the gap in present high data transmission fiber connectivity and as a provisional backbone for rapidly deployable wireless communication infrastructure. The manuscript highlights on the implementation of 10Gbps SAC-OCDMA FSO communications using modified two dimensional Golomb code (2D MGC) that possesses better auto correlation, minimum cross correlation and high cardinality. A comparison based on pseudo orthogonal (PSO) matrix code and modified two dimensional Golomb code (2D MGC) is developed in the proposed SAC OCDMA-FSO communication module taking different parameters into account. The simulative outcome signifies that the communication radius is bounded by the multiple access interference (MAI). In this work, a comparison is made in terms of bit error rate (BER), and quality factor (Q) based on modified two dimensional Golomb code (2D MGC) and PSO matrix code. It is observed that the 2D MGC yields better results compared to the PSO matrix code. The simulation results are validated using optisystem version 14.

Effective Team Practices: Interprofessional Contributions to Communication Issues With a Parent's Perspective.

PubMed

Cooper-Duffy, Karena; Eaker, Kerri

2017-05-17

This clinical focus article contains a detailed description of how to build effective teams that use interprofessional collaborative practice (IPCP) with special-education professionals, speech-language pathologists, and families of children with severe disabilities. This clinical focus article provides information on using the essential elements of team building and IPCP to provide quality care to families who have children with severe disabilities. The 6 essential elements for team building are described, with suggestions for including families in each: goal-setting, roles and responsibilities, effective and efficient process, communication and interpersonal relationships, collaborative problem solving, and evaluation. The 4 competency domains of IPCP are embedded into each of the team-building elements to demonstrate how teams can implement IPCP. A case study illustrates the difficulty one parent experienced working with a team across the 6 essential team-building elements when seeking communication services for her child with severe disabilities. Building teams with IPCP can be effective for including families and creating high-quality outcomes for individuals with severe disabilities.

Teamwork and communication: an effective approach to patient safety.

PubMed

Mujumdar, Sandhya; Santos, Diana

2014-01-01

Teamwork and communication failures are leading causes of patient safety incidents in health care. Though health care providers must work in teams, they are not well-trained in teamwork and communication skills. Health care faces the problems of differences in communication styles, communication failures and poor teamwork. There is enough evidence in the literature to show that communication failure is detrimental to patient safety. It is estimated that 80% of serious medical errors worldwide take place because of miscommunication between medical providers. NUH recognizes that effective communication and teamwork are essential in the delivery of high quality safe patient care, especially in a complex organization. NUH is a good example, where there is a rich mix of nationalities and races, in staff and in patients, and there is a rapidly expanding care environment. NUH had to overcome these challenges by adopting a multi-pronged approach. The trials and tribulations of NUH in this journey were worthwhile as the patient safety climate survey scores improved over the years.

GLOBECOM '87 - Global Telecommunications Conference, Tokyo, Japan, Nov. 15-18, 1987, Conference Record. Volumes 1, 2, & 3

NASA Astrophysics Data System (ADS)

The present conference on global telecommunications discusses topics in the fields of Integrated Services Digital Network (ISDN) technology field trial planning and results to date, motion video coding, ISDN networking, future network communications security, flexible and intelligent voice/data networks, Asian and Pacific lightwave and radio systems, subscriber radio systems, the performance of distributed systems, signal processing theory, satellite communications modulation and coding, and terminals for the handicapped. Also discussed are knowledge-based technologies for communications systems, future satellite transmissions, high quality image services, novel digital signal processors, broadband network access interface, traffic engineering for ISDN design and planning, telecommunications software, coherent optical communications, multimedia terminal systems, advanced speed coding, portable and mobile radio communications, multi-Gbit/second lightwave transmission systems, enhanced capability digital terminals, communications network reliability, advanced antimultipath fading techniques, undersea lightwave transmission, image coding, modulation and synchronization, adaptive signal processing, integrated optical devices, VLSI technologies for ISDN, field performance of packet switching, CSMA protocols, optical transport system architectures for broadband ISDN, mobile satellite communications, indoor wireless communication, echo cancellation in communications, and distributed network algorithms.

Signal quality of endovascular electroencephalography

NASA Astrophysics Data System (ADS)

He, Bryan D.; Ebrahimi, Mosalam; Palafox, Leon; Srinivasan, Lakshminarayan

2016-02-01

Objective, Approach. A growing number of prototypes for diagnosing and treating neurological and psychiatric diseases are predicated on access to high-quality brain signals, which typically requires surgically opening the skull. Where endovascular navigation previously transformed the treatment of cerebral vascular malformations, we now show that it can provide access to brain signals with substantially higher signal quality than scalp recordings. Main results. While endovascular signals were known to be larger in amplitude than scalp signals, our analysis in rabbits borrows a standard technique from communication theory to show endovascular signals also have up to 100× better signal-to-noise ratio. Significance. With a viable minimally-invasive path to high-quality brain signals, patients with brain diseases could one day receive potent electroceuticals through the bloodstream, in the course of a brief outpatient procedure.

The Association of Perceived Provider-Patient Communication and Relationship Quality with Colorectal Cancer Screening

ERIC Educational Resources Information Center

Underhill, Meghan L.; Kiviniemi, Marc T.

2012-01-01

Background: Two-thirds of adults aged 50 years and older are adherent to recommendations for colorectal cancer screening. Provider-patient communication and characteristics of the patient-provider relationship may relate to screening behavior. Methods: The association of provider communication quality, relationship, and colorectal cancer screening…

Cohesion in Online Student Teams versus Traditional Teams

ERIC Educational Resources Information Center

Hansen, David E.

2016-01-01

Researchers have found that the electronic methods in use for online team communication today increase communication quality in project-based work situations. Because communication quality is known to influence group cohesion, the present research examined whether online student project teams are more cohesive than traditional teams. We tested…

Sunflower Seeds at Syracuse.

ERIC Educational Resources Information Center

Shaw, Kenneth A.

1993-01-01

Syracuse University (New York) has found that the focused, collaborative approach to institutional administration embodied in Total Quality Management is beneficial. It requires allocation of adequate time and resources, observation of others, communication, addressing high-need areas first, and willingness to adapt, but it may bring resistance…

Desktop Publishing for Counselors.

ERIC Educational Resources Information Center

Lucking, Robert; Mitchum, Nancy

1990-01-01

Discusses the fundamentals of desktop publishing for counselors, including hardware and software systems and peripherals. Notes by using desktop publishing, counselors can produce their own high-quality documents without the expense of commercial printers. Concludes computers present a way of streamlining the communications of a counseling…

STD Education: Challenge for the 80s.

ERIC Educational Resources Information Center

Kroger, Fred; Wiesner, Paul J.

1981-01-01

Sexually transmitted diseases (STD) are the most pervasive, destructive, and costly communicable disease problems facing America's youth. The need for and appropriateness of school-based STD education, some elements of high-quality STD education, and strategies for dealing constructively with controversy are discussed. (JN)

Glaucoma patient-provider communication about vision quality-of-life

PubMed Central

Sleath, Betsy; Sayner, Robyn; Vitko, Michelle; Carpenter, Delesha M.; Blalock, Susan J.; Muir, Kelly W.; Giangiacomo, Annette L.; Hartnett, Mary Elizabeth; Robin, Alan L.

2016-01-01

Objective The purpose of this study was to: (a) describe the extent to which ophthalmologists and glaucoma patients discuss vision quality-of-life during office visits, and (b) examine the association between patient and ophthalmologist characteristics and provider-patient communication about vision quality-of-life. Methods Patients with glaucoma who were newly prescribed or on glaucoma medications were recruited at six ophthalmology clinics. Patients' visits were video-tape recorded and quality-of-life communication variables were coded. Generalized estimating equations were used to analyze the data. Results Two hundred and seventy-nine patients participated. Specific glaucoma quality-of-life domains were discussed during only 13% of visits. Older patients were significantly more likely to discuss one or more vision quality-of-life domains than younger patients. African American patients were significantly less likely to make statements about their vision quality-of-life and providers were less likely to ask them one or more vision quality-of-life questions than non-African American patients. Conclusion Eye care providers and patients infrequently discussed the patient's vision quality-of-life during glaucoma visits. African American patients were less likely to communicate about vision quality-of-life than non-African American patients. Practice Implications Eye care providers should make sure to discuss vision quality-of-life with glaucoma patients. PMID:27916461

Making good better: implementing a standardized handoff in pediatric transport.

PubMed

Weingart, Caroline; Herstich, Tracey; Baker, Pam; Garrett, M Lynne; Bird, Michael; Billock, James; Schwartz, Hamilton P; Bigham, Michael T

2013-01-01

Failures in communication lead to adverse events in healthcare. Handoffs, defined as the transfer of information, responsibility, and authority from one provider to another, have been identified as a cause of communication failure compromising patient safety. Locally, there was dissatisfaction among caregivers working on the general care and intensive care units regarding the quality of information received from the pediatric transport team for transferred patients. Using the Model for Improvement, a quality improvement team was engaged to lead this improvement effort. The team developed a standardized and scripted transport handoff process that incorporated parental input. The primary measure was provider satisfaction (reported as overall handoff score, OHS). Secondary outcomes included the use of components outlined by the Joint Commission's guidelines for safe handoff. Data were collected using a Likert-style survey and collated using Microsoft Excel. Baseline measures of OHS were 81.5 ± 19.4 (mean±SD) with an interval analysis showing no improvement (81.6±17.4, P=0.99). Further modifications were made to both education and process with an improved OHS (88.8±11.1, P<0.05). Certain specific handoff components showed the greatest improvement according to caregivers. This practical, low-cost quality-improvement project may help others improve handoff communication and provide safe, high-quality care. Copyright © 2013 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.

Parent-child relationships, partner relationships, and emotional adjustment: a birth-to-maturity prospective study.

PubMed

Overbeek, Geertjan; Stattin, Håkan; Vermulst, Ad; Ha, Thao; Engels, Rutger C M E

2007-03-01

This study examined whether detrimental childhood relationships with parents were related to partner relationship quality and emotional adjustment in adulthood. The authors tested a theoretical model in which (a) low-quality parent-child relationships were related to conflict and low-quality communication with parents in adolescence, (b) parent-adolescent conflict and low-quality communication were linked to low-quality partner relationships in young adulthood, and (c) low-quality partner relationships in young adulthood were predictive of low-quality partner relationships as well as depression, anxiety, and dissatisfaction with life at midlife. Multi-informant data were used from 212 Swedish individuals who were followed from birth into adulthood. Results demonstrated that, as hypothesized, negative parent-child bonds were indirectly related to low-quality partner relationships and dissatisfaction with life in adulthood (but not anxiety and depression) through conflictual parent-adolescent communication and low-quality partner relationships in young adulthood.

Interns overestimate the effectiveness of their hand-off communication.

PubMed

Chang, Vivian Y; Arora, Vineet M; Lev-Ari, Shiri; D'Arcy, Michael; Keysar, Boaz

2010-03-01

Theories from the psychology of communication may be applicable in understanding why hand-off communication is inherently problematic. The purpose of this study was to assess whether postcall pediatric interns can correctly estimate the patient care information and rationale received by on-call interns during hand-off communication. Pediatric interns at the University of Chicago were interviewed about the hand-off. Postcall interns were asked to predict what on-call interns would report as the important pieces of information communicated during the hand-off about each patient, with accompanying rationale. Postcall interns also guessed on-call interns' rating of how well the hand-offs went. Then, on-call interns were asked to list the most important pieces of information for each patient that postcall interns communicated during the hand-off, with accompanying rationale. On-call interns also rated how well the hand-offs went. Interns had access to written hand-offs during the interviews. We conducted 52 interviews, which constituted 59% of eligible interviews. Seventy-two patients were discussed. The most important piece of information about a patient was not successfully communicated 60% of the time, despite the postcall intern's believing that it was communicated. Postcall and on-call interns did not agree on the rationales provided for 60% of items. In addition, an item was more likely to be effectively communicated when it was a to-do item (65%) or an item related to anticipatory guidance (69%) compared with a knowledge item (38%). Despite the lack of agreement on content and rationale of information communicated during hand-offs, peer ratings of hand-off quality were high. Pediatric interns overestimated the effectiveness of their hand-off communication. Theories from communication psychology suggest that miscommunication is caused by egocentric thought processes and a tendency for the speaker to overestimate the receiver's understanding. This study demonstrates that systematic causes of miscommunication may play a role in hand-off quality.

Implementation of dictionary pair learning algorithm for image quality improvement

NASA Astrophysics Data System (ADS)

Vimala, C.; Aruna Priya, P.

2018-04-01

This paper proposes an image denoising on dictionary pair learning algorithm. Visual information is transmitted in the form of digital images is becoming a major method of communication in the modern age, but the image obtained after transmissions is often corrupted with noise. The received image needs processing before it can be used in applications. Image denoising involves the manipulation of the image data to produce a visually high quality image.

Dentist-Patient Communication and Denture Quality Associated with Complete Denture Satisfaction Among Taiwanese Elderly Wearers.

PubMed

Chen, Jen-Hao; Huang, Hsiao-Ling; Lin, Ying-Chun; Chou, Tsau-Mau; Ebinger, John; Lee, Huey-Er

2015-01-01

The aim of this study was to explore individual (ie, sociodemographic characteristics, patient personality) and clinical factors (ie, dentist-patient communication, denture quality) associated with complete denture satisfaction among the Taiwanese elderly population. A multistage sampling and cross-sectional design was used to collect data. A total of 387 fully edentulous citizens, aged 65 years and older and who had received new sets of complete dentures, were selected. The participants completed clinical dental examinations and questionnaires by personal interview to collect information on denture satisfaction and associated variables. The relationship among three groups of these participants (satisfied, neutral, and dissatisfied) and potential factors were simultaneously examined using polytomous logistic regression analysis. Overall, 36.7% of the participants were dissatisfied with their dentures. Living status (crude odds ratio [COR] = 2.04), personality (COR = 4.86), dentist-patient communication (COR = 7.46), and denture quality (COR = 5.02) were associated with complete denture satisfaction. The multivariate regression model showed that dentist-patient communication (adjusted odds ratio [AOR] = 6.41) and denture quality (AOR = 4.40) were significant complete denture satisfaction factors that diluted the effect of living status and personality. Inadequate dentistpatient communication and low denture quality were associated with the dissatisfaction of patients with dentures. To increase complete denture satisfaction, the importance of training programs aimed at enhancing dentist-patient communication and denture quality cannot be overemphasized.

The effect of resident physician stress, burnout, and empathy on patient-centered communication during the long-call shift.

PubMed

Passalacqua, Stacey A; Segrin, Chris

2012-01-01

During the long-call shift medical residents experience a number of stressors that could compromise the quality of care they provide to their patients. The aim of this study was to investigate how perceived stress and burnout affect changes in empathy over the long-call shift and how those changes in empathy are associated with patient-centered communication practices. Residents (n=93) completed self-report measures of stress, burnout, and empathy at the start of their long-call shift and then completed measures of empathy and patient-centered communication at the end of the same shift. There was a significant decline in physician empathy from the beginning to the end of the long-call shift. Perceived stress was significantly associated with higher burnout, which was, in turn, significantly associated with declines in empathy from pre- to posttest. Declines in empathy predicted lower self-reported patient-centered communication during the latter half of the shift. This study suggests that residents who perceive high levels of stress are at risk for burnout and deterioration in empathy toward their patients, both of which may compromise the quality of their interactions with patients.

Decision-making in adult thalassemia patients undergoing unrelated bone marrow transplantation: quality of life, communication and ethical issues.

PubMed

Caocci, G; Pisu, S; Argiolu, F; Giardini, C; Locatelli, F; Vacca, A; Orofino, M G; Piras, E; De Stefano, P; Addari, M C; Ledda, A; La Nasa, G

2006-01-01

Bone marrow transplantation (BMT) represents a potentially curative treatment of thalassemia. For patients without an HLA-identical sibling donor, recourse to an unrelated donor is a practicable option but the candidates and their families are faced with a difficult decision. They can either choose to continue the supportive therapy, with no chance of definitive cure, or they accept the mortality risk of BMT in the hope of obtaining a definitive resolution of the disease. We investigated the communication strategies and the post transplantation quality of life (QoL) in 19 adult thalassemia patients surviving after an unrelated donor BMT. The patients were given two questionnaires: a questionnaire to evaluate pre-transplantation communication factors and the EORTC QLQ-C30 questionnaire to assess global QoL. All patients were satisfied with the communication modalities employed by the physicians. The global post transplantation QoL in our patient cohort was found to be good. The approach used in this study may offer a contribution to understanding the decision-making process leading to the choice of a treatment with a high mortality risk for a chronic, non-malignant disease. Finally, some ethical issues of this therapeutic approach are briefly addressed.

High efficiency video coding for ultrasound video communication in m-health systems.

PubMed

Panayides, A; Antoniou, Z; Pattichis, M S; Pattichis, C S; Constantinides, A G

2012-01-01

Emerging high efficiency video compression methods and wider availability of wireless network infrastructure will significantly advance existing m-health applications. For medical video communications, the emerging video compression and network standards support low-delay and high-resolution video transmission, at the clinically acquired resolution and frame rates. Such advances are expected to further promote the adoption of m-health systems for remote diagnosis and emergency incidents in daily clinical practice. This paper compares the performance of the emerging high efficiency video coding (HEVC) standard to the current state-of-the-art H.264/AVC standard. The experimental evaluation, based on five atherosclerotic plaque ultrasound videos encoded at QCIF, CIF, and 4CIF resolutions demonstrates that 50% reductions in bitrate requirements is possible for equivalent clinical quality.

High Temperature Semiconductor Process

NASA Technical Reports Server (NTRS)

1998-01-01

A sputtering deposition system capable of depositing large areas of high temperature superconducting materials was developed by CVC Products, Inc. with the support of the Jet Propulsion Laboratory SBIR (Small Business Innovative Research) program. The system was devleoped for NASA to produce high quality films of high temperature superconducting material for microwave communication system components. The system is also being used to deposit ferroelectric material for capacitors and the development of new electro-optical materials.2002103899

Health Literacy and Communication Quality in Health Care Organizations

PubMed Central

Wynia, Matthew K.; Osborn, Chandra Y.

2011-01-01

The relationship between limited health literacy and poor health may be due to poor communication quality within health care delivery organizations. We explored the relationship between health literacy status and receiving patient-centered communication in clinics and hospitals serving communication-vulnerable patient populations. Thirteen health care organizations nationwide distributed a survey to 5,929 patients. All patients completed seven items assessing patient-centered communication. One third also completed three items assessing health literacy. The majority of patients had self-reported health literacy challenges, reporting problems learning about their medical condition because of difficulty understanding written information (53%), a lack of confidence in completing medical forms by themselves (61%), and needing someone to help them read hospital/clinic materials (57%). Logistic regression models showed that, after adjustment for patient demographic characteristics and health care organization type, patients with limited health literacy were 28–79% less likely than those with adequate health literacy to report their health care organization “always” provides patient-centered communication across seven communication items. Using a scaled composite of these items, limited health literacy remained associated with lower reported communication quality. These results suggest that improving communication quality in health care organizations might help to address the challenges facing patients with limited health literacy. They also highlight that efforts to address the needs of patients with limited health literacy should be sensitive to the range of communication challenges confronting these patients and their caregivers. PMID:20845197

High Data Rate Satellite Communications for Environmental Remote Sensing

NASA Astrophysics Data System (ADS)

Jackson, J. M.; Munger, J.; Emch, P. G.; Sen, B.; Gu, D.

2014-12-01

Satellite to ground communication bandwidth limitations place constraints on current earth remote sensing instruments which limit the spatial and spectral resolution of data transmitted to the ground for processing. Instruments such as VIIRS, CrIS and OMPS on the Soumi-NPP spacecraft must aggregate data both spatially and spectrally in order to fit inside current data rate constraints limiting the optimal use of the as-built sensors. Future planned missions such as HyspIRI, SLI, PACE, and NISAR will have to trade spatial and spectral resolution if increased communication band width is not made available. A number of high-impact, environmental remote sensing disciplines such as hurricane observation, mega-city air quality, wild fire detection and monitoring, and monitoring of coastal oceans would benefit dramatically from enabling the downlinking of sensor data at higher spatial and spectral resolutions. The enabling technologies of multi-Gbps Ka-Band communication, flexible high speed on-board processing, and multi-Terabit SSRs are currently available with high technological maturity enabling high data volume mission requirements to be met with minimal mission constraints while utilizing a limited set of ground sites from NASA's Near Earth Network (NEN) or TDRSS. These enabling technologies will be described in detail with emphasis on benefits to future remote sensing missions currently under consideration by government agencies.

Evaluation of beef eating quality by Irish consumers.

PubMed

McCarthy, S N; Henchion, M; White, A; Brandon, K; Allen, P

2017-10-01

A consumer's decision to purchase beef is strongly linked to its sensory properties and consistent eating quality is one of the most important attributes. Consumer taste panels were held according to the Meat Standards Australia guidelines and consumers scored beef according to its palatability attributes and completed a socio-demographic questionnaire. Consumers were able to distinguish between beef quality on a scale from unsatisfactory to premium with high accuracy. Premium cuts of beef scored significantly higher on all of the scales compared to poorer quality cuts. Men rated grilled beef higher on juiciness and flavour scales compared to women. Being the main purchaser of beef had no impact on rating scores. Overall the results show that consumers can judge eating quality with high accuracy. Further research is needed to determine how best to communicate inherent benefits that are not visible into extrinsic eating quality indicators, to provide the consumer with consistent indications of quality at the point of purchase. Copyright © 2017 Elsevier Ltd. All rights reserved.

Validation of balance-quality assessment using a modified bathroom scale.

PubMed

Hewson, D J; Duchêne, J; Hogrel, J-Y

2015-02-01

The balance quality tester (BQT), based on a standard electronic bathroom scale has been developed in order to assess balance quality. The BQT includes automatic detection of the person to be tested by means of an infrared detector and bluetooth communication capability for remote assessment when linked to a long-distance communication device such as a mobile phone. The BQT was compared to a standard force plate for validity and agreement. The two most widely reported parameters in balance literature, the area of the centre of pressure (COP) displacement and the velocity of the COP displacement, were compared for 12 subjects, each of whom was tested on ten occasions on each of the 2 days. No significant differences were observed between the BQT and the force plate for either of the two parameters. In addition a high level of agreement was observed between both devices. The BQT is a valid device for remote assessment of balance quality, and could provide a useful tool for long-term monitoring of people with balance problems, particularly during home monitoring.

Quantifying the quality of precipitation data from different sources

NASA Astrophysics Data System (ADS)

Leijnse, Hidde; Wauben, Wiel; Overeem, Aart; de Haij, Marijn

2015-04-01

There is an increasing demand for high-resolution rainfall data. The current manual and automatic networks of climate and meteorological stations provide high quality rainfall data, but they cannot provide the high spatial and temporal resolution required for many applications. This can only partly be solved by using remotely sensed data. It is therefore necessary to consider third-party data, such as rain gauges operated by amateurs and rainfall intensities from commercial cellular communication links. The quality of such third-party data is highly variable and generally lower than that of dedicated networks. Often, such data quality information is missing for third party data. In order to be able to use data from various sources it is vital that quantitative knowledge of the data quality is available. This holds for all data sources, including the rain gauges in the reference networks of climate and meteorological stations. Data quality information is generally either not available or very limited for third-party data sources. For most dedicated climate meteorological networks, this information is only available for the sensor in laboratory conditions. In many cases, however, a significant part of the measurement errors and uncertainties is determined by the siting and maintenance of the sensor, for which generally only qualitative information is available. Furthermore sensors may have limitations under specific conditions. We aim to quantify data quality for different data sources by performing analyses on collocated data sets. Here we present an intercomparison of two years of precipitation data from six different sources (manual rain gauge, automatic rain gauge, present weather sensor, weather radar, commercial cellular communication links, and Meteosat) at three different locations in the Netherlands. We use auxiliary meteorological data to determine if the quality is influenced by other variables (e.g. the temperature influencing the evaporation from the rain gauge). We use three techniques to compare the data sets: 1) direct comparison; 2) triple collocation (see Stoffelen, 1998); and 3) comparison of statistics. Stoffelen, A. (1998). Toward the true near-surface wind speed: Error modeling and calibration using triple collocation. Journal of Geophysical Research: Oceans (1978-2012), 103(C4), 7755-7766.

Nursing and finance: making the connection.

PubMed

Brennan, Terry; Hinson, Nancy; Taylor, Mardy

2008-01-01

Nursing and finance are critical to each other's success in maintaining financial viability and providing high-quality care. Finance departments should educate, inform, communicate, and empathize. Nursing departments should think creatively, get involved in budget committees and board meetings, and set an example of collaboration and cooperation.

GLOBECOM '84 - Global Telecommunications Conference, Atlanta, GA, November 26-29, 1984, Conference Record. Volume 3

NASA Astrophysics Data System (ADS)

Attention is given to aspects of quality assurance methodologies in development life cycles, optical intercity transmission systems, multiaccess protocols, system and technology aspects in the case of regional/domestic satellites, advances in SSB-AM radio transmission over terrestrial and satellite network, and development environments for telecommunications systems. Other subjects studied are concerned with business communication networks for voice and data, VLSI in local network and communication protocol, product evaluation and support, an update regarding Videotex, topics in communication theory, topics in radio propagation, a status report regarding societal effects of technology in the workplace, digital image processing, and adaptive signal processing for communications. The management of the reliability function in the development process is considered along with Giga-bit technologies for long distance large capacity optical transmission equipment. The application of gallium arsenide analog and digital integrated circuits for high-speed fiber optical communications, and a simple algorithm for image data coding.

A framework for visual communication at Nature.

PubMed

Krause, Kelly

2016-04-25

The scientific journal Nature, published weekly since 1869, serves as an excellent case study in visual communication. While journals are becoming increasingly specialist, Nature remains firmly multidisciplinary; and unlike many scientific journals, it contains original journalism, opinion pieces, and expert analysis in addition to peer-reviewed research papers. This variety of content types-covering an extensive range of scientific disciplines-translates into a wide and varied audience, and the need to employ an equally wide variety of communication styles.For example, a research paper may employ technical language to communicate to a highly specialized audience in that field, whereas a news story on the same subject will explain the science to an educated lay audience, often adding a wider context and stripping out acronyms. Each type of piece will use a communication approach tailored for its intended audience.This is true for visual content as well: the intended audience of a scientific figure, illustration or data visualization will determine the design approach to that visual. At Nature, given the high volume of content plus high quality standards, this process is applied in a fairly systematic way, using a framework to guide creative decision-making. That framework is described here, along with a discussion of best practices for the design of research figures and graphics by context. © The Author(s) 2016.

Standardized Patient Training Programs: an Efficient Solution to the Call for Quality Improvement in Oncologist Communication Skills.

PubMed

Ju, Melody; Berman, Abigail T; Vapiwala, Neha

2015-09-01

Several key medical and oncologic professional societies have endorsed the importance of physician communication as a quality improvement metric. Despite this clear message, there remain substantial barriers to communication skills training (CST) in oncologic specialties. Herein, we describe the major barriers to communications training and propose standardized patient (SP) programs as efficient and strategic starting points and as expansion opportunities for new and existing CSTs.

Validation of an organizational communication climate assessment toolkit.

PubMed

Wynia, Matthew K; Johnson, Megan; McCoy, Thomas P; Griffin, Leah Passmore; Osborn, Chandra Y

2010-01-01

Effective communication is critical to providing quality health care and can be affected by a number of modifiable organizational factors. The authors performed a prospective multisite validation study of an organizational communication climate assessment tool in 13 geographically and ethnically diverse health care organizations. Communication climate was measured across 9 discrete domains. Patient and staff surveys with matched items in each domain were developed using a national consensus process, which then underwent psychometric field testing and assessment of domain coherence. The authors found meaningful within-site and between-site performance score variability in all domains. In multivariable models, most communication domains were significant predictors of patient-reported quality of care and trust. The authors conclude that these assessment tools provide a valid empirical assessment of organizational communication climate in 9 domains. Assessment results may be useful to track organizational performance, to benchmark, and to inform tailored quality improvement interventions.

Breast cancer treatment decision making among Latinas and non-Latina Whites: a communication model predicting decisional outcomes and quality of life.

PubMed

Yanez, Betina; Stanton, Annette L; Maly, Rose C

2012-09-01

Deciding among medical treatment options is a pivotal event following cancer diagnosis, a task that can be particularly daunting for individuals uncomfortable with communication in a medical context. Few studies have explored the surgical decision-making process and associated outcomes among Latinas. We propose a model to elucidate pathways through which acculturation (indicated by language use) and reports of communication effectiveness specific to medical decision making contribute to decisional outcomes (i.e., congruency between preferred and actual involvement in decision making, treatment satisfaction) and quality of life among Latinas and non-Latina White women with breast cancer. Latinas (N = 326) and non-Latina Whites (N = 168) completed measures six months after breast cancer diagnosis, and quality of life was assessed 18 months after diagnosis. Structural equation modeling was used to examine relationships between language use, communication effectiveness, and outcomes. Among Latinas, 63% reported congruency in decision making, whereas 76% of non-Latina Whites reported congruency. In Latinas, greater use of English was related to better reported communication effectiveness. Effectiveness in communication was not related to congruency in decision making, but several indicators of effectiveness in communication were related to greater treatment satisfaction, as was greater congruency in decision making. Greater treatment satisfaction predicted more favorable quality of life. The final model fit the data well only for Latinas. Differences in quality of life and effectiveness in communication were observed between racial/ethnic groups. Findings underscore the importance of developing targeted interventions for physicians and Latinas with breast cancer to enhance communication in decision making. PsycINFO Database Record (c) 2012 APA, all rights reserved.

Structured nursing communication on interdisciplinary acute care teams improves perceptions of safety, efficiency, understanding of care plan and teamwork as well as job satisfaction.

PubMed

Gausvik, Christian; Lautar, Ashley; Miller, Lisa; Pallerla, Harini; Schlaudecker, Jeffrey

2015-01-01

Efficient, accurate, and timely communication is required for quality health care and is strongly linked to health care staff job satisfaction. Developing ways to improve communication is key to increasing quality of care, and interdisciplinary care teams allow for improved communication among health care professionals. This study examines the patient- and family-centered use of structured interdisciplinary bedside rounds (SIBR) on an acute care for the elderly (ACE) unit in a 555-bed metropolitan community hospital. This mixed methods study surveyed 24 nurses, therapists, patient care assistants, and social workers to measure perceptions of teamwork, communication, understanding of the plan for the day, safety, efficiency, and job satisfaction. A similar survey was administered to a control group of 38 of the same staff categories on different units in the same hospital. The control group units utilized traditional physician-centric rounding. Significant differences were found in each category between the SIBR staff on the ACE unit and the control staff. Nurse job satisfaction is an important marker of retention and recruitment, and improved communication may be an important aspect of increasing this satisfaction. Furthermore, improved communication is key to maintaining a safe hospital environment with quality patient care. Interdisciplinary team rounds that take place at the bedside improve both nursing satisfaction and related communication markers of quality and safety, and may help to achieve higher nurse retention and safer patient care. These results point to the interconnectedness and dual benefit to both job satisfaction and patient quality of care that can come from enhancements to team communication.

Clinical handover as an interactive event: informational and interactional communication strategies in effective shift-change handovers.

PubMed

Eggins, Suzanne; Slade, Diana

2012-01-01

Clinical handover -- the transfer between clinicians of responsibility and accountability for patients and their care (AMA 2006) -- is a pivotal and high-risk communicative event in hospital practice. Studies focusing on critical incidents, mortality, risk and patient harm in hospitals have highlighted ineffective communication -- including incomplete and unstructured clinical handovers -- as a major contributing factor (NSW Health 2005; ACSQHC 2010). In Australia, as internationally, Health Departments and hospital management have responded by introducing standardised handover communication protocols. This paper problematises one such protocol - the ISBAR tool - and argues that the narrow understanding of communication on which such protocols are based may seriously constrain their ability to shape effective handovers. Based on analysis of audio-recorded shift-change clinical handovers between medical staff we argue that handover communication must be conceptualised as inherently interactive and that attempts to describe, model and teach handover practice must recognise both informational and interactive communication strategies. By comparing the communicative performance of participants in authentic handover events we identify communication strategies that are more and less likely to lead to an effective handover and demonstrate the importance of focusing close up on communication to improve the quality and safety of healthcare interactions.

Quality of life and communication in orthognathic treatment.

PubMed

Catt, Susan L; Ahmad, Sofia; Collyer, Jeremy; Hardwick, Lauren; Shah, Nahush; Winchester, Lindsay

2018-06-01

The primary aim was to determine what, if any, relationships exist between communication and quality of life in patients receiving orthognathic treatment since this has not been explored. A secondary aim was to compare the Quality of Life (QoL) of a pre-treatment sample with those at 2 years post-surgery. A cross-sectional questionnaire method was used. Outpatient clinics providing orthognathic treatment at four UK hospital sites. Two separate samples of pre-treatment (n = 73) and 2-year post-surgery (n = 78) patients participated in the study. At clinic appointments, all eligible patients were invited to complete the Orthognathic Quality of Life Questionnaire (OQLQ), a previously validated condition-specific quality of life measure. At the same time, participants at the 2-year post-surgery stage also completed a second short questionnaire, the Communication Assessment Tool-Team (CAT-T), where they rated the quality of communication they had received during treatment. One hundred and fifty-one complete responses were received. The average age was 24.5 years (S.D. 9.77) and the majority (67%) were female in both groups. Statistically significant associations were found between QoL and quality of communication in the treated sample. Findings also showed a comparatively poorer QoL for the pre-treatment participants. This reduced QoL was more pronounced in females than males for all aspects except dentofacial appearance. There was an improvement in QoL for patients at 2 years post-surgery compared to pre-treatment. There is an association between QoL and quality of communication as reported by participants at 2 years post-surgery. These novel findings are similar to outcomes in other patient settings such as oncology, but further investigation is required to establish the direction of cause and effect.

Thought-based row-column scanning communication board for individuals with cerebral palsy.

PubMed

Scherer, Reinhold; Billinger, Martin; Wagner, Johanna; Schwarz, Andreas; Hettich, Dirk Tassilo; Bolinger, Elaina; Lloria Garcia, Mariano; Navarro, Juan; Müller-Putz, Gernot

2015-02-01

Impairment of an individual's ability to communicate is a major hurdle for active participation in education and social life. A lot of individuals with cerebral palsy (CP) have normal intelligence, however, due to their inability to communicate, they fall behind. Non-invasive electroencephalogram (EEG) based brain-computer interfaces (BCIs) have been proposed as potential assistive devices for individuals with CP. BCIs translate brain signals directly into action. Motor activity is no longer required. However, translation of EEG signals may be unreliable and requires months of training. Moreover, individuals with CP may exhibit high levels of spontaneous and uncontrolled movement, which has a large impact on EEG signal quality and results in incorrect translations. We introduce a novel thought-based row-column scanning communication board that was developed following user-centered design principles. Key features include an automatic online artifact reduction method and an evidence accumulation procedure for decision making. The latter allows robust decision making with unreliable BCI input. Fourteen users with CP participated in a supporting online study and helped to evaluate the performance of the developed system. Users were asked to select target items with the row-column scanning communication board. The results suggest that seven among eleven remaining users performed better than chance and were consequently able to communicate by using the developed system. Three users were excluded because of insufficient EEG signal quality. These results are very encouraging and represent a good foundation for the development of real-world BCI-based communication devices for users with CP. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Validation of the Family Inpatient Communication Survey.

PubMed

Torke, Alexia M; Monahan, Patrick; Callahan, Christopher M; Helft, Paul R; Sachs, Greg A; Wocial, Lucia D; Slaven, James E; Montz, Kianna; Inger, Lev; Burke, Emily S

2017-01-01

Although many family members who make surrogate decisions report problems with communication, there is no validated instrument to accurately measure surrogate/clinician communication for older adults in the acute hospital setting. The objective of this study was to validate a survey of surrogate-rated communication quality in the hospital that would be useful to clinicians, researchers, and health systems. After expert review and cognitive interviewing (n = 10 surrogates), we enrolled 350 surrogates (250 development sample and 100 validation sample) of hospitalized adults aged 65 years and older from three hospitals in one metropolitan area. The communication survey and a measure of decision quality were administered within hospital days 3 and 10. Mental health and satisfaction measures were administered six to eight weeks later. Factor analysis showed support for both one-factor (Total Communication) and two-factor models (Information and Emotional Support). Item reduction led to a final 30-item scale. For the validation sample, internal reliability (Cronbach's alpha) was 0.96 (total), 0.94 (Information), and 0.90 (Emotional Support). Confirmatory factor analysis fit statistics were adequate (one-factor model, comparative fit index = 0.981, root mean square error of approximation = 0.62, weighted root mean square residual = 1.011; two-factor model comparative fit index = 0.984, root mean square error of approximation = 0.055, weighted root mean square residual = 0.930). Total score and subscales showed significant associations with the Decision Conflict Scale (Pearson correlation -0.43, P < 0.001 for total score). Emotional Support was associated with improved mental health outcomes at six to eight weeks, such as anxiety (-0.19 P < 0.001), and Information was associated with satisfaction with the hospital stay (0.49, P < 0.001). The survey shows high reliability and validity in measuring communication experiences for hospital surrogates. The scale has promise for measurement of communication quality and is predictive of important outcomes, such as surrogate satisfaction and well-being. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Examining the role of communication on sibling relationship quality and interaction for sibling pairs with and without a developmental disability.

PubMed

Smith, Ashlyn L; Romski, Maryann; Sevcik, Rose A

2013-09-01

This study examined communication interaction patterns when one sibling had a developmental disability as well as the role of communication skills in sibling relationship quality. Thirty sibling dyads were categorized into one of three communication status groups: emerging, context-dependent, and independent communicators. Independent communicators and their siblings did not differ in terms of syntactic complexity but typically developing siblings dominated the interaction and exhibited greater lexical diversity regardless of communication status. Communication status did not impact the warmth/closeness, rivalry, or conflict in the sibling relationship, but siblings of independent communicators engaged in the greatest amount of helping and managing behaviors. These results represent a first step in understanding the role of communication skills in the sibling relationship for families of children with disabilities.

Trauma-related symptoms in neglected preschoolers and affective quality of mother-child communication.

PubMed

Milot, Tristan; St-Laurent, Diane; Ethier, Louise S; Provost, Marc A

2010-11-01

This study (a) assessed whether child neglect is associated with posttraumatic stress disorder (PTSD) and dissociative symptoms in the preschool period and (b) examined the role of quality of mother-child affective communication in the development of trauma-related symptoms among neglected children. Participants were 33 neglected and 72 non-neglected preschoolers (mean age = 60 months). Neglected children were recruited from the Child Protection Agencies. Neglected and non-neglected children victims of other form of abuse were excluded from the study. Trauma symptoms were evaluated through mother and preschool teacher reports. Quality of mother-child affective communication was assessed in a lab visit during an unstructured task. According to teachers, neglected children displayed more PTSD and dissociative symptoms than non-neglected children. Quality of mother-child communication was lower in neglected dyads. Mother-child affective communication predicted teacher-reported child trauma symptomatology, over and above child neglect. Discussion focuses on the traumatic nature of child neglect and the underlying parent-child relational processes.

Multi-disciplinary communication networks for skin risk assessment in nursing homes with high IT sophistication.

PubMed

Alexander, Gregory L; Pasupathy, Kalyan S; Steege, Linsey M; Strecker, E Bradley; Carley, Kathleen M

2014-08-01

The role of nursing home (NH) information technology (IT) in quality improvement has not been clearly established, and its impacts on communication between care givers and patient outcomes in these settings deserve further attention. In this research, we describe a mixed method approach to explore communication strategies used by healthcare providers for resident skin risk in NH with high IT sophistication (ITS). Sample included NH participating in the statewide survey of ITS. We incorporated rigorous observation of 8- and 12-h shifts, and focus groups to identify how NH IT and a range of synchronous and asynchronous tools are used. Social network analysis tools and qualitative analysis were used to analyze data and identify relationships between ITS dimensions and communication interactions between care providers. Two of the nine ITS dimensions (resident care-technological and administrative activities-technological) and total ITS were significantly negatively correlated with number of unique interactions. As more processes in resident care and administrative activities are supported by technology, the lower the number of observed unique interactions. Additionally, four thematic areas emerged from staff focus groups that demonstrate how important IT is to resident care in these facilities including providing resident-centered care, teamwork and collaboration, maintaining safety and quality, and using standardized information resources. Our findings in this study confirm prior research that as technology support (resident care and administrative activities) and overall ITS increases, observed interactions between staff members decrease. Conversations during staff interviews focused on how technology facilitated resident centered care through enhanced information sharing, greater virtual collaboration between team members, and improved care delivery. These results provide evidence for improving the design and implementation of IT in long term care systems to support communication and associated resident outcomes. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

A Systematic Review of End-of-Life Care Communication Skills Training for Generalist Palliative Care Providers: Research Quality and Reporting Guidance.

PubMed

Brighton, Lisa Jane; Koffman, Jonathan; Hawkins, Amy; McDonald, Christine; O'Brien, Suzanne; Robinson, Vicky; Khan, Shaheen A; George, Rob; Higginson, Irene J; Selman, Lucy Ellen

2017-09-01

End-of-life care (EoLC) communication skills training for generalist palliative care providers is recommended in policy guidance globally. Although many training programs now exist, there has been no comprehensive evidence synthesis to inform future training delivery and evaluation. To identify and appraise how EoLC communication skills training interventions for generalist palliative care providers are developed, delivered, evaluated, and reported. Systematic review. Ten electronic databases (inception to December 2015) and five relevant journals (January 2004 to December 2015) were searched. Studies testing the effectiveness of EoLC communication skills training for generalists were included. Two independent authors assessed study quality. Descriptive statistics and narrative synthesis are used to summarize the findings. From 11,441 unique records, 170 reports were identified (157 published, 13 unpublished), representing 160 evaluation studies of 153 training interventions. Of published papers, eight were of low quality, 108 medium, and 41 high. Few interventions were developed with service user involvement (n = 7), and most were taught using a mixture of didactics (n = 123), reflection and discussion (n = 105), and role play (n = 86). Evaluation designs were weak: <30% were controlled, <15% randomized participants. Over half (n = 85) relied on staff self-reported outcomes to assess effectiveness, and 49% did not cite psychometrically validated measures. Key information (e.g., training duration, participant flow) was poorly reported. Despite a proliferation of EoLC communication skills training interventions in the literature, evidence is limited by poor reporting and weak methodology. Based on our findings, we present a CONSORT statement supplement to improve future reporting and encourage more rigorous testing. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

Fathers in Turkey: Paternity Characteristics, Gender Role, Communication Skills

ERIC Educational Resources Information Center

ünüvar, Perihan

2017-01-01

Objective of this study is to examine the correlation the quality of paternity, gender roles and communication skills of fathers. The scores in the scale of supporting developmental tasks were used in order to determine the quality of paternity. The other data collection tools were the BEM sex role inventory and the communication skills inventory.…

High Quality Teaching in a University: Identification and Description.

ERIC Educational Resources Information Center

Moses, Ingrid

1985-01-01

The teaching approaches and attitudes toward teaching of University of Queensland faculty rated superior under one rating system are examined, including professional and personal skills and attitudes such as subject area competence, ability to communicate knowledge in various classroom contexts, and commitment to facilitating learning in…

Proceedings of the Space Shuttle Sortie Workshop. Volume 2: Working group reports

NASA Technical Reports Server (NTRS)

1972-01-01

Details are presented on the mission planning progress in each of the working paper reports. The general topics covered are the following: space technology; materials processing and space manufacturing; communications and navigation; earth and ocean physics; oceanography; earth resources and surface environmental quality; meteorology and atmospheric environmental quality; life sciences; atmospheric and space physics; solar physics; high energy cosmic rays; X-ray and gamma ray astronomy; ultraviolet-optical astronomy; planetary astronomy; and infrared astronomy.

Comparative Effectiveness of Disease Management With Information Communication Technology for Preventing Hospitalization and Readmission in Adults With Chronic Congestive Heart Failure.

PubMed

Aronow, Wilbert S; Shamliyan, Tatyana A

2018-06-01

Critical appraisal of all available evidence regarding the role of noninvasive communication technology for improving patient survival and reducing hospital admissions in adults with chronic heart failure (HF). Systematic literature review and grading of the quality of evidence according to the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) Working Group approach. Four databases were searched in March 2018 to find 2 high-quality meta-analyses and published and unpublished data from 58 randomized controlled trials (RCTs) that compared noninvasive communication technology with usual care in community-dwelling adults with HF. Direct meta-analysis of aggregate data with random effects models. Moderate-quality evidence suggests that there are no differences in all-cause mortality between telemonitoring and usual care, whereas complex telemonitoring that includes transmission of patient parameters and analysis by health care professionals decreases all-cause mortality (relative risk [RR] 0.78, 95% confidence interval [CI] 0.62, 0.99; 2885 people in 12 RCTs). Moderate-quality evidence suggests that telemonitoring prevents HF-related hospitalizations (RR 0.74; 95% CI 0.62, 0.88; 4001 people in 11 RCTs). Moderate-quality evidence suggests that structured telephone support decreases all-cause mortality (RR 0.86; 95% CI 0.77, 0.97; 9535 people in 24 RCTs) and HF-related hospitalizations (RR 0.83; 95% CI 0.73, 0.94; 7030 people in 16 RCTs). Use of a mobile personal digital assistant prevents HF-related hospitalizations (RR 0.58; 95% CI 0.44, 0.77; 674 people in 3 RCTs). The evidence regarding the comparative effectiveness of specific telecommunication devices is insufficient. The results from many completed studies are not available. Clinicians should offer noninvasive monitoring with communication technology applications to all HF patients. Future research should examine comparative effectiveness of technology applications in patient subpopulations. Copyright © 2018 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Bidirectional chaos communication between two outer semiconductor lasers coupled mutually with a central semiconductor laser.

PubMed

Li, Ping; Wu, Jia-Gui; Wu, Zheng-Mao; Lin, Xiao-Dong; Deng, Dao; Liu, Yu-Ran; Xia, Guang-Qiong

2011-11-21

Based on a linear chain composed of a central semiconductor laser and two outer semiconductor lasers, chaos synchronization and bidirectional communication between two outer lasers have been investigated under the case that the central laser and the two outer lasers are coupled mutually, whereas there exists no coupling between the two outer lasers. The simulation results show that high-quality and stable isochronal synchronization between the two outer lasers can be achieved, while the cross-correlation coefficients between the two outer lasers and the central laser are very low under proper operation condition. Based on the high performance chaos synchronization between the two outer lasers, message bidirectional transmissions of bit rates up to 20 Gbit/s can be realized through adopting a novel decoding scheme which is different from that based on chaos pass filtering effect. Furthermore, the security of bidirectional communication is also analyzed. © 2011 Optical Society of America

Cancer control and the communication innovation in South Korea: implications for cancer disparities.

PubMed

Jung, Minsoo

2013-01-01

Over the last 10 years, the number of cancer survivors in South Korea has reached nearly one million with a survival rate of 49.4%. However, integrated supportive care for cancer survivors is lagging. One area in which the current cancer control policy needs updating is in the utilization of information and communication technology (ICT). The remarkable progress in the field of ICT over the past 10 years presents exciting new opportunities for health promotion. Recent communication innovations are conducive to the exchange of meta-information, giving rise to a new service area and transforming patients into active medical consumers. Consequently, such innovations encourage active participation in the mutual utilization and sharing of high-quality information. However, these benefits from new ICTs will almost certainly not be equally available to all, leading to so-called communication inequalities where cancer survivors from lower socioeconomic classes will likely have more limited access to the best means of making use of the health information. Therefore, most essentially, emphasis must be placed on helping cancer survivors and their caregivers utilize such advances in ICT to create a more efficient flow of health information, thereby reducing communication inequalities and expanding social support. Once we enhance access to health information and better manage the quality of information, as a matter of fact, we can expect an alleviation of the health inequalities faced by cancer survivors.

Integration of HIV care into maternal health services: a crucial change required in improving quality of obstetric care in countries with high HIV prevalence.

PubMed

Madzimbamuto, Farai D; Ray, Sunanda; Mogobe, Keitshokile D

2013-06-10

The failure to reduce preventable maternal deaths represents a violation of women's right to life, health, non-discrimination and equality. Maternal deaths result from weaknesses in health systems: inadequate financing of services, poor information systems, inefficient logistics management and most important, the lack of investment in the most valuable resource, the human resource of health workers. Inadequate senior leadership, poor communication and low staff morale are cited repeatedly in explaining low quality of healthcare. Vertical programmes undermine other service areas by creating competition for scarce skilled staff, separate reporting systems and duplication of training and tasks. Confidential enquiries and other quality-improvement activities have identified underlying causes of maternal deaths, but depend on the health system to respond with remedies. Instead of separate vertical programmes for management of HIV, tuberculosis, and reproductive health, integration of care and joint management of pregnancy and HIV would be more effective. Addressing health system failures that lead to each woman's death would have a wider impact on improving the quality of care provided in the health service as a whole. More could be achieved if existing resources were used more effectively. The challenge for African countries is how to get into practice interventions known from research to be effective in improving quality of care. Advocacy and commitment to saving women's lives are crucial elements for campaigns to influence governments and policy -makers to act on the findings of these enquiries. Health professional training curricula should be updated to include perspectives on patients' rights, communication skills, and integrated approaches, while using adult learning methods and problem-solving techniques. In countries with high rates of Human Immunodeficiency Virus (HIV), indirect causes of maternal deaths from HIV-associated infections now exceed direct causes of hemorrhage, hypertension and sepsis. Advocacy for all pregnant HIV-positive women to be on anti-retroviral therapy must extend to improvements in the quality of service offered, better organised obstetric services and integration of clinical HIV care into maternity services. Improved communication and specialist support to peripheral facilities can be facilitated through advances in technology such as mobile phones.

The Relationship of Patient-Provider Communication on Quality of Life among African-American and White Cancer Survivors.

PubMed

Li, Chien-Ching; Matthews, Alicia K; Dossaji, Mazahir; Fullam, Francis

2017-07-01

Prior research has demonstrated poorer patient-provider communication ratings among African American compared to White patients. The quality of patient-provider communication has been shown to impact treatment outcomes among cancer patients. A secondary data analysis design was used to determine the relationship of six patient-provider communication variables on the physical health quality of life (PHQOL) and mental health quality of life (MHQOL) of African American and White cancer patients (N = 479). We also examined whether the relationship between communication patterns and QOL differed based on race/ethnicity. Mean physical and mental health QOL scores for the sample were 69.8 and 77.6, respectively. After controlling for significant sociodemographic, clinical, and hospital variables, results showed that patients who experienced fewer interpersonal communication barriers who were more satisfied with the information given by providers had higher PHQOL and MHQOL scores. Additionally, patients who felt more comfort in asking questions or had fewer unmet information needs had higher MHQOL. A stratified analysis showed that the relationship of overall satisfaction with information on MHQOL was stronger among African American patients than White patients. Future research should focus on the development of interventions to improve patient-provider communication as a means for enhancing QOL outcomes among cancer survivors.

Adolescents' drinking and drunkenness more likely in one-parent families and due to poor communication with mother.

PubMed

Tomčíková, Zuzana; Veselská, Zuzana Dankulincová; Gecková, Andrea Madarasová; van Dijk, Jitse P; Reijneveld, Sijmen A

2015-03-01

Alcohol use is a relatively common behaviour, particularly among adolescents, and has become a major public health concern. This study explores the associations between family composition, the quality of adolescents' communication with parents and adolescents' recent frequent alcohol drinking and lifetime drunkenness. Data were obtained from the Slovak part of the 2005-2006 Health Behaviour in School-aged Children (HBSC) study. The sample consisted of 3,882 students (46.3% males; mean age 13.3; ± 1.6). Data on drinking alcohol in the past week, lifetime drunkenness, communication and family composition were collected via anonymous questionnaires stratified for ages 11, 13 and 15 years and following the methodology of the HBSC study. The results showed that living in an incomplete family increased the risk of frequent drinking and drunkenness among adolescents as well as a low quality of communication between mothers and their children. Risks were higher for drunkenness than for frequent alcohol use and strongly increased by age, with the communication with parents worsening at increasing age. Our findings show the importance of the quality of communication between parents and adolescents in preventing the hazardous alcohol use among adolescents. Preventive interventions to reduce adolescents' use of alcohol should therefore also target the quality of communication in the family.

Advanced communications payload for mobile applications

NASA Technical Reports Server (NTRS)

Ames, S. A.; Kwan, R. K.

1990-01-01

An advanced satellite payload is proposed for single hop linking of mobile terminals of all classes as well as Very Small Aperture Terminal's (VSAT's). It relies on an intensive use of communications on-board processing and beam hopping for efficient link design to maximize capacity and a large satellite antenna aperture and high satellite transmitter power to minimize the cost of the ground terminals. Intersatellite links are used to improve the link quality and for high capacity relay. Power budgets are presented for links between the satellite and mobile, VSAT, and hub terminals. Defeating the effects of shadowing and fading requires the use of differentially coherent demodulation, concatenated forward error correction coding, and interleaving, all on a single link basis.

How Differences Between Manager and Clinician Perceptions of Safety Culture Impact Hospital Processes of Care.

PubMed

Richter, Jason; Mazurenko, Olena; Kazley, Abby Swanson; Ford, Eric W

2017-11-04

Evidenced-based processes of care improve patient outcomes, yet universal compliance is lacking, and perceptions of the quality of care are highly variable. The purpose of this study is to examine how differences in clinician and management perceptions on teamwork and communication relate to adherence to hospital processes of care. Hospitals submitted identifiable data for the 2012 Hospital Survey on Patient Safety Culture and the Centers for Medicare and Medicaid Services' Hospital Compare. The dependent variable was a composite, developed from the scores on adherence to acute myocardial infarction, heart failure, and pneumonia process of care measures. The primary independent variables reflected 4 safety culture domains: communication openness, feedback about errors, teamwork within units, and teamwork between units. We assigned each hospital into one of 4 groups based on agreement between managers and clinicians on each domain. Each hospital was categorized as "high" (above the median) or "low" (below) for clinicians and managers in communication and teamwork. We found a positive relationship between perceived teamwork and communication climate and processes of care measures. If managers and clinicians perceived the communication openness as high, the hospital was more likely to adhere with processes of care. Similarly, if clinicians perceived teamwork across units as high, the hospital was more likely to adhere to processes of care. Manager and staff perceptions about teamwork and communications impact adherence to processes of care. Policies should recognize the importance of perceptions of both clinicians and managers on teamwork and communication and seek to improve organizational climate and practices. Clinician perceptions of teamwork across units are more closely linked to processes of care, so managers should be cognizant and try to improve their perceptions.

The impact of the teachers’ non-verbal communication on success in teaching

PubMed Central

BAMBAEEROO, FATEMEH; SHOKRPOUR, NASRIN

2017-01-01

Introduction: Non-verbal communication skills, also called sign language or silent language, include all behaviors performed in the presence of others or perceived either consciously or unconsciously. The main aim of this review article was to determine the effect of the teachers’ non-verbal communication on success in teaching using the findings of the studies conducted on the relationship between quality of teaching and the teachers’ use of non-verbal communication and also its impact on success in teaching. Methods: Considering the research method, i.e. a review article, we searched for all articles in this field using key words such as success in teaching, verbal communication and non-verbal communication. In this study, we did not encode the articles. Results: The results of this revealed that there was a strong relationship among the quality, amount and the method of using non-verbal communication by teachers while teaching. Based on the findings of the studies reviewed, it was found that the more the teachers used verbal and non-verbal communication, the more efficacious their education and the students’ academic progress were. Under non-verbal communication, some other patterns were used. For example, emotive, team work, supportive, imaginative, purposive, and balanced communication using speech, body, and pictures all have been effective in students’ learning and academic success. The teachers’ attention to the students’ non-verbal reactions and arranging the syllabus considering the students’ mood and readiness have been emphasized in the studies reviewed. Conclusion: It was concluded that if this skill is practiced by teachers, it will have a positive and profound effect on the students’ mood. Non-verbal communication is highly reliable in the communication process, so if the recipient of a message is between two contradictory verbal and nonverbal messages, logic dictates that we push him toward the non-verbal message and ask him to pay more attention to non-verbal than verbal messages because non-verbal cues frequently reveal the intention of the sender of the information and reflect his/her emotional reactions. Based on the obtained results of this study, it is recommended that attention to non-verbal communication skills can make a positive change in the future of a student’s life. It seems necessary for the teachers to practice and learn effective communication skills, especially for those who always interact with a large group of students. One of the factors contributing to the success or failure of students is the quality of the relationship and how the teacher builds this relationship with students. Especially, it is more effective for students who are more responsive to human relations and communication skills. Finally, it is recommended that the teachers should improve their communication skills to have better communication with their audience. The authorities are recommended to help improve the teachers’ level of communication skills through holding training courses. PMID:28367460

The impact of the teachers' non-verbal communication on success in teaching.

PubMed

Bambaeeroo, Fatemeh; Shokrpour, Nasrin

2017-04-01

Non-verbal communication skills, also called sign language or silent language, include all behaviors performed in the presence of others or perceived either consciously or unconsciously. The main aim of this review article was to determine the effect of the teachers' non-verbal communication on success in teaching using the findings of the studies conducted on the relationship between quality of teaching and the teachers' use of non-verbal communication and also its impact on success in teaching. Considering the research method, i.e. a review article, we searched for all articles in this field using key words such as success in teaching, verbal communication and non-verbal communication. In this study, we did not encode the articles. The results of this revealed that there was a strong relationship among the quality, amount and the method of using non-verbal communication by teachers while teaching. Based on the findings of the studies reviewed, it was found that the more the teachers used verbal and non-verbal communication, the more efficacious their education and the students' academic progress were. Under non-verbal communication, some other patterns were used. For example, emotive, team work, supportive, imaginative, purposive, and balanced communication using speech, body, and pictures all have been effective in students' learning and academic success. The teachers' attention to the students' non-verbal reactions and arranging the syllabus considering the students' mood and readiness have been emphasized in the studies reviewed. It was concluded that if this skill is practiced by teachers, it will have a positive and profound effect on the students' mood. Non-verbal communication is highly reliable in the communication process, so if the recipient of a message is between two contradictory verbal and nonverbal messages, logic dictates that we push him toward the non-verbal message and ask him to pay more attention to non-verbal than verbal messages because non-verbal cues frequently reveal the intention of the sender of the information and reflect his/her emotional reactions. Based on the obtained results of this study, it is recommended that attention to non-verbal communication skills can make a positive change in the future of a student's life. It seems necessary for the teachers to practice and learn effective communication skills, especially for those who always interact with a large group of students. One of the factors contributing to the success or failure of students is the quality of the relationship and how the teacher builds this relationship with students. Especially, it is more effective for students who are more responsive to human relations and communication skills. Finally, it is recommended that the teachers should improve their communication skills to have better communication with their audience. The authorities are recommended to help improve the teachers' level of communication skills through holding training courses.

Information Communication Technology for Educational Quality: Challenges, Prospects in Ethiopian Context

ERIC Educational Resources Information Center

Sani, Dureti; Tasisa, Wakgari; Panigraphi, Manas Ranjan

2013-01-01

The major purpose of this project was to assess and review the principal role of ICT in supplementing the General Quality Improvement program (GEQIP) in Western Harerghe, Ethiopia. The project also further analyzed the contribution of Information Communication Technology (ICT) to the indicators of GEQIP like quality, equity, access and internal…

A Research Agenda for Communication Between Health Care Professionals and Patients Living With Serious Illness.

PubMed

Tulsky, James A; Beach, Mary Catherine; Butow, Phyllis N; Hickman, Susan E; Mack, Jennifer W; Morrison, R Sean; Street, Richard L; Sudore, Rebecca L; White, Douglas B; Pollak, Kathryn I

2017-09-01

Poor communication by health care professionals contributes to physical and psychological suffering in patients living with serious illness. Patients may not fully understand their illness, prognosis, and treatment options or may not receive medical care consistent with their goals. Despite considerable research exploring the role of communication in this setting, many questions remain, and a clear agenda for communication research is lacking. Through a consensus conference and subsequent activities, we reviewed the state of the science, identified key evidence gaps in understanding the impact of communication on patient outcomes, and created an agenda for future research. We considered 7 broad topics: shared decision making, advance care planning, communication training, measuring communication, communication about prognosis, emotion and serious illness communication, and cultural issues. We identified 5 areas in which further research could substantially move the field forward and help enhance patient care: measurement and methodology, including how to determine communication quality; mechanisms of communication, such as identifying the specific clinician behaviors that patients experience as both honest and compassionate, or the role of bias in the clinical encounter; alternative approaches to advance care planning that focus on the quality of serious illness communication and not simply completion of forms; teaching and disseminating communication skills; and approaches, such as economic incentives and other clinician motivators, to change communication behavior. Our findings highlight the urgent need to improve quality of communication between health care professionals and patients living with serious illness through a broad range of research that covers communication skills, tools, patient education, and models of care.

Certifying leaders? high-quality management practices and healthy organisations: an ISO-9000 based standardisation approach

PubMed Central

MONTANO, Diego

2016-01-01

The present study proposes a set of quality requirements to management practices by taking into account the empirical evidence on their potential effects on health, the systemic nature of social organisations, and the current conceptualisations of management functions within the framework of comprehensive quality management systems. Systematic reviews and meta-analyses focusing on the associations between leadership and/or supervision and health in occupational settings are evaluated, and the core elements of an ISO 9001 standardisation approach are presented. Six major occupational health requirements to high-quality management practices are identified pertaining to communication processes, organisational justice, role clarity, decision making, social influence processes and management support. It is concluded that the quality of management practices may be improved by developing a quality management system of management practices that ensures not only conformity to product but also to occupational safety and health requirements. Further research may evaluate the practicability of the proposed approach. PMID:26860787

Certifying leaders? high-quality management practices and healthy organisations: an ISO-9000 based standardisation approach.

PubMed

Montano, Diego

2016-08-05

The present study proposes a set of quality requirements to management practices by taking into account the empirical evidence on their potential effects on health, the systemic nature of social organisations, and the current conceptualisations of management functions within the framework of comprehensive quality management systems. Systematic reviews and meta-analyses focusing on the associations between leadership and/or supervision and health in occupational settings are evaluated, and the core elements of an ISO 9001 standardisation approach are presented. Six major occupational health requirements to high-quality management practices are identified pertaining to communication processes, organisational justice, role clarity, decision making, social influence processes and management support. It is concluded that the quality of management practices may be improved by developing a quality management system of management practices that ensures not only conformity to product but also to occupational safety and health requirements. Further research may evaluate the practicability of the proposed approach.

Microgravity

NASA Image and Video Library

1998-02-05

Scarning electron microscope images of the surface of ZBLAN fibers pulled in microgravity (ug) and on Earth (1g) show the crystallization that normally occurs in ground-based processing. The face of each crystal will reflect or refract a portion of the optical signal, thus degrading its quality. NASA is conducting research on pulling ZBLAN fibers in the low-g environment of space to prevent crystallization that limits ZBLAN's usefulness in optical fiber-based communications. ZBLAN is a heavy-metal fluoride glass that shows exdeptional promise for high-throughput communications with infrared lasers. Photo credit: NASA/Marshall Space Flight Center

Quality of life and adolescents' communication with their significant others (mother, father, and best friend): the mediating effect of attachment to pets.

PubMed

Marsa-Sambola, Ferran; Williams, Joanne; Muldoon, Janine; Lawrence, Alistair; Connor, Melanie; Currie, Candace

2017-06-01

The relationship between adolescents' communication with their significant others (mother, father, and best friend) and quality of life (KIDSCREEN) was investigated in 2262 Scottish adolescent pet owners. The variable attachment to pets was also tested and assessed as a mediator of this relationship. A positive relationship between adolescents' communication with their significant other (mother, father, and best friend) and quality of life decreased when controlling for attachment to dogs. In cat owners, a positive relationship between communication with a best friend and quality of life decreased when controlling for attachment to cats. In cat and dog owners, attachment to these pets predicted higher levels of quality of life. Higher attachment to dogs and cats was explained by good best friend (IV) and attachment to pets (DV) and best friends. Mediation effects of attachment to dogs and cats might be explained in terms of the caring activities associated with these types of pets.

Health care using high-bandwidth communication to overcome distance and time barriers for the Department of Defense

NASA Astrophysics Data System (ADS)

Mun, Seong K.; Freedman, Matthew T.; Gelish, Anthony; de Treville, Robert E.; Sheehy, Monet R.; Hansen, Mark; Hill, Mac; Zacharia, Elisabeth; Sullivan, Michael J.; Sebera, C. Wayne

1993-01-01

Image management and communications (IMAC) network, also known as picture archiving and communication system (PACS) consists of (1) digital image acquisition, (2) image review station (3) image storage device(s), image reading workstation, and (4) communication capability. When these subsystems are integrated over a high speed communication technology, possibilities are numerous in improving the timeliness and quality of diagnostic services within a hospital or at remote clinical sites. Teleradiology system uses basically the same hardware configuration together with a long distance communication capability. Functional characteristics of components are highlighted. Many medical imaging systems are already in digital form. These digital images constitute approximately 30% of the total volume of images produced in a radiology department. The remaining 70% of images include conventional x-ray films of the chest, skeleton, abdomen, and GI tract. Unless one develops a method of handling these conventional film images, global improvement in productivity in image management and radiology service throughout a hospital cannot be achieved. Currently, there are two method of producing digital information representing these conventional analog images for IMAC: film digitizers that scan the conventional films, and computed radiography (CR) that captures x-ray images using storage phosphor plate that is subsequently scanned by a laser beam.

Odyssey personal communications satellite system

NASA Technical Reports Server (NTRS)

Spitzer, Christopher J.

1993-01-01

The spectacular growth of cellular telephone networks has proved the demand for personal communications. Large regions of the world are too sparsely populated to be economically served by terrestrial cellular communications. Since satellites are well suited to this application, TRW filed with the FCC on May 31, 1993 for the Odyssey construction permit. Odyssey will provide high quality wireless communication services worldwide from satellites. These services will include: voice, data, paging, and messaging. Odyssey will be an economical approach to providing communications. A constellation of 12 satellites will be orbited in three, 55 deg. inclined planes at an altitude of 10,354 km to provide continuous coverage of designated regions. Two satellites will be visible anywhere in the world at all times. This dual visibility leads to high line-of-sight elevation angles, minimizing obstructions by terrain, trees and buildings. Each satellite generates a multibeam antenna pattern that divides its coverage area into a set of contiguous cells. The communications system employs spread spectrum CDMA on both the uplinks and downlinks. This signaling method permits band sharing with other systems and applications. Signal processing is accomplished on the ground at the satellite's 'Gateway' stations. The 'bent pipe' transponders accommodates different regional standards, as well as signaling changes over time. The low power Odyssey handset will be cellular compatible. Multipath fade protection is provided in the handset.

Do mobile clinics provide high-quality antenatal care? A comparison of care delivery, knowledge outcomes and perception of quality of care between fixed and mobile clinics in central Haiti.

PubMed

Phillips, Erica; Stoltzfus, Rebecca J; Michaud, Lesly; Pierre, Gracia Lionel Fils; Vermeylen, Francoise; Pelletier, David

2017-10-16

Antenatal care (ANC) is an important health service for women in developing countries, with numerous proven benefits. Global coverage of ANC has steadily increased over the past 30 years, in part due to increased community-based outreach. However, commensurate improvements in health outcomes such as reductions in the prevalence of maternal anemia and infants born small-for-gestational age have not been achieved, even with increased coverage, indicating that quality of care may be inadequate. Mobile clinics are one community-based strategy used to further improve coverage of ANC, but their quality of care delivery has rarely been evaluated. To determine the quality of care of ANC in central Haiti, we compared adherence to national guidelines between fixed and mobile clinics by performing direct observations of antenatal care consultations and exit interviews with recipients of care using a multi-stage random sampling procedure. Outcome variables were eight components of care, and women's knowledge and perception of care quality. There were significant differences in the predicted proportion or probability of recommended services for four of eight care components, including intake, laboratory examinations, infection control, and supplies, iron folic acid supplements and Tetanus Toxoid vaccine provided to women. These care components were more likely performed in fixed clinics, except for distribution of supplies, iron-folic acid supplements, and Tetanus Toxoid vaccine, more likely provided in mobile clinics. There were no differences between clinic type for the proportion of total physical exam procedures performed, health and communication messages delivered, provider communication or documentation. Women's knowledge about educational topics was poor, but women perceived extremely high quality of care in both clinic models. Although adherence to guidelines differed by clinic type for half of the care components, both clinics had a low percentage of overall services delivered. Efforts to improve provider performance and quality are therefore needed in both models. Mobile clinics must deliver high-quality ANC to improve health and nutrition outcomes.

Improving care coordination between nephrology and primary care: a quality improvement initiative using the renal physicians association toolkit.

PubMed

Haley, William E; Beckrich, Amy L; Sayre, Judith; McNeil, Rebecca; Fumo, Peter; Rao, Vijaykumar M; Lerma, Edgar V

2015-01-01

Individuals at risk for chronic kidney disease (CKD), including those with diabetes mellitus and hypertension, are prevalent in primary care physician (PCP) practices. A major systemic barrier to mitigating risk of progression to kidney failure and to optimal care is failure of communication and coordination among PCPs and nephrologists. Quality improvement. Longitudinal practice-level study of tool-based intervention in nephrology practices and their referring PCP practices. 9 PCP and 5 nephrology practices in Philadelphia and Chicago. Tools from Renal Physicians Association toolkit were modified and provided for use by PCPs and nephrologists to improve identification of CKD, communication, and comanagement. CKD identification, referral to nephrologists, communication among PCPs and nephrologists, comanagement processes. Pre- and postimplementation interviews, questionnaires, site visits, and monthly teleconferences were used to ascertain practice patterns, perceptions, and tool use. Interview transcripts were reviewed for themes using qualitative analysis based on grounded theory. Chart audits assessed CKD identification and referral (PCPs). PCPs improved processes for CKD identification, referral to nephrologists, communication, and execution of comanagement plans. Documentation of glomerular filtration rate was increased significantly (P=0.01). Nephrologists improved referral and comanagement processes. PCP postintervention interviews documented increased awareness of risk factors, the need to track high-risk patients, and the importance of early referral. Final nephrologist interviews revealed heightened attention to communication and comanagement with PCPs and increased levels of satisfaction among all parties. Nephrology practices volunteered to participate and recruit their referring PCP practices. Audit tools were developed for quality improvement assessment, but were not designed to provide statistically significant estimates. The use of specifically tailored tools led to enhanced awareness and identification of CKD among PCPs, increased communication between practices, and improvement in comanagement and cooperation between PCPs and nephrologists. Copyright © 2014 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Optical overview and qualification of the LLCD space terminal

NASA Astrophysics Data System (ADS)

DeVoe, C. E.; Pillsbury, A. D.; Khatri, F.; Burnside, J. M.; Raudenbush, A. C.; Petrilli, L. J.; Williams, T.

2017-11-01

In October 2013 the Lunar Laser Communications Demonstration (LLCD) made communications history by successfully demonstrating 622 megabits per second laser communication from the moon's orbit to earth. The LLCD consisted of the Lunar Laser Communication Space Terminal (LLST), developed by MIT Lincoln Laboratory, mounted on NASA's Lunar Atmosphere and Dust Environment Explorer (LADEE) spacecraft and a primary ground terminal located in New Mexico, the Lunar Laser Communications Ground Terminal (LLGT), and two alternate ground terminals. This paper presents the optical layout of the LLST, the approach for testing the optical subsystems, and the results of the optical qualification of the LLST. Also described is the optical test set used to qualify the LLST. The architecture philosophy for the optics was to keep a small, simple optical backend that provided excellent boresighting and high isolation between the optical paths, high quality wavefront on axis, with minimal throughput losses on all paths. The front end large optics consisted of a Cassegrain 107mm telescope with an f/0.7 parabolic primary mirror and a solar window to reduce the thermal load on the telescope and to minimize background light received at the sensors.

Using Problem-Solving Frameworks to Address Challenging Behavior of Students with High-Functioning Autism and/or Asperger Syndrome

ERIC Educational Resources Information Center

O'Connor, Karen V.; Stichter, Janine P.

2011-01-01

Students with high-functioning autism and/or Asperger Syndrome (HFA/AS) are characterized by difficulties with communication as well as impairments in social interaction skills. Students with HFA/AS have been shown to generate solutions that are lower quality (e.g., less socially appropriate) than those of their typical peers and also to have…

Children with Speech, Language and Communication Needs: Their Perceptions of Their Quality of Life

ERIC Educational Resources Information Center

Markham, Chris; van Laar, Darren; Gibbard, Deborah; Dean, Taraneh

2009-01-01

Background: This study is part of a programme of research aiming to develop a quantitative measure of quality of life for children with communication needs. It builds on the preliminary findings of Markham and Dean (2006), which described some of the perception's parents and carers of children with speech language and communication needs had…

Health Telematics: A challenge for Healthcare Quality

DTIC Science & Technology

2001-10-25

coordination of medical professionals and the quality of care. A a consequence, Health Telematics is a striking challenge for : 1. The communication between... professionals . Many experiences of professional networks all around the world demonstrate the feasibility and the benefits of such an electronic...communication between doctors, nurses, hospitals, labs... 2. The communication between professionals and their patients. Are the professionals ready

An overview of satellite transmission issues and the ISDN

NASA Astrophysics Data System (ADS)

Knight, Ivor N.; Neibert, Mark T.

Satellite communications are examined in terms of services, flexibility, connectivity, and quality. Present business communications services and the need for a corporate communication network are discussed. The development of an integrated services digital network (ISDN) is proposed; the capabilities and advantages of ISDN are described. Consideration is given to the interconnectibility of ISDN and methods for improving transmission quality.

Promoting STEM Education: A Communications Toolkit

ERIC Educational Resources Information Center

National Governors Association, 2008

2008-01-01

As governors move this important STEM (Science, Technology, Engineering and Mathematics) policy agenda forward, they may find that some of their constituents have yet to be persuaded of the need for improvement. Some citizens and stakeholders may fail to grasp the strong link between high-quality STEM education and economic development in the…

Photography To Enhance Aesthetic Skills.

ERIC Educational Resources Information Center

McIsaac, Marina Stock

Recognizing that photography in the classroom is highly motivating in that it offers a unique vehicle for communicating ideas visually, this study was designed to isolate variables which can be both observed and evaluated in photographs and for which instruction can be designed. Relationships among the technical and aesthetic qualities in…

Give Everyone a Vested Interest in Food Service.

ERIC Educational Resources Information Center

Watkins, Shirley Maree

1987-01-01

Describes the school food service industry, providing 27 million meals daily in 89,000 schools, as second only to McDonald's in size. Offers advice for developing a superior, cooperative business venture. Focus must be on visible managers, high quality staff, clearly communicated objectives, and customer satisfaction. (MLH)

ONE FISH, TWO FISH, RED FISH, BLUE FISH: THE FISH QUALITY INDEX AS A RISK COMMUNICATION TOOL

EPA Science Inventory

Many people are at high risk for methyl mercury toxicity because of their consumption of contaminated fish. Often health risks of Persistent Bioaccumulative Toxicants (PT) such as methyl mercury, PCBs or Dioxins are underestimated because of their amplification in the food chain ...

Audio/ Videoconferencing Packages: Low Cost

ERIC Educational Resources Information Center

Treblay, Remy; Fyvie, Barb; Koritko, Brenda

2005-01-01

A comparison was conducted of "Voxwire MeetingRoom" and "iVocalize" v4.1.0.3, both Web-conferencing products using voice-over-Internet protocol (VoIP) to provide unlimited, inexpensive, international audio communication, and high-quality Web-conferencing fostering collaborative learning. The study used the evaluation criteria used in earlier…

Collaborative Wikipedia Projects in the Virtual Classroom

ERIC Educational Resources Information Center

Kenny, A. J.; Wolt, J. D.; Hurd, H. S.

2013-01-01

Wikipedia is a web-based, free-content encyclopedia that is openly editable and, thus, provides a unique platform for collaborations. Wikipedia projects are increasingly being integrated into upper-level courses across the country to explore advanced concepts, communicate science, and provide high-quality information to the public. Here we outline…

Influencing Practices through Videotape. A Systematic Evaluation of Communications Technology.

ERIC Educational Resources Information Center

Decker, Daniel J.; Merrill, William G.

1990-01-01

Effectiveness of a videotape on milking procedures was evaluated by showing it to 218 dairy farmers, with previewing evaluation, 2 viewings with discussion between, and postviewing evaluation. Tape quality and information content were rated highly, but an immediate second viewing was considered less effective than providing tapes for subsequent…

Providing Early Childhood Teachers with Opportunities to Understand Diversity and the Achievement Gap

ERIC Educational Resources Information Center

Meece, Darrell; Wingate, Kimberly O'Kelley

2010-01-01

High quality teaching--providing children with support, feedback, and positive communication--is associated with closing the achievement gap between minority and majority children. It is important for students in teacher preparation programs to understand changes in curricular approaches to diversity--from the color-blind approach, to…

Quality of life in people with Parkinson's disease: the relevance of social relationships and communication.

PubMed

Takahashi, Kayoko; Kamide, Naoto; Suzuki, Makoto; Fukuda, Michinari

2016-01-01

[Purpose] Maintaining high quality of life is crucial for the rehabilitation of patients with Parkinson's disease. The quality of life scales currently in use do not assess all quality of life domains or their importance for each individual. Therefore, a new quality of life measure, the Schedule for the Evaluation of Individual Quality of Life-Direct Weighting, was used to investigate quality of life in people with Parkinson's disease. [Subjects and Methods] Fifteen people with idiopathic Parkinson's disaese (average age = 80.0 years, standard deviation = 10.3 years, Hoehn & Yahr stages 1-4) were interviewed using the Schedule for the Evaluation of Individual Quality of Life-Direct Weighting. Its quality of life constructs were tested by comparing them against disease-specific quality of life (39-items Parkinson's Disease Questionnaire), motor functioning (Unified Parkinson's Disease Rating Scale Part III), and activities of daily living (Barthel Index). [Results] Social connections such as "family" and "friends" were revealed as important constructs of life satisfaction. The Schedule for the Evaluation of Individual Quality of Life-Direct Weighting was not significantly correlated with the 39-items Parkinson's Disease Questionnaire, Unified Parkinson's Disease Rating Scale Part III, or Barthel Index but was significantly correlated with the "communication" dimension of the 39-items Parkinson's Disease Questionnaire. [Conclusion] The Schedule for the Evaluation of Individual Quality of Life-Direct Weighting detected various domains of quality of life, especially social relationships with family and friends. "Being heard" was also revealed as an essential component of life satisfaction, as it provides patients with a feeling of acceptance and assurance, possibly resulting in better quality of life.

Mindfulness predicts student nurses' communication self-efficacy: A cross-national comparative study.

PubMed

Sundling, Vibeke; Sundler, Annelie J; Holmström, Inger K; Kristensen, Dorte Vesterager; Eide, Hilde

2017-08-01

The aim of this study was to compare student nurses' communication self-efficacy, empathy, and mindfulness across two countries, and to analyse the relationship between these qualities. The study had a cross-sectional design. Data was collected from final year student nurses in Norway and Sweden. Communication self-efficacy, empathy, and mindfulness were reported by questionnaires; Clear-cut communication with patients, Jefferson Scale of Empathy, and Langer 14 items mindfulness scale. The study included 156 student nurses, 94 (60%) were Swedish. The mean communication self-efficacy score was 119 (95% CI 116-122), empathy score 115 (95% CI 113-117) and mindfulness score 79 (95% CI 78-81). A Mann-Whitney test showed that Swedish students scored significantly higher on communication self-efficacy, empathy, and mindfulness than Norwegian students did. When adjusted for age, gender, and country in a multiple linear regression, mindfulness was the only independent predictor of communication self-efficacy. The Swedish student nurses in this study scored higher on communication self-efficacy, empathy, and mindfulness than Norwegian students did. Student nurses scoring high on mindfulness rated their communication self-efficacy higher. A mindful learning approach may improve communication self-efficacy and possibly the effect of communication skills training. Copyright © 2017 Elsevier B.V. All rights reserved.

Video on phone lines: technology and applications

NASA Astrophysics Data System (ADS)

Hsing, T. Russell

1996-03-01

Recent advances in communications signal processing and VLSI technology are fostering tremendous interest in transmitting high-speed digital data over ordinary telephone lines at bit rates substantially above the ISDN Basic Access rate (144 Kbit/s). Two new technologies, high-bit-rate digital subscriber lines and asymmetric digital subscriber lines promise transmission over most of the embedded loop plant at 1.544 Mbit/s and beyond. Stimulated by these research promises and rapid advances on video coding techniques and the standards activity, information networks around the globe are now exploring possible business opportunities of offering quality video services (such as distant learning, telemedicine, and telecommuting etc.) through this high-speed digital transport capability in the copper loop plant. Visual communications for residential customers have become more feasible than ever both technically and economically.

The end-of-life phase of high-grade glioma patients: dying with dignity?

PubMed

Sizoo, Eefje M; Taphoorn, Martin J B; Uitdehaag, Bernard; Heimans, Jan J; Deliens, Luc; Reijneveld, Jaap C; Pasman, H Roeline W

2013-01-01

In the end-of-life (EOL) phase, high-grade glioma (HGG) patients have a high symptom burden and often lose independence because of physical and cognitive dysfunction. This might affect the patient's personal dignity. We aimed to (a) assess the proportion of HGG patients dying with dignity as perceived by their relatives and (b) identify disease and care factors correlated with dying with dignity in HGG patients. We approached relatives of a cohort of 155 deceased HGG patients for the study. Participants completed a questionnaire concerning the EOL phase of the patient, covering several subthemes: (a) symptoms and signs, (b) health-related quality of life, (c) decision making, (d) place and quality of EOL care, and (e) dying with dignity. Relatives of 81 patients participated and 75% indicated that the patient died with dignity. These patients had fewer communication deficits, experienced fewer transitions between health care settings in the EOL phase, and more frequently died at their preferred place of death. Relatives were more satisfied with the physician providing EOL care and reported that the physician adequately explained treatment options. Multivariate analysis identified satisfaction with the physician, the ability to communicate, and the absence of transitions between settings as most predictive of a dignified death. Physicians caring for HGG patients in the EOL phase should timely focus on explaining possible treatment options, because patients experience communication deficits toward death. Physicians should strive to allow patients to die at their preferred place and avoid transitions during the last month of life.

Strategies for communicating quality expectations for environmental service contracts : final report.

DOT National Transportation Integrated Search

2017-03-01

This study explores the communication of quality expectations between the Office of Environment Services (OES) and environmental consulting firms contributing to the Plan Development Process of the Georgia Department of Transportation (GDOT). The ove...

From service quality in organisations to self-determination at home.

PubMed

Martínez-Tur, V; Moliner, C; Peñarroja, V; Gracia, E; Peiró, J M

2015-10-01

In our proposed model, family members' perceptions of service quality in organisations improve communication about self-determination. In turn, family perceptions of communication openness have a positive relationship with self-determination attitudes of family members. Finally, these attitudes predict self-determination behaviours of individuals with intellectual disability, as reported by family members. We tested this model with a sample of 625 family members (196 using 'day care services' and 429 using 'occupational services'). Multi-sample structural equation modelling (SEM) supported the model. Communication and attitudes fully mediated the link from service quality to self-determination behaviours. Improving family members' perceptions of service quality and opening channels of communication between professionals and family members are useful strategies to facilitate parents' positive attitudes and increase the frequency of self-determination behaviours at home. © 2015 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

Wireless Infrastructure M2M Network For Distributed Power Grid Monitoring

PubMed Central

Gharavi, Hamid; Hu, Bin

2018-01-01

With the massive integration of distributed renewable energy sources (RESs) into the power system, the demand for timely and reliable network quality monitoring, control, and fault analysis is rapidly growing. Following the successful deployment of Phasor Measurement Units (PMUs) in transmission systems for power monitoring, a new opportunity to utilize PMU measurement data for power quality assessment in distribution grid systems is emerging. The main problem however, is that a distribution grid system does not normally have the support of an infrastructure network. Therefore, the main objective in this paper is to develop a Machine-to-Machine (M2M) communication network that can support wide ranging sensory data, including high rate synchrophasor data for real-time communication. In particular, we evaluate the suitability of the emerging IEEE 802.11ah standard by exploiting its important features, such as classifying the power grid sensory data into different categories according to their traffic characteristics. For performance evaluation we use our hardware in the loop grid communication network testbed to access the performance of the network. PMID:29503505

Wireless Infrastructure M2M Network For Distributed Power Grid Monitoring.

PubMed

Gharavi, Hamid; Hu, Bin

2017-01-01

With the massive integration of distributed renewable energy sources (RESs) into the power system, the demand for timely and reliable network quality monitoring, control, and fault analysis is rapidly growing. Following the successful deployment of Phasor Measurement Units (PMUs) in transmission systems for power monitoring, a new opportunity to utilize PMU measurement data for power quality assessment in distribution grid systems is emerging. The main problem however, is that a distribution grid system does not normally have the support of an infrastructure network. Therefore, the main objective in this paper is to develop a Machine-to-Machine (M2M) communication network that can support wide ranging sensory data, including high rate synchrophasor data for real-time communication. In particular, we evaluate the suitability of the emerging IEEE 802.11ah standard by exploiting its important features, such as classifying the power grid sensory data into different categories according to their traffic characteristics. For performance evaluation we use our hardware in the loop grid communication network testbed to access the performance of the network.

Information theoretical assessment of visual communication with subband coding

NASA Astrophysics Data System (ADS)

Rahman, Zia-ur; Fales, Carl L.; Huck, Friedrich O.

1994-09-01

A well-designed visual communication channel is one which transmits the most information about a radiance field with the fewest artifacts. The role of image processing, encoding and restoration is to improve the quality of visual communication channels by minimizing the error in the transmitted data. Conventionally this role has been analyzed strictly in the digital domain neglecting the effects of image-gathering and image-display devices on the quality of the image. This results in the design of a visual communication channel which is `suboptimal.' We propose an end-to-end assessment of the imaging process which incorporates the influences of these devices in the design of the encoder and the restoration process. This assessment combines Shannon's communication theory with Wiener's restoration filter and with the critical design factors of the image gathering and display devices, thus providing the metrics needed to quantify and optimize the end-to-end performance of the visual communication channel. Results show that the design of the image-gathering device plays a significant role in determining the quality of the visual communication channel and in designing the analysis filters for subband encoding.

Quality of Life, Values, and Teamwork in Geriatric Care: Do We Communicate What We Mean?

ERIC Educational Resources Information Center

Clark, Philip G.

1995-01-01

Outlines a framework for organizing discussions of quality of life for elderly persons with disabilities, reviews relevant empirical research, and develops a framework for understanding the different interpretations of quality of life as it is used in communication among health care providers, elderly patients, and their families. New models of…

Acculturation and parent-adolescent communication about sex in Filipino-American families: a community-based participatory research study.

PubMed

Chung, Paul J; Travis, Raphael; Kilpatrick, Shelley D; Elliott, Marc N; Lui, Camillia; Khandwala, Shefali B; Dancel, Theresa M; Vollandt, Lori; Schuster, Mark A

2007-06-01

To examine whether acculturation is associated with parent-adolescent communication about sex in Filipino-American families. Filipino-Americans, the United States' second-largest Asian and Pacific Islander (API) group, have more adolescent pregnancy and HIV infection than other APIs. High-quality parent-adolescent communication about sex has been associated with healthy sexual development, and acculturation has been associated with various increased health risks. Whether acculturation affects parent-adolescent communication is unknown. We surveyed 120 pairs of Filipino-American parents and adolescents at a single large high school. We asked adolescents about their frequency of parent-adolescent communication about sex and measured adolescent acculturation in two ways: disagreement with traditional Asian values and preferential use of English. In bivariate and multivariate regressions, we examined whether adolescent acculturation was associated with adolescent reports of parent-adolescent communication. Few adolescents (22%) reported regularly discussing sex with parents. Although most adolescents (72%) agreed with traditional Asian values, most (63%) preferred using English. In bivariate regressions, less parent-adolescent communication about sex was associated with less adolescent agreement with traditional Asian values (p = .002) and more adolescent English use (p = .009). In multivariate regressions, these associations were largely explained by adolescent perceptions of parent knowledge about their whereabouts and activities. Acculturation may influence Filipino-American parent-adolescent communication about sex and, consequently, Filipino-American adolescent sexual health. Health care and public health providers may need to tailor adolescent sexual health programs based on acculturation or other immigration-related factors.

Pre-Scheduled and Self Organized Sleep-Scheduling Algorithms for Efficient K-Coverage in Wireless Sensor Networks

PubMed Central

Hwang, I-Shyan

2017-01-01

The K-coverage configuration that guarantees coverage of each location by at least K sensors is highly popular and is extensively used to monitor diversified applications in wireless sensor networks. Long network lifetime and high detection quality are the essentials of such K-covered sleep-scheduling algorithms. However, the existing sleep-scheduling algorithms either cause high cost or cannot preserve the detection quality effectively. In this paper, the Pre-Scheduling-based K-coverage Group Scheduling (PSKGS) and Self-Organized K-coverage Scheduling (SKS) algorithms are proposed to settle the problems in the existing sleep-scheduling algorithms. Simulation results show that our pre-scheduled-based KGS approach enhances the detection quality and network lifetime, whereas the self-organized-based SKS algorithm minimizes the computation and communication cost of the nodes and thereby is energy efficient. Besides, SKS outperforms PSKGS in terms of network lifetime and detection quality as it is self-organized. PMID:29257078

High-quality and small-capacity e-learning video featuring lecturer-superimposing PC screen images

NASA Astrophysics Data System (ADS)

Nomura, Yoshihiko; Murakami, Michinobu; Sakamoto, Ryota; Sugiura, Tokuhiro; Matsui, Hirokazu; Kato, Norihiko

2006-10-01

Information processing and communication technology are progressing quickly, and are prevailing throughout various technological fields. Therefore, the development of such technology should respond to the needs for improvement of quality in the e-learning education system. The authors propose a new video-image compression processing system that ingeniously employs the features of the lecturing scene. While dynamic lecturing scene is shot by a digital video camera, screen images are electronically stored by a PC screen image capturing software in relatively long period at a practical class. Then, a lecturer and a lecture stick are extracted from the digital video images by pattern recognition techniques, and the extracted images are superimposed on the appropriate PC screen images by off-line processing. Thus, we have succeeded to create a high-quality and small-capacity (HQ/SC) video-on-demand educational content featuring the advantages: the high quality of image sharpness, the small electronic file capacity, and the realistic lecturer motion.

STBC AF relay for unmanned aircraft system

NASA Astrophysics Data System (ADS)

Adachi, Fumiyuki; Miyazaki, Hiroyuki; Endo, Chikara

2015-01-01

If a large scale disaster similar to the Great East Japan Earthquake 2011 happens, some areas may be isolated from the communications network. Recently, unmanned aircraft system (UAS) based wireless relay communication has been attracting much attention since it is able to quickly re-establish the connection between isolated areas and the network. However, the channel between ground station (GS) and unmanned aircraft (UA) is unreliable due to UA's swing motion and as consequence, the relay communication quality degrades. In this paper, we introduce space-time block coded (STBC) amplify-and-forward (AF) relay for UAS based wireless relay communication to improve relay communication quality. A group of UAs forms single frequency network (SFN) to perform STBC-AF cooperative relay. In STBC-AF relay, only conjugate operation, block exchange and amplifying are required at UAs. Therefore, STBC-AF relay improves the relay communication quality while alleviating the complexity problem at UAs. It is shown by computer simulation that STBC-AF relay can achieve better throughput performance than conventional AF relay.

Large Aperture "Photon Bucket" Optical Receiver Performance in High Background Environments

NASA Technical Reports Server (NTRS)

Vilnrotter, Victor A.; Hoppe, D.

2011-01-01

The potential development of large aperture groundbased "photon bucket" optical receivers for deep space communications, with acceptable performance even when pointing close to the sun, is receiving considerable attention. Sunlight scattered by the atmosphere becomes significant at micron wavelengths when pointing to a few degrees from the sun, even with the narrowest bandwidth optical filters. In addition, high quality optical apertures in the 10-30 meter range are costly and difficult to build with accurate surfaces to ensure narrow fields-of-view (FOV). One approach currently under consideration is to polish the aluminum reflector panels of large 34-meter microwave antennas to high reflectance, and accept the relatively large FOV generated by state-of-the-art polished aluminum panels with rms surface accuracies on the order of a few microns, corresponding to several-hundred micro-radian FOV, hence generating centimeter-diameter focused spots at the Cassegrain focus of 34-meter antennas. Assuming pulse-position modulation (PPM) and Poisson-distributed photon-counting detection, a "polished panel" photon-bucket receiver with large FOV will collect hundreds of background photons per PPM slot, along with comparable signal photons due to its large aperture. It is demonstrated that communications performance in terms of PPM symbol-error probability in high-background high-signal environments depends more strongly on signal than on background photons, implying that large increases in background energy can be compensated by a disproportionally small increase in signal energy. This surprising result suggests that large optical apertures with relatively poor surface quality may nevertheless provide acceptable performance for deep-space optical communications, potentially enabling the construction of cost-effective hybrid RF/optical receivers in the future.

The Iridium (tm) system: Personal communications anytime, anyplace

NASA Technical Reports Server (NTRS)

Hatlelid, John E.; Casey, Larry

1993-01-01

The Iridium system is designed to provide handheld personal communications between diverse locations around the world at any time and without prior knowledge of the location of the personal units. This paper provides an overview of the system, the services it provides, its operation, and an overview of the commercial practices and relatively high volume satellite production techniques which will make the system cost effective. A constellation of 66 satellites will provide an orbiting, spherical-shell, infrastructure for this global calling capability. The satellites act as tall cellular towers and allow convenient operation for portable handheld telephones. The system will provide a full range of services including voice, paging, data, geolocation, and fax capabilities. Motorola is a world leader in the production of high volume, high quality, reliable telecommunications hardware. One of Iridium's goals is to apply these production techniques to high reliability space hardware. Concurrent engineering, high performance work teams, advanced manufacturing technologies, and improved assembly and test methods are some of the techniques that will keep the Iridium system cost effective. Mobile, global, flexible personal communications are coming that will allow anyone to call or receive a call from/to anyplace at anytime. The Iridium system will provide communications where none exist today. This connectivity will allow increased information transfer, open new markets for various business endeavors, and in general increase productivity and development.

The Iridium (tm) system: Personal communications anytime, anyplace

NASA Astrophysics Data System (ADS)

Hatlelid, John E.; Casey, Larry

The Iridium system is designed to provide handheld personal communications between diverse locations around the world at any time and without prior knowledge of the location of the personal units. This paper provides an overview of the system, the services it provides, its operation, and an overview of the commercial practices and relatively high volume satellite production techniques which will make the system cost effective. A constellation of 66 satellites will provide an orbiting, spherical-shell, infrastructure for this global calling capability. The satellites act as tall cellular towers and allow convenient operation for portable handheld telephones. The system will provide a full range of services including voice, paging, data, geolocation, and fax capabilities. Motorola is a world leader in the production of high volume, high quality, reliable telecommunications hardware. One of Iridium's goals is to apply these production techniques to high reliability space hardware. Concurrent engineering, high performance work teams, advanced manufacturing technologies, and improved assembly and test methods are some of the techniques that will keep the Iridium system cost effective. Mobile, global, flexible personal communications are coming that will allow anyone to call or receive a call from/to anyplace at anytime. The Iridium system will provide communications where none exist today. This connectivity will allow increased information transfer, open new markets for various business endeavors, and in general increase productivity and development.

Impact of provider-patient communication on cancer screening adherence: A systematic review.

PubMed

Peterson, Emily B; Ostroff, Jamie S; DuHamel, Katherine N; D'Agostino, Thomas A; Hernandez, Marisol; Canzona, Mollie R; Bylund, Carma L

2016-12-01

Cancer screening is critical for early detection and a lack of screening is associated with late-stage diagnosis and lower survival rates. The goal of this review was to analyze studies that focused on the role of provider-patient communication in screening behavior for cervical, breast, and colorectal cancer. A comprehensive search was conducted in four online databases between 1992 and 2016. Studies were included when the provider being studied was a primary care provider and the communication was face-to-face. The search resulted in 3252 records for review and 35 articles were included in the review. Studies were divided into three categories: studies comparing recommendation status to screening compliance; studies examining the relationship between communication quality and screening behavior; and intervention studies that used provider communication to improve screening behavior. There is overwhelming evidence that provider recommendation significantly improves screening rates. Studies examining quality of communication are heterogeneous in method, operationalization and results, but suggest giving information and shared decision making had a significant relationship with screening behavior. Intervention studies were similarly heterogeneous and showed positive results of communication interventions on screening behavior. Overall, results suggest that provider recommendation is necessary but not sufficient for optimal adherence to cancer screening guidelines. Quality studies suggest that provider-patient communication is more nuanced than just a simple recommendation. Discussions surrounding the recommendation may have an important bearing on a person's decision to get screened. Research needs to move beyond studies examining recommendations and adherence and focus more on the relationship between communication quality and screening adherence. Copyright © 2016 Elsevier Inc. All rights reserved.

Implementing Family Meetings Into a Respiratory Care Unit: A Care and Communication Quality Improvement Project.

PubMed

Loeslie, Vicki; Abcejo, Ma Sunnimpha; Anderson, Claudia; Leibenguth, Emily; Mielke, Cathy; Rabatin, Jeffrey

Substantial evidence in critical care literature identifies a lack of quality and quantity of communication between patients, families, and clinicians while in the intensive care unit. Barriers include time, multiple caregivers, communication skills, culture, language, stress, and optimal meeting space. For patients who are chronically critically ill, the need for a structured method of communication is paramount for discussion of goals of care. The objective of this quality improvement project was to identify barriers to communication, then develop, implement, and evaluate a process for semistructured family meetings in a 9-bed respiratory care unit. Using set dates and times, family meetings were offered to patients and families admitted to the respiratory care unit. Multiple avenues of communication were utilized to facilitate attendance. Utilizing evidence-based family meeting literature, a guide for family meetings was developed. Templates were developed for documentation of the family meeting in the electronic medical record. Multiple communication barriers were identified. Frequency of family meeting occurrence rose from 31% to 88%. Staff satisfaction with meeting frequency, meeting length, and discussion of congruent goals of care between patient/family and health care providers improved. Patient/family satisfaction with consistency of message between team members; understanding of medications, tests, and dismissal plan; and efficacy to address their concerns with the medical team improved. This quality improvement project was implemented to address the communication gap in the care of complex patients who require prolonged hospitalizations. By identifying this need, engaging stakeholders, and developing a family meeting plan to meet to address these needs, communication between all members of the patient's care team has improved.

Complexities of emergency communication: clinicians' perceptions of communication challenges in a trilingual emergency department.

PubMed

Pun, Jack Kh; Chan, Engle Angela; Murray, Kristen A; Slade, Diana; Matthiessen, Christian Mim

2017-11-01

To understand the challenges that clinicians face in communicating with patients and other clinicians within a Hong Kong trilingual emergency department. Effective communication has long been recognised as fundamental to the delivery of quality health care, especially in high-risk and time-constrained environments such as emergency departments. The issue of effective communication is particularly relevant in Hong Kong emergency departments, due to the high volume of patients and the linguistic complexity of this healthcare context. In Hong Kong, emergency department clinicians are native speakers of Chinese, but have received their medical training in English. The clinicians read and record virtually all of their medical documentation in English, yet they communicate verbally with patients in Cantonese and Mandarin. In addition, communication between clinicians occurs in spoken Cantonese, mixed with medical English. Thus, medical information is translated numerous times within one patient journey. This complex linguistic environment creates the potential for miscommunication. A mixed-methods design consisting of a quantitative survey with a sequential qualitative interview. Data were collected in a survey from a purposive sample of 58 clinicians and analysed through descriptive statistics. Eighteen of the clinicians were then invited to take part in semi-structured interviews, the data from which were then subjected to a manifest content analysis. Nearly half of the clinicians surveyed believed that medical information may be omitted or altered through repeated translation in a trilingual emergency department. Eighty-three per cent of clinicians stated that there are communication problems at triage. Over 40% said that they have difficulties in documenting medical information. Around 50% believed that long work hours reduced their ability to communicate effectively with patients. In addition, 34% admitted that they rarely or never listen to patients during a consultation. The findings reveal that the quality of communication in this Hong Kong emergency department is compromised by specific factors inherent in the linguistic complexity of Hong Kong emergency departments. These factors include the constant translation of medical information, inadequate documentation of medical information and significant professional and cultural pressures. Each of these issues increases the likelihood that healthcare communication will be difficult, incomplete or incorrect. This research provides empirical evidence for, and justifies the development of, an effective framework to enable clinicians to overcome communication challenges. The findings of this study may shed light on the unique conditions faced by clinicians, particularly in relation to communication, in the complex trilingual healthcare context of an emergency department similar to those in Hong Kong, and provide potential policy solutions for barriers to improve communication in such settings. © 2016 John Wiley & Sons Ltd.

Connecting congregations: technology resources influence parish nurse practice.

PubMed

Zerull, Lisa M; Near, Kelly K; Ragon, Bart; Farrell, Sarah P

2009-01-01

This descriptive pilot study evaluated the influence of health resource information education and the use of Web-based communication technology on the professional practice of the parish nurse in the congregational setting. Five parish nurse participants from varied denominations in rural and nonrural Virginia received a laptop computer, printer, video projector, and webcam along with high-speed Internet access in each congregational setting. The nurses attended two group education sessions that incorporated computer applications and training in accessing and using quality health information resources and communication applications such as a group "chat" software and webcam to communicate with others through high-speed Internet access. Qualitative analysis from semistructured interviews of nurses confirmed that participants found the project to be beneficial in terms of awareness, education, and applicability of technology use in parish nurse practice. Quantitative data from preproject and postproject surveys found significant differences in nurses' abilities and confidence with technology use and application. Findings showed that the knowledge and experience gained from this study enhanced parish nurse practice and confidence in using technology for communication, health education, and counseling.

ICC '86; Proceedings of the International Conference on Communications, Toronto, Canada, June 22-25, 1986, Conference Record. Volumes 1, 2, & 3

NASA Astrophysics Data System (ADS)

Papers are presented on ISDN, mobile radio systems and techniques for digital connectivity, centralized and distributed algorithms in computer networks, communications networks, quality assurance and impact on cost, adaptive filters in communications, the spread spectrum, signal processing, video communication techniques, and digital satellite services. Topics discussed include performance evaluation issues for integrated protocols, packet network operations, the computer network theory and multiple-access, microwave single sideband systems, switching architectures, fiber optic systems, wireless local communications, modulation, coding, and synchronization, remote switching, software quality, transmission, and expert systems in network operations. Consideration is given to wide area networks, image and speech processing, office communications application protocols, multimedia systems, customer-controlled network operations, digital radio systems, channel modeling and signal processing in digital communications, earth station/on-board modems, computer communications system performance evaluation, source encoding, compression, and quantization, and adaptive communications systems.

Family Avoidance of Communication about Cancer: A Dyadic Examination.

PubMed

Shin, Dong Wook; Shin, Jooyeon; Kim, So Young; Yang, Hyung-Kook; Cho, Juhee; Youm, Jung Ho; Choi, Gyu Seog; Hong, Nam Soo; Cho, BeLong; Park, Jong-Hyock

2016-01-01

This study aimed to examine the following questions: to what extent do patients and caregivers perceive their family members to be avoidant of communication regarding patient's cancer, and to what extent do these perceptions interrelate; and how do such perceptions influence their own and each other's communication behaviors, communication outcome, mental health, and quality of life. A national survey was performed with 990 patient-caregiver dyads (participation rate, 76.2%). To examine the dyadic interaction, we developed linked patient and family member questionnaires, including the Family Avoidance of Communication about Cancer (FACC) scale. The mean scores (standard deviations) of patient- and caregiver-perceived FACC were low at 10.9 (15.5) and 15.5 (17.5), respectively (p < 0.001), and concordance was low, a well (Spearman's rho, 0.23). Patient-perceived FACC was associated with lower levels of disclosure and behaviors of holding back communication, as well as lower levels of mental health outcome and quality of life. The same was true for caregivers (all p < 0.05). Patient-perceived FACC was associated with caregiver holding back, caregiver's depression level, and caregiver quality of life (all p < 0.05). Both patient- and caregiver-perceived FACC were independently associated with communication difficulty within the family. Future research would benefit from the measurement of FACC from both patients and caregivers, and promote family intervention to enhance openness to communication, which would be helpful for improving mental health and quality of life for both patients and caregivers.

Crew Resource Management for Obstetric and Neonatal Teams to Improve Communication During Cesarean Births.

PubMed

Mancuso, Mary P; Dziadkowiec, Oliwier; Kleiner, Catherine; Halverson-Carpenter, Katherine; Link, Terri; Barry, James

2016-01-01

To assess the effectiveness of crew resource management training and interventions on the quality and quantity of communication during cesarean births in a tertiary academic hospital's labor and birthing services. A prospective pre-post crew resource management training intervention. Tertiary academic hospital in the Western United States. All members of obstetric and neonatal teams that participated in cesarean births. Over a 5-month time period, all obstetric and neonatal staff were required to participate in team training in crew resource management critical language, communication, and team structure. Trained observers collected baseline data (n = 52) for 3 months on the quantity and quality of communications that occurred during cesarean births. Postintervention data (n = 50) were gathered for 3 months after team training. Analysis approach included use of Fisher's exact test, independent-samples t test, and multilevel generalized linear regression models with Poisson distribution. There was a statistically significant increase in quantity and quality of communication from pre- to postintervention assessment for obstetric and neonatal staff. Although the increase in quality was similarly great between both types of teams, increase in quantity was more substantial in obstetric staff. Principles of team communication training shown to be effective in increasing communication among team members in a variety of clinical areas were also effective in improving communication in the labor and birth setting during cesarean births. Copyright © 2016 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

Triangulated Proxy Reporting: a technique for improving how communication partners come to know people with severe cognitive impairment.

PubMed

Lyons, Gordon; De Bortoli, Tania; Arthur-Kelly, Michael

2017-09-01

This paper explains and demonstrates the pilot application of Triangulated Proxy Reporting (TPR); a practical technique for enhancing communication around people who have severe cognitive impairment (SCI). An introduction explains SCI and how this impacts on communication; and consequently on quality of care and quality of life. This is followed by an explanation of TPR and its origins in triangulation research techniques. An illustrative vignette explicates its utility and value in a group home for a resident with profound multiple disabilities. The Discussion and Conclusion sections propose the wider application of TPR for different cohorts of people with SCIs, their communication partners and service providers. TPR presents as a practical technique for enhancing communication interactions with people who have SCI. The paper demonstrates the potential of the technique for improving engagement amongst those with profound multiple disabilities, severe acquired brain injury and advanced dementia and their partners in and across different care settings. Implications for Rehabilitation Triangulated Proxy Reporting (TPR) shows potential to improve communications between people with severe cognitive impairments and their communication partners. TPR can lead to improved quality of care and quality of life for people with profound multiple disabilities, very advanced dementia and severe acquired brain injury, who otherwise are very difficult to support. TPR is a relatively simple and inexpensive technique that service providers can incorporate into practice to improving communications between clients with severe cognitive impairments, their carers and other support professionals.

eMovie: a storyboard-based tool for making molecular movies.

PubMed

Hodis, Eran; Schreiber, Gideon; Rother, Kristian; Sussman, Joel L

2007-05-01

The 3D structures of macromolecules are difficult to grasp and also to communicate. By their nature, movies or animations are particularly useful for highlighting key features by offering a 'guided tour' of structures and conformation changes. However, high-quality movies are rarely seen because they are currently difficult and time consuming to make. By adopting the traditional movie 'storyboard' concept, which gives guidance and direction to filming, eMovie makes the creation of lengthy molecular animations much easier. This tool is a plug-in for the open-source molecular graphics program PyMOL, and enables experts and novices alike to produce informative and high-quality molecular animations.

Thin-slice vision: inference of confidence measure from perceptual video quality

NASA Astrophysics Data System (ADS)

Hameed, Abdul; Balas, Benjamin; Dai, Rui

2016-11-01

There has been considerable research on thin-slice judgments, but no study has demonstrated the predictive validity of confidence measures when assessors watch videos acquired from communication systems, in which the perceptual quality of videos could be degraded by limited bandwidth and unreliable network conditions. This paper studies the relationship between high-level thin-slice judgments of human behavior and factors that contribute to perceptual video quality. Based on a large number of subjective test results, it has been found that the confidence of a single individual present in all the videos, called speaker's confidence (SC), could be predicted by a list of features that contribute to perceptual video quality. Two prediction models, one based on artificial neural network and the other based on a decision tree, were built to predict SC. Experimental results have shown that both prediction models can result in high correlation measures.

It’s Not What You Say …

PubMed Central

Levinson, Wendy; Hudak, Pamela L.; Feldman, Jacob J.; Frankel, Richard M.; Kuby, Alma; Bereknyei, Sylvia; Braddock, Clarence

2013-01-01

Background Excellent communication between surgeons and patients is critical to helping patients to make informed decisions and is a key component of both high quality of care and patient satisfaction. Understanding racial disparities in communication is essential to provide quality care to all patients. Objective To examine the content and process of informed decision-making (IDM) between orthopedic surgeons and elderly white versus African American patients. To assess the association of race and patient satisfaction with surgeon communication. Research Design Analysis of audiotape recordings of office visits between orthopedic surgeons and patients. Participants Eighty-nine orthopedic surgeons and 886 patients age 60 years or older in Chicago, Illinois. Methods Tapes were analyzed by coders for content using 9 elements of IDM and for process using 4 global ratings of the relationship-building component of communication (responsiveness, respect, listening, and sharing). Ratings by race were compared using χ2 analysis. Patients completed a questionnaire rating satisfaction with surgeon communication and the visit overall. Logistic analysis was used to assess the effect of race on satisfaction. Results Overall there were practically no significant differences in the content of the 9 IDM elements based on race. However, coder ratings of relationship were higher on 3 of 4 global ratings (responsiveness, respect, and listening) in visits with white patients compared with African American patients (P < 0.01). Patient ratings of communication and overall satisfaction with the visit were significantly higher for white patients. Conclusions The content of IDM conversations does not differ by race. Yet differences in the process of relationship building and in patient satisfaction ratings were clearly present. Efforts to enhance cultural communication competence of surgeons should emphasize the skills of building relationships with patients in addition to the content of IDM. PMID:18362821

An experiment shows that a well-designed report on costs and quality can help consumers choose high-value health care.

PubMed

Hibbard, Judith H; Greene, Jessica; Sofaer, Shoshanna; Firminger, Kirsten; Hirsh, Judith

2012-03-01

Advocates of health reform continue to pursue policies and tools that will make information about comparative costs and resource use available to consumers. Reformers expect that consumers will use the data to choose high-value providers-those who offer higher quality and lower prices-and thus contribute to the broader goal of controlling national health care spending. However, communicating this information effectively is more challenging than it might first appear. For example, consumers are more interested in the quality of health care than in its cost, and many perceive a low-cost provider to be substandard. In this study of 1,421 employees, we examined how different presentations of information affect the likelihood that consumers will make high-value choices. We found that a substantial minority of the respondents shied away from low-cost providers, and even consumers who pay a larger share of their health care costs themselves were likely to equate high cost with high quality. At the same time, we found that presenting cost data alongside easy-to-interpret quality information and highlighting high-value options improved the likelihood that consumers would choose those options. Reporting strategies that follow such a format will help consumers understand that a doctor who provides higher-quality care than other doctors does not necessarily cost more.

Adventures in Citizen Science: Lessons learned engaging volunteer water quality monitors for over 30 years.

NASA Astrophysics Data System (ADS)

Schloss, J. A.

2012-12-01

The New Hampshire Lakes Lay Monitoring Program was originally designed by faculty at the University of New Hampshire in 1979 to provide the capacity to better monitor for long-term lake water quality changes and trends. As participants became educated, empowered and engaged the program soon evolved to also become a participatory research enterprise. This resulted in not only providing useful information for informed local stewardship and protection at the local level but also for state and region-wide decision-making, state and federal assessments/reporting and advancing our understanding of lake and watershed science. Our successes and failures have been more dependent on understanding the particular human dimensions that influence our volunteers and less to do with the typical project management, quality assurance, and communication concerns we typically deal with in professional based research efforts. Our participants are extremely diverse in terms of their life experiences, interests and motivations so the key to long-term commitment and high quality participation is understanding the difference between a citizen monitor and your archetypical research technician or student. This presentation will highlight some important lessons learned on how to involve various types of volunteers from school groups to retirees, as well as particular approaches and concerns regarding program management, retention, quality control and communications.

Public Trust and Initiatives for New Health Care Partnerships

PubMed Central

Mechanic, David

1998-01-01

Effective communication between doctor and patient is a critical component of high-quality care. The physician's credibility has a significant effect on treatment outcomes. Because changes in medicine and larger cultural trends challenge the ability of clinicians to engage their patients' trust, new kinds of partnerships must be created. To do this effectively, physicians have to sharpen their communication skills and devise strategies for assuring that their patients become informed allies in their own treatment. A number of innovations are helping to build these alliances: training in communication skills; creative uses of the Internet and videotape technologies; improved “customer service” programs; critical pathways for patients; and special educational aids. All these tools promise to be useful, but they require careful development and evaluation. PMID:9614423

Brief report: parent-child sexuality communication and autism spectrum disorders.

PubMed

Holmes, Laura G; Himle, Michael B

2014-11-01

While considerable research has focused on promoting independence and optimizing quality of life for adolescents and young adult with autism spectrum disorder (ASD), sexual development and sexuality education have been largely neglected. Experts recommend that parents be the primary source of sex education for adolescents with ASD, and that sex education be tailored to a child's developmental level. Prior studies show that parents of youth with ASD are uncertain about how to best communicate about sex and which topics to discuss with their children. In the current study we administered an online survey to 190 parents of adolescents with ASD in order to better understand sexuality communication patterns between parents and adolescents with both low and high functioning ASD.

Public trust and initiatives for new health care partnerships.

PubMed

Mechanic, D

1998-01-01

Effective communication between doctor and patient is a critical component of high-quality care. The physician's credibility has a significant effect on treatment outcomes. Because changes in medicine and larger cultural trends challenge the ability of clinicians to engage their patients' trust, new kinds of partnerships must be created. To do this effectively, physicians have to sharpen their communication skills and devise strategies for assuring that their patients become informed allies in their own treatment. A number of innovations are helping to build these alliances: training in communication skills; creative uses of the Internet and videotape technologies; improved "customer service" programs; critical pathways for patients; and special educational aids. All these tools promise to be useful, but they require careful development and evaluation.

The intended and unintended consequences of communication systems on general internal medicine inpatient care delivery: a prospective observational case study of five teaching hospitals.

PubMed

Wu, Robert C; Lo, Vivian; Morra, Dante; Wong, Brian M; Sargeant, Robert; Locke, Ken; Cavalcanti, Rodrigo; Quan, Sherman D; Rossos, Peter; Tran, Kim; Cheung, Mark

2013-01-01

Effective clinical communication is critical to providing high-quality patient care. Hospitals have used different types of interventions to improve communication between care teams, but there have been few studies of their effectiveness. To describe the effects of different communication interventions and their problems. Prospective observational case study using a mixed methods approach of quantitative and qualitative methods. General internal medicine (GIM) inpatient wards at five tertiary care academic teaching hospitals. Clinicians consisting of residents, attending physicians, nurses, and allied health (AH) staff working on the GIM wards. Ethnographic methods and interviews with clinical staff (doctors, nurses, medical students, and AH professionals) were conducted over a 16-month period from 2009 to 2010. We identified four categories that described the intended and unintended consequences of communication interventions: impacts on senders, receivers, interprofessional collaboration, and the use of informal communication processes. The use of alphanumeric pagers, smartphones, and web-based communication systems had positive effects for senders and receivers, but unintended consequences were seen with all interventions in all four categories. Interventions that aimed to improve clinical communications solved some but not all problems, and unintended effects were seen with all systems.

Welcome to the NASA High Performance Computing and Communications Computational Aerosciences (CAS) Workshop 2000

NASA Technical Reports Server (NTRS)

Schulbach, Catherine H. (Editor)

2000-01-01

The purpose of the CAS workshop is to bring together NASA's scientists and engineers and their counterparts in industry, other government agencies, and academia working in the Computational Aerosciences and related fields. This workshop is part of the technology transfer plan of the NASA High Performance Computing and Communications (HPCC) Program. Specific objectives of the CAS workshop are to: (1) communicate the goals and objectives of HPCC and CAS, (2) promote and disseminate CAS technology within the appropriate technical communities, including NASA, industry, academia, and other government labs, (3) help promote synergy among CAS and other HPCC scientists, and (4) permit feedback from peer researchers on issues facing High Performance Computing in general and the CAS project in particular. This year we had a number of exciting presentations in the traditional aeronautics, aerospace sciences, and high-end computing areas and in the less familiar (to many of us affiliated with CAS) earth science, space science, and revolutionary computing areas. Presentations of more than 40 high quality papers were organized into ten sessions and presented over the three-day workshop. The proceedings are organized here for easy access: by author, title and topic.

Automating annotation of information-giving for analysis of clinical conversation.

PubMed

Mayfield, Elijah; Laws, M Barton; Wilson, Ira B; Penstein Rosé, Carolyn

2014-02-01

Coding of clinical communication for fine-grained features such as speech acts has produced a substantial literature. However, annotation by humans is laborious and expensive, limiting application of these methods. We aimed to show that through machine learning, computers could code certain categories of speech acts with sufficient reliability to make useful distinctions among clinical encounters. The data were transcripts of 415 routine outpatient visits of HIV patients which had previously been coded for speech acts using the Generalized Medical Interaction Analysis System (GMIAS); 50 had also been coded for larger scale features using the Comprehensive Analysis of the Structure of Encounters System (CASES). We aggregated selected speech acts into information-giving and requesting, then trained the machine to automatically annotate using logistic regression classification. We evaluated reliability by per-speech act accuracy. We used multiple regression to predict patient reports of communication quality from post-visit surveys using the patient and provider information-giving to information-requesting ratio (briefly, information-giving ratio) and patient gender. Automated coding produces moderate reliability with human coding (accuracy 71.2%, κ=0.57), with high correlation between machine and human prediction of the information-giving ratio (r=0.96). The regression significantly predicted four of five patient-reported measures of communication quality (r=0.263-0.344). The information-giving ratio is a useful and intuitive measure for predicting patient perception of provider-patient communication quality. These predictions can be made with automated annotation, which is a practical option for studying large collections of clinical encounters with objectivity, consistency, and low cost, providing greater opportunity for training and reflection for care providers.

Implementing Delivery Room Checklists and Communication Standards in a Multi-Neonatal ICU Quality Improvement Collaborative.

PubMed

Bennett, Stacie C; Finer, Neil; Halamek, Louis P; Mickas, Nick; Bennett, Mihoko V; Nisbet, Courtney C; Sharek, Paul J

2016-08-01

The 2015 American Academy of Pediatrics Neonatal Resuscitation Program (NRP) and International Liaison Committee on Resuscitation (ILCOR) resuscitation guidelines state, "It is still suggested that briefing and debriefing techniques be used whenever possible for neonatal resuscitation." Effective communication and reliable delivery of evidence-based best practices are critical aspects of the 2015 NRP guidelines. To promote optimal communication and best practice-focused checklists use during active neonatal resuscitation, the Readiness Bundle (RB) was integrated within the larger change package deployed in the California Perinatal Quality Care Collaborative's (CPQCC) 12-month Delivery Room Management Quality Improvement Collaborative. The RB consisted of (1) a checklist for high-risk neonatal resuscitations and (2) briefings and debriefings to improve teamwork and communication in the delivery room (DR). Implementation of the RB was encouraged, compliance with the RB was tracked monthly up through 6 months after the completion of the collaborative, and satisfaction with the RB was evaluated. Twenty-four neonatal intensive care units (NICUs) participated in the CPQCCDR collaborative. Before the initiation of the collaborative, the elements of the RB were complied with in 0 of 740 reported deliveries (0%). During the 12-month collaborative, compliance with the RB improved to a median of 71%, which was surpassed in the 6-month period after the collaborative ended (80%). One-hundred percent of responding NICUs would recommend the RB to other NICUs working on improving DR management. The RB was rapidly adopted, with compliance sustained for 6 months after completion of the collaborative. Inclusion of the RB in the next generation of the NRP guidelines is encouraged.

[Congresses of the Spanish Association of Pediatrics: bibliometric analysis as a springboard for debate].

PubMed

González de Dios, J; Paredes Cencillo, C

2004-12-01

Congresses are periodic meetings that are required to make known and discuss advances in the various fields of medicine. Bibliometric indicators are important tools used to determine the quality of scientific publications. However, this type of study is infrequently performed in free communications of congresses. A bibliometric study of all the free communications published in the congresses of the Spanish Association of Pediatrics over 4 years, divided in two periods (1996-1997 and 2000-2001) (n = 2677) was performed. Bibliometric indicators were classified into quantitative (productivity), qualitative (statistical accessibility) and scientific evidence. Quantitative indicators: There were 928 free communications in 1996, 681 in 1997, 560 in 2000, and 508 in 2001. Eighty-eight percent were in poster format and 87 % were in structured format. There was a median of six authors per communication. The main subject areas were infectology, neonatology, hemato-oncology, neurology and endocrinology. Ninety-five per cent of communications were signed by hospitals with a marked contribution by hospitals in Andalusia and Madrid. Qualitative indicators: Statistical accessibility < 2 in 86 % and > 7 in 2.9 %. Scientific evidence indicators: The quality of scientific evidence was good in only 1 % and was average in 9 %, since 90 % of all the studies were descriptive (mainly clinical cases). Evidence-based methodological concepts were used in only 1.9 %. Compared with 1996-1997, in 2000-2001 there were fewer communications, more posters, and more structured communications, as well as greater statistical accessibility and better scientific evidence indicators, but these differences were not statistically significant. Bibliometric study of the congresses of the Spanish Association of Pediatrics is a good starting point to analyze the quality of pediatric meetings and discuss possible solutions: a rigorous scientific committee with quality criteria, more analytical and/or experimental studies and fewer descriptive studies (especially clinical cases); restricting the number of authors per communication, greater collaboration with epidemiologists and/or biostatisticians, and favoring structured communications would also improve quality.

The forensic psychiatric report.

PubMed

Norko, Michael A; Buchanan, Mar Alec

2015-01-01

The construction of a written forensic report is a core component of forensic practice, demonstrating the evaluator's skill in conducting the evaluation and in communicating relevant information to the legal audience in an effective manner. Although communication skills and quality of written documentation are important in clinical psychiatry generally, they form the sine qua non of successful forensic work, which consists in telling complex stories in a coherent and compelling fashion. High quality forensic reports require careful preparation from the earliest stages of work on a case. They generally follow an expected structure, which permits the evaluator to provide all the data necessary to form a carefully reasoned opinion that addresses the legal questions posed. Formats and content of reports vary according to the type of case and the circumstances of the evaluation and so require flexibility within customary frameworks. The style and quality of writing are critical to the crafting of forensic reports. The effects on legal decision-makers of various approaches to the presentation of information in reports has not been studied empirically, but guidance from experienced forensic psychiatrists is available. There is a small body of research on quality improvement in forensic writing, and further empiric study is warranted.

Tailored Communication Within Mobile Apps for Diabetes Self-Management: A Systematic Review

PubMed Central

Wahl, Astrid Klopstad; Cvancarova Småstuen, Milada; Ribu, Lis

2017-01-01

Background The prevalence of diabetes is increasing and with the requirements for self-management and risk of late complications, it remains a challenge for the individual and society. Patients can benefit from support from health care personnel in their self-management, and the traditional communication between patients and health care personnel is changing. Smartphones and apps offer a unique platform for communication, but apps with integrated health care personnel communication based on patient data are yet to be investigated to provide evidence of possible effects. Objective Our goal was to systematically review studies that aimed to evaluate integrated communication within mobile apps for tailored feedback between patients with diabetes and health care personnel in terms of (1) study characteristics, (2) functions, (3) study outcomes, (4) effects, and (5) methodological quality. Methods A systematic literature search was conducted following our International Prospective Register of Systematic Reviews (PROSPERO) protocol, searching for apps with integrated communication for persons with diabetes tested in a controlled trial in the period 2008 to 2016. We searched the databases PubMed, Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Central, Excerpta Medica database (EMBASE), ClinicalTrials.gov, and the World Health Organization (WHO) International Clinical Trials Registry Platform. The search was closed in September 2016. Reference lists of primary articles and review papers were assessed. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and we applied the Cochrane risk of bias tool to assess methodological quality. Results We identified 2822 citations and after duplicate removal, we assessed 1128 citations. A total of 6 papers were included in this systematic review, reporting on data from 431 persons participating in small trials of short duration. The integrated communication features were mostly individualized as written non–real-time feedback. The number of functions varied from 2 to 9, and blood glucose tracking was the most common. HbA1c was the most common primary outcome, but the remaining reported outcomes were not standardized and comparable. Because of both the heterogeneity of the included trials and the poor methodological quality of the studies, a meta-analysis was not possible. A statistically significant improvement in the primary measure of outcome was found in 3 of the 6 included studies, of which 2 were HbA1c and 1 was mean daytime ambulatory blood pressure. Participants in the included trials reported positive usability or feasibility postintervention in 5 out of 6 trials. The overall methodological quality of the trials was, however, scored as an uncertain risk of bias. Conclusions This systematic review highlights the need for more trials of higher methodological quality. Few studies offer an integrated function for communication and feedback from health care personnel, and the research field represents an area of heterogeneity with few studies of highly rigorous methodological quality. This, in combination with a low number of participants and a short follow-up, is making it difficult to provide reliable evidence of effects for stakeholders. PMID:28645890

Physician-patient communication in HIV disease: the importance of patient, physician, and visit characteristics.

PubMed

Wilson, I B; Kaplan, S

2000-12-15

Although previous work that considered a variety of chronic conditions has shown that higher quality physician-patient communication care is related to better health outcomes, the quality of physician-patient communication itself for patients with HIV disease has not been well studied. To determine the relationship of patient, visit, physician, and physician practice characteristics to two measures of physician-patient communication for patients with HIV disease. Cross-sectional survey of physicians and patients. Cohort study enrolling patients from throughout eastern Massachusetts. 264 patients with HIV disease and their their primary HIV physicians (n = 69). Two measures of physician-patient communication were used, a five-item general communication measure (Cronbach's alpha = 0.93), and a four-item HIV-specific communication measure that included items about alcohol, drug use, and sexual behaviors (Cronbach's alpha = 0.92). The mean age of patients was 39. 5 years, 24% patients were women, 31.1% were nonwhite, and 52% indicated same-sex contact as their principal HIV risk factor. The mean age of physicians was 39.1 years, 33.3% were female, 39.7% were specialists, and 25.0% self-identified as gay, lesbian, or bisexual. In multivariable models relating patient and visit characteristics to general communication, longer reported visit length (p<.0001), longer duration of the physician-patient relationship (p =.02), and female gender (p =.04) were significantly associated with better communication. The interaction of patient gender and visit length was also significant (p =.02); longer visit length was more strongly associated with better general communication for male than female patients. In similar models relating patient and visit characteristics to HIV-specific communication, longer visit length (p <.0001) and less advanced disease stage (p =.009) were associated with better communication. In multivariable models relating physician and practice characteristics to general communication no variables were significant. However, both female physician gender (p =.002) and gay/lesbian/bisexual sexual preference (p =.003) were significantly associated with better HIV-specific communication. In this study, female and homosexual physicians provided higher quality HIV-specific communication than male and heterosexual physicians. Better understanding the processes by which female and homosexual physicians achieve higher quality communication may help other physicians communicate more effectively. Health care providers and third-party payers should be aware that shorter visits may compromise physician-patient communication, and that this effect may be more consequential for male patients.

"Power quality system," a new system of quality management for globalization: towards innovation and competitive advantages.

PubMed

Abdul-Rahman, H; Berawi, M A

Knowledge Management (KM) addresses the critical issues of organizational adoption, survival and competence in the face of an increasingly changing environment. KM embodies organizational processes that seek a synergistic combination of the data and information processing capabilities of information and communication technologies (ICT), and the creative and innovative capacity of human beings to improve ICT In that role, knowledge management will improve quality management and avoid or minimize losses and weakness that usually come from poor performance as well as increase the competitive level of the company and its ability to survive in the global marketplace. To achieve quality, all parties including the clients, company consultants, contractors, entrepreneurs, suppliers, and the governing bodies (i.e., all involved stake-holders) need to collaborate and commit to achieving quality. The design based organizations in major business and construction companies have to be quality driven to support healthy growth in today's competitive market. In the march towards vision 2020 and globalization (i.e., the one world community) of many companies, their design based organizations need to have superior quality management and knowledge management to anticipate changes. The implementation of a quality system such as the ISO 9000 Standards, Total Quality Management, or Quality Function Deployment (QFD) focuses the company's resources towards achieving faster and better results in the global market with less cost. To anticipate the needs of the marketplace and clients as the world and technology change, a new system, which we call Power Quality System (PQS), has been designed. PQS is a combination of information and communication technologies (ICT) and the creative and innovative capacity of human beings to meet the challenges of the new world business and to develop high quality products.

Factors Affecting Quality of Laboratory Services in Public and Private Health Facilities in Addis Ababa, Ethiopia.

PubMed

Mesfin, Eyob Abera; Taye, Binyam; Belay, Getachew; Ashenafi, Aytenew; Girma, Veronica

2017-10-01

Quality laboratory service is an essential component of health care system but in Sub-Saharan Africa such as Ethiopia, laboratories quality system remains weak due to several factors and it needs more attention to strengthen its capacity and quality system. A cross sectional study was conducted using a questionnaire to assess factors affecting the quality of laboratory service at private and public health institutions in Addis Ababa. A total of 213 laboratory professionals participated in the study and 131 (61.5%) participants had bachelor degree. Majority, 133 (62.4%), of the professionals did not attend any work related training. Seventy five (35.2%) respondents believed that their laboratories did not provide quality laboratory services and the major reported factors affecting provision of quality services were shortage of resources (64.3%), poor management support (57.3%), poor equipment quality (53.4%), high workload (41.1%), lack of equipment calibration (38.3%) and lack of knowledge (23.3%). Moreover logistic regression analysis showed that provision of quality laboratory service was significantly associated with result verification (AOR=9.21, 95% CI=2.26, 37.48), internal quality control (AOR= 6.11, 95% CI=2.11, 17.70), turnaround time (AOR=5.11, 95% CI=1.94, 13.46), shortage of equipment (AOR=7.76, 95% CI=2.55, 23.66), communication with clinicians (AOR=3.24, 95% CI=1.25, 8.41) and lack of job description (AOR=3.67, 95% CI=1.319, 10.22). In conclusion, the major factors that affecting the quality of laboratory service were associated with poor human resource management, poor resources provision, poor management commitment, ineffective communication system and lack of well-established quality management system.

Factors Affecting Quality of Laboratory Services in Public and Private Health Facilities in Addis Ababa, Ethiopia

PubMed Central

Taye, Binyam; Belay, Getachew; Ashenafi, Aytenew; Girma, Veronica

2017-01-01

Background Quality laboratory service is an essential component of health care system but in Sub-Saharan Africa such as Ethiopia, laboratories quality system remains weak due to several factors and it needs more attention to strengthen its capacity and quality system. Methodology A cross sectional study was conducted using a questionnaire to assess factors affecting the quality of laboratory service at private and public health institutions in Addis Ababa. Results A total of 213 laboratory professionals participated in the study and 131 (61.5%) participants had bachelor degree. Majority, 133 (62.4%), of the professionals did not attend any work related training. Seventy five (35.2%) respondents believed that their laboratories did not provide quality laboratory services and the major reported factors affecting provision of quality services were shortage of resources (64.3%), poor management support (57.3%), poor equipment quality (53.4%), high workload (41.1%), lack of equipment calibration (38.3%) and lack of knowledge (23.3%). Moreover logistic regression analysis showed that provision of quality laboratory service was significantly associated with result verification (AOR=9.21, 95% CI=2.26, 37.48), internal quality control (AOR= 6.11, 95% CI=2.11, 17.70), turnaround time (AOR=5.11, 95% CI=1.94, 13.46), shortage of equipment (AOR=7.76, 95% CI=2.55, 23.66), communication with clinicians (AOR=3.24, 95% CI=1.25, 8.41) and lack of job description (AOR=3.67, 95% CI=1.319, 10.22). Conclusion In conclusion, the major factors that affecting the quality of laboratory service were associated with poor human resource management, poor resources provision, poor management commitment, ineffective communication system and lack of well-established quality management system. PMID:29075171

Augmentative and Alternative Communication Practice in the Pursuit of Family Quality of Life: A Review of the Literature

ERIC Educational Resources Information Center

Saito, Yumiko; Turnbull, Ann

2007-01-01

Augmentative and Alternative Communication (AAC) practice may have both positive and negative impacts on quality of life (QOL) of children with AAC as well as their entire family. Thirteen studies were reviewed to analyze family outcomes and perspectives on AAC practice by using a family quality of life (FQOL) framework comprised of five…

Characterizations of a quality certified athletic trainer.

PubMed

Raab, Scot; Wolfe, Brent D; Gould, Trenton E; Piland, Scott G

2011-01-01

Didactic proficiency does not ensure clinical aptitude. Quality athletic health care requires clinical knowledge and affective traits. To develop a grounded theory explaining the constructs of a quality certified athletic trainer (AT). Delphi study. Interviews in conference rooms or business offices and by telephone. Thirteen ATs (men = 8, women = 5) stratified across the largest employment settings (high school, college, clinical) in the 4 largest districts of the National Athletic Trainers? Association (2, 3, 4, 9). Open-ended interview questions were audio recorded, transcribed, and reviewed before condensing. Two member checks ensured trustworthiness. Open coding reduced text to descriptive adjectives. We grouped adjectives into 5 constructs (care, communication, commitment, integrity, knowledge) and grouped these constructs into 2 higher-order constructs (affective traits, effective traits). According to participants, ATs who demonstrate the ability to care, show commitment and integrity, value professional knowledge, and communicate effectively with others can be identified as quality ATs. These abilities facilitate the creation of positive relationships. These relationships allow the quality AT to interact with patients and other health care professionals on a knowledgeable basis that ultimately improves health care delivery. Our resulting theory supported the examination of characteristics not traditionally assessed in an athletic training education program. If researchers can show that these characteristics develop ATs into quality ATs (eg, those who work better with others, relate meaningfully with patients, and improve the standard of health care), they must be cultivated in the educational setting.

Development and validation of a tool to improve paediatric referral/consultation communication.

PubMed

Stille, Christopher J; Mazor, Kathleen M; Meterko, Vanessa; Wasserman, Richard C

2011-08-01

To develop a template to promote brief but high-quality communication between paediatric primary care clinicians and consulting specialists. Through an iterative process with academic and community-based paediatric primary care providers and specialists, the authors identified what content elements would be of value when communicating around referrals. The authors then developed a one-page template to encourage both primary care and specialty clinicians to include these elements when communicating about referrals. Trained clinician reviewers examined a sample of 206 referrals from community primary care providers (PCPs) to specialists in five paediatric specialties at an academic medical centre, coding communication content and rating the overall value of the referral communication. The relationship between the value ratings and each content element was examined to determine which content elements contributed to perceived value. Almost all content elements were associated with increased value as rated by clinician reviewers. The most valuable communications from PCP to specialist contained specific questions for the specialist and/or physical exam features, and the most valuable from specialist to PCP contained brief education for the PCP about the condition; all three elements were found in a minority of communications reviewed. A limited set of communication elements is suitable for a brief communication template in communication from paediatric PCPs to specialists. The use of such a template may add value to interphysician communication.

Odyssey, an optimized personal communications satellite system

NASA Astrophysics Data System (ADS)

Rusch, Roger J.

Personal communications places severe demands on service providers and transmission facilities. Customers are not satisfied with the current levels of service and want improvements. Among the characteristics that users seek are: lower service rates, hand held convenience, acceptable time delays, ubiquitous service, high availability, reliability, and high quality. The space industry is developing commercial space systems for providing mobile communications to personal telephones. Provision of land mobile satellite service is fundamentally different from the fixed satellite service provided by geostationary satellites. In fixed service, the earth based antennas can depend on a clear path from user to satellite. Mobile users in a terrestrial environment commonly encounter blockage due to vegetation, terrain or buildings. Consequently, high elevation angles are of premium value. TRW studied the issues and concluded that a Medium Earth Orbit constellation is the best solution for Personal Communications Satellite Service. TRW has developed Odyssey, which uses twelve satellites in medium altitude orbit to provide personal communications satellite service. The Odyssey communications system projects a multibeam antenna pattern to the Earth. The attitude control system orients the satellites to ensure constant coverage of land mass and coastal areas. Pointing can be reprogrammed by ground control to ensure optimized coverage of the desired service areas. The payload architecture features non-processing, "bent pipe" transponders and matrix amplifiers to ensure dynamic power delivery to high demand areas. Circuit capacity is 3000 circuits per satellite. Each satellite weighs 1917 kg (4226 pounds) at launch and the solar arrays provide 3126 Watts of power. Satellites are launched in pairs on Ariane, Atlas, or other vehicles. Each satellite is placed in a circular orbit at an altitude of 10,354 km. There are three orbit planes inclined at 55° to the equatorial plane. Deployment of the satellites permits phased introduction of service. After only three launches, in which two satellites are launched into each plane, continuous service can be provided to most of the world. After three more launches for a total of 12 satellites, service can be expanded to all populated regions of the Earth with path diversity to most regions. The Odyssey system is superior to both geostationary satellites and low earth orbiting satellites. Odyssey provides many benefits to the end user which are described in the paper. These include: low cost, convenience, high availability, reliability, and acceptable time delay. Odyssey exhibits benefits for telecommunications operators: simple operations, incremental, phased startup, long space segment life-time, high profitability, dynamic flexibility for adjustment and short time to market. Since submission of an FCC application in 1991, TRW has continued to explore ways to further improve the Odyssey approach by expanding coverage to the entire world and reducing the initial investment while maintaining high quality service.

Odyssey, an optimized personal communications satellite system

NASA Astrophysics Data System (ADS)

Rusch, Roger J.

Personal communications places severe demands on service providers and transmission facilities. Customers are not satisfied with the current levels of service and want improvements. Among the characteristics that users seek are: lower service rates, hand held convenience, acceptable time delays, ubiquitous service, high availability, reliability, and high quality. The space industry in developing commercial space systems for providing mobile communications to personal telephones. Provision of land mobile satellite service is fundamentally different from the fixed satellite service provided by geostationary satellites. In fixed service, the earth based antennas can depend on a clear path from user to satellite. Mobile users in a terrestrial environment commonly encounter blockage due to vegetation, terrain or buildings. Consequently, high elevation angles are of premium value. TRW studied the issues and concluded that a Medium Earth Orbit constellation is the best solution for Personal Communications Satellite Service. TRW has developed Odyssey, which uses twelve satellites in medium altitude orbit to provide personal communications satellite service. The Odyssey communications system projects a multibeam antenna pattern to the Earth. The attitude control system orients the satellites to ensure constant coverage of land mass and coastal areas. Pointing can be reprogrammed by ground control to ensure optimized coverage of the desired service areas. The payload architecture features non-processing, 'bent pipe' transponders and matrix amplifiers to ensure dynamic power delivery to high demand areas. Circuit capacity is 3000 circuits per satellite. Each satellite weighs 1917 kg (4226 pounds) at launch and the solar arrays provide 3126 watts of power. Satellites are launched in pairs on Ariane, Atlas, or other vehicles. Each satellite is placed in a circular orbit at an altitude of 10,354 km.

Long-term improvements in oral communication skills and quality of peer relations in children with cochlear implants: parental testimony.

PubMed

Bat-Chava, Y; Martin, D; Imperatore, L

2014-11-01

Few research studies have examined longitudinal improvements in oral communication skills and quality of peer relationships of children with implants. Moreover, although the emerging literature suggests that improvement in social functioning follows improvement in oral communication, it is still unknown what factors enhance or impede the relations between these constructs. Based on parent interviews, the current study examined the long-term improvements in speech and oral language skills and relationships with hearing peers in 19 implanted children. Results demonstrate that on average, children continue to improve in oral communication skills and quality of peer relationships even years after implantation, especially those with initial poorer skills. While oral communication ability and quality of peer relationships are strongly associated at each time point, gains in these two variables are associated only for some of the children. Other factors, including self-confidence and peer acceptance, seem to moderate this relationship. Qualitative data are presented to illustrate these relations among variables and to assist in theory building. The results highlight the need for more specific examination of various developmental periods in combination with the progress of oral communication and peer relationships among children with implants. © 2013 John Wiley & Sons Ltd.

The Contribution of Early Communication Quality to Low-Income Children's Language Success.

PubMed

Hirsh-Pasek, Kathy; Adamson, Lauren B; Bakeman, Roger; Owen, Margaret Tresch; Golinkoff, Roberta Michnick; Pace, Amy; Yust, Paula K S; Suma, Katharine

2015-07-01

The disparity in the amount and quality of language that low-income children hear relative to their more-affluent peers is often referred to as the 30-million-word gap. Here, we expand the literature about this disparity by reporting the relative contributions of the quality of early parent-child communication and the quantity of language input in 60 low-income families. Including both successful and struggling language learners from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development, we noted wide variation in the quality of nonverbal and verbal interactions (symbol-infused joint engagement, routines and rituals, fluent and connected communication) at 24 months, which accounted for 27% of the variance in expressive language 1 year later. These indicators of quality were considerably more potent predictors of later language ability than was the quantity of mothers' words during the interaction or sensitive parenting. Bridging the word gap requires attention to how caregivers and children establish a communication foundation within low-income families. © The Author(s) 2015.

Chapter 1: The Appalachian regional reforestation initiative

Treesearch

Patrick Angel; Vic Davis; Jim Burger; Don Graves; Carl Zipper

2017-01-01

The Appalachian Regional Reforestation Initiative (ARRI) is a cooperative effort by the States of the Appalachian region with the U.S. Department of the Interior's Office of Surface Mining Reclamation and Enforcement (OSMRE) to encourage restoration of high-quality forests on reclaimed coal mines in the eastern United States. The goals of ARRI are to communicate...

The "New Economy": Real or High-Tech Bubble? Myths and Realities.

ERIC Educational Resources Information Center

Brown, Bettina Lankard

The "New Economy" implies a society in which information/communication technology is changing the nature of the workplace and contributing to more efficient and productive practices geared toward improving the quality of products and services. Recent events such as the collapse of dot.coms and corporate scandals have led some to doubt…

Caring for Infants and Toddlers in Groups: Developmentally Appropriate Practice.

ERIC Educational Resources Information Center

Lally, J. Ronald; Griffin, Abbey; Fenichel, Emily; Segal, Marilyn; Szanton, Eleanor; Weissbourd, Bernice

Noting that high quality group care for infants and toddlers can enrich children's early experience and provide critical support to their families, this guide is designed to help caregivers and other interested parties in early care and education recognize and communicate the skills and knowledge needed to offer nurturing group care that supports…

Proceedings of the ASCUE Summer Conference (26th Annual, Myrtle Beach, South Carolina, June 20-24, 1993).

ERIC Educational Resources Information Center

Association of Small Computer Users in Education, Greencastle, IN.

This proceedings report includes 37 papers presented at the 1993 presented on the following topics: information technology in college recruiting; introductory networks in the classroom; Total Quality Management in higher education and a computing services organization; a High Tech Student Workstation; network communication for students and…

78 FR 12750 - Information Collection(s) Being Reviewed by the Federal Communications Commission, Comments...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-25

... retain benefits. Statutory authority for this information collection is contained in 47 U.S.C. sections... Plan for Our Future; Establish Just and Reasonable Rates for Local Exchange Carriers; High-Cost... to file a five-year service quality improvement plan by July 1, 2013, and to file annually thereafter...

Physical Education Websites and Webpages in the State of Alabama: Are We Painting a Positive Self-Portrait?

ERIC Educational Resources Information Center

Washburn, Nicholas; Sinelnikov, Oleg A.

2016-01-01

A well-designed, high quality physical education (PE) website is beneficial for establishing communication, presenting a positive image, encouraging and improving parental involvement, encouraging students to take control of their own health, collaborating with other educational resources, and most important, improving student learning. However,…

Unleashing Creativity in Linguistic Discourses through Advertising Skills

ERIC Educational Resources Information Center

Suneetha, Y.

2015-01-01

Creative fluency is positively correlated with the quantity and quality of talk as well. The fluency gives an indication of the learner's ability to cope with real-time communication. This paper makes a correlative study on nurturing narrative tasks through advertising skills. English advertising exploits from the high adaptability of the English…

Integration of Video-Based Demonstrations to Prepare Students for the Organic Chemistry Laboratory

ERIC Educational Resources Information Center

Nadelson, Louis S.; Scaggs, Jonathan; Sheffield, Colin; McDougal, Owen M.

2015-01-01

Consistent, high-quality introductions to organic chemistry laboratory techniques effectively and efficiently support student learning in the organic chemistry laboratory. In this work, we developed and deployed a series of instructional videos to communicate core laboratory techniques and concepts. Using a quasi-experimental design, we tested the…

Effective Communication and Creating Professional Learning Communities Is a Valuable Practice for Superintendents

ERIC Educational Resources Information Center

Hilliard, Ann Toler; Newsome, Edward, Jr.

2013-01-01

As the chief executive officer, the superintendent must demonstrate high quality performance at every level in order to impact student achievement. In order to be an effective superintendent, the individual must have knowledge and skills in educational leadership and be able to articulate information clearly and precisely about the school…

An Evaluation of Healthy Relationship Education to Reduce Intimate Partner Violence

ERIC Educational Resources Information Center

Antle, Becky F.; Karam, Eli; Christensen, Dana N.; Barbee, Anita P.; Sar, Bibhuti K.

2011-01-01

This research evaluated the impact of the Within My Reach healthy relationship education program on intimate partner violence for 419 high-risk adults in an urban area. Key outcomes such as relationship knowledge, communication/conflict resolution skills, relationship quality, and physical and emotional abuse were evaluated through survey research…

Untapped Potential: The Status of Middle School Science Education in California. Strengthening Science Education in California

ERIC Educational Resources Information Center

Hartry, Ardice; Dorph, Rena; Shields, Patrick; Tiffany-Morales, Juliet; Romero, Valeria

2012-01-01

Despite the expressed need for high-quality science education, very little research has been conducted on what middle school science learning opportunities look like in practice. This study was conducted in support of "Strengthening Science Education in California", a research, policy, and communications initiative. Partners in this…

Educational Scenarios with Smartphones in Cultural Heritage Sites and Environments

ERIC Educational Resources Information Center

Styliaras, Georgios; Koukopoulos, Dimitrios

2012-01-01

The needs of everyday life for communication and interactivity anywhere and at anytime have led to the tremendous development of mobile devices and applications. Nowadays, we want to have access to enhanced services with high quality at indoor and outdoor environments. Smartphone is a clever new media that supports interactivity and communication…

Design considerations for computationally constrained two-way real-time video communication

NASA Astrophysics Data System (ADS)

Bivolarski, Lazar M.; Saunders, Steven E.; Ralston, John D.

2009-08-01

Today's video codecs have evolved primarily to meet the requirements of the motion picture and broadcast industries, where high-complexity studio encoding can be utilized to create highly-compressed master copies that are then broadcast one-way for playback using less-expensive, lower-complexity consumer devices for decoding and playback. Related standards activities have largely ignored the computational complexity and bandwidth constraints of wireless or Internet based real-time video communications using devices such as cell phones or webcams. Telecommunications industry efforts to develop and standardize video codecs for applications such as video telephony and video conferencing have not yielded image size, quality, and frame-rate performance that match today's consumer expectations and market requirements for Internet and mobile video services. This paper reviews the constraints and the corresponding video codec requirements imposed by real-time, 2-way mobile video applications. Several promising elements of a new mobile video codec architecture are identified, and more comprehensive computational complexity metrics and video quality metrics are proposed in order to support the design, testing, and standardization of these new mobile video codecs.

Visualizing desirable patient healthcare experiences.

PubMed

Liu, Sandra S; Kim, Hyung T; Chen, Jie; An, Lingling

2010-01-01

High healthcare cost has drawn much attention and healthcare service providers (HSPs) are expected to deliver high-quality and consistent care. Therefore, an intimate understanding of the most desirable experience from a patient's and/or family's perspective as well as effective mapping and communication of such findings should facilitate HSPs' efforts in attaining sustainable competitive advantage in an increasingly discerning environment. This study describes (a) the critical quality attributes (CQAs) of the experience desired by patients and (b) the application of two visualization tools that are relatively new to the healthcare sector, namely the "spider-web diagram" and "promotion and detraction matrix." The visualization tools are tested with primary data collected from telephone surveys of 1,800 patients who had received care during calendar year 2005 at 6 of 61 hospitals within St. Louis, Missouri-based, Ascension Health. Five CQAs were found by factor analysis. The spider-web diagram illustrates that communication and empowerment and compassionate and respectful care are the most important CQAs, and accordingly, the promotion and detraction matrix shows those attributes that have the greatest effect for creating promoters, preventing detractors, and improving consumer's likelihood to recommend the healthcare provider.

The smartphone in medicine: a review of current and potential use among physicians and students.

PubMed

Ozdalga, Errol; Ozdalga, Ark; Ahuja, Neera

2012-09-27

Advancements in technology have always had major impacts in medicine. The smartphone is one of the most ubiquitous and dynamic trends in communication, in which one's mobile phone can also be used for communicating via email, performing Internet searches, and using specific applications. The smartphone is one of the fastest growing sectors in the technology industry, and its impact in medicine has already been significant. To provide a comprehensive and up-to-date summary of the role of the smartphone in medicine by highlighting the ways in which it can enhance continuing medical education, patient care, and communication. We also examine the evidence base for this technology. We conducted a review of all published uses of the smartphone that could be applicable to the field of medicine and medical education with the exclusion of only surgical-related uses. In the 60 studies that were identified, we found many uses for the smartphone in medicine; however, we also found that very few high-quality studies exist to help us understand how best to use this technology. While the smartphone's role in medicine and education appears promising and exciting, more high-quality studies are needed to better understand the role it will have in this field. We recommend popular smartphone applications for physicians that are lacking in evidence and discuss future studies to support their use.

Low-latency situational awareness for UxV platforms

NASA Astrophysics Data System (ADS)

Berends, David C.

2012-06-01

Providing high quality, low latency video from unmanned vehicles through bandwidth-limited communications channels remains a formidable challenge for modern vision system designers. SRI has developed a number of enabling technologies to address this, including the use of SWaP-optimized Systems-on-a-Chip which provide Multispectral Fusion and Contrast Enhancement as well as H.264 video compression. Further, the use of salience-based image prefiltering prior to image compression greatly reduces output video bandwidth by selectively blurring non-important scene regions. Combined with our customization of the VLC open source video viewer for low latency video decoding, SRI developed a prototype high performance, high quality vision system for UxV application in support of very demanding system latency requirements and user CONOPS.

Communication Patterns in Preschool Education Institutions – Practical Examples

PubMed Central

Radic-Hozo, Endica

2014-01-01

Introduction: Proper communication in pre-school institutions for education is undeniable importance to the development of the child, as evidenced by numerous studies. After the child's birth follows the most complex phase in its early phases - preschool education. Only high-quality, synergistic relationship triad: parent-child-educator and the modern postulates of preschool child education, warrants successful preschool child education. Methods and materials: Description, with examples from daily practice in a large institution for preschool education, marked were the critical points on the complex way in child education, many pitfalls encountered by both parents and educators. Considered are the errors in communication with the proposed solution to avoid the same in practice. Conclusion: Proper, daily communication in the preschool institution for education, within a relationship between parent-child-educator, mutual consultation, respect, acceptance, facilitation, resulting in successful common goal - the proper education and socialization of children in institutions for preschool education. PMID:25568636

Technology requirements for post-1985 communications satellites

NASA Technical Reports Server (NTRS)

Burtt, J. E.; Moe, C. R.; Elms, R. V.; Delateur, L. A.; Sedlacek, W. C.; Younger, G. G.

1973-01-01

The technical and functional requirements for commercial communication satellites are discussed. The need for providing quality service at an acceptable cost is emphasized. Specialized services are postulated in a needs model which forecasts future demands. This needs model is based upon 322 separately identified needs for long distance communication. It is shown that the 1985 demand for satellite communication service for a domestic region such as the United States, and surrounding sea and air lanes, may require on the order of 100,000 MHz of bandwith. This level of demand can be met by means of the presently allocated bandwidths and developing some key technologies. Suggested improvements include: (1) improving antennas so that high speed switching will be possible; (2) development of solid state transponders for 12 GHz and possibly higher frequencies; (3) development of switched or steered beam antennas with 10 db or higher gain for aircraft; and (4) continued development of improved video channel compression techniques and hardware.

Satisfaction With Communication In Primary Care For Spanish-Speaking And English-Speaking Parents

PubMed Central

Flower, Kori B.; Skinner, Asheley C.; Yin, H. Shonna; Rothman, Russell L.; Sanders, Lee M.; Delamater, Alan; Perrin, Eliana M.

2017-01-01

Background and Objective Effective communication with primary care physicians is important yet incompletely understood for Spanish-speaking parents. We predicted lower satisfaction among Spanish-speaking compared with English-speaking Latino and non-Latino parents. Methods Cross-sectional analysis at 2-month well visits within the Greenlight study at 4 pediatric resident clinics. Parents reported satisfaction with 14 physician communication items using the validated Communication Assessment Tool (CAT). High satisfaction was defined as “excellent” on each CAT item. Mean estimations compared satisfaction for communication items among Spanish and English-speaking Latinos and non-Latinos. We used generalized linear regression modeling, adjusted for parent age, education, income, and clinic site. Among Spanish-speaking parents, we compared visits conducted in Spanish with and without an interpreter, and in English. Results Compared with English-speaking Latino (N=127) and non-Latino parents (N=432), fewer Spanish-speaking parents (N=303) reported satisfaction with 14 communication items. No significant differences were found between English-speaking Latinos and non-Latinos. Greatest differences were found in: greeting that made the parent comfortable (59.4% of Spanish-speaking Latinos endorsing “Excellent” vs. 77.5% English-speaking Latinos, p<0.01) and discussing follow-up (62.5% of Spanish-speaking Latinos vs. 79.8% English-speaking Latinos, p<0.01). After adjusting for parent age, education, income, and study site, Spanish-speaking Latinos were still less likely to report high satisfaction with these communication items. Satisfaction was not different among Spanish-speaking parents when the physician spoke Spanish versus used an interpreter. Conclusions Satisfaction with physician communication was associated with language, but not ethnicity. Spanish-speaking parents less frequently report satisfaction with communication, and innovative solutions to enhance communication quality are needed. PMID:28104488

Self-reported financial burden and satisfaction with care among patients with cancer.

PubMed

Chino, Fumiko; Peppercorn, Jeffrey; Taylor, Donald H; Lu, Ying; Samsa, Gregory; Abernethy, Amy P; Zafar, S Yousuf

2014-04-01

Health care-related costs and satisfaction are compelling targets for quality improvement in cancer care delivery; however, little is known about how financial burden affects patient satisfaction. This was an observational, cross-sectional, survey-based study assessing patient-reported financial burden (FB). Eligible patients were ≥ 21 years with solid tumor malignancy and were receiving chemotherapy or hormonal therapy for ≥ 1 month. The Patient Satisfaction Questionnaire Short-Form assessed patient satisfaction with health care. Subjective FB related to cancer treatment was measured on a 5-point Likert scale. Of 174 participants (32% response rate), 47% reported significant/catastrophic FB. Participants reported highest satisfaction with interpersonal manner and lowest satisfaction with financial aspects of care. In adjusted analysis, high FB was negatively associated with general satisfaction (coefficient: -.29), satisfaction with technical quality (coefficient: -.26), and satisfaction with financial aspects of care (coefficient: -.62). Older age was associated with higher scores in all satisfaction subscales except patient-physician communication and financial aspects. Annual household income of <$20,000 was associated with lower satisfaction scores in all subscales except time spent with doctor. High FB was not associated with patient satisfaction scores for accessibility and convenience, communication, interpersonal manner, or time spent with doctor. FB is a potentially modifiable correlate of poor satisfaction with cancer care including general satisfaction and satisfaction with the technical quality of care. Addressing cancer-associated FB may lead to improved satisfaction, which in turn can influence adherence, outcomes, and quality of life.

Australian pharmacies prevent potential adverse reactions in patients taking warfarin requesting over-the-counter analgesia.

PubMed

MacFarlane, Brett V; Bergin, Jenny K; Reeves, Peter; Matthews, Andrew

2015-06-01

The objective of this article was to assess if Australian pharmacy staff prevent potential adverse reactions in warfarin patients requesting over-the-counter (OTC) analgesia. Mystery shoppers entered 170 pharmacies across Australia to request OTC analgesia for a hypothetical patient with a wrist injury who currently takes warfarin following a heart valve replacement. The request was made to the first pharmacist or non-pharmacist staff member to approach the mystery shopper. The interaction was audio-taped and assessed by a pharmacist. The OTC analgesic recommended was assessed for the potential to cause an adverse bleeding event. The quality of advice given with the OTC analgesic was assessed against determined criteria. Results were compared with scenarios of similar request type where the hypothetical patient was not taking warfarin. Mystery shoppers enquiring about taking OTC analgesics concomitantly with warfarin had access to the pharmacist in 97.0% of cases. All 170 pharmacies recommended OTC analgesics that were less likely to cause adverse events when taken with warfarin. The advice given and the communication between pharmacy staff and mystery shoppers were of high quality. Australian pharmacies support the quality use of medicines by patients taking warfarin by providing expeditious access to the pharmacist, appropriate recommendations of OTC analgesics, high standards of quality of advice and they communicate in a way to ensure ease of understanding by the consumer. The protocols used by pharmacy staff help prevent potentially serious adverse drug events. © 2014 Royal Pharmaceutical Society.

Is Communication a Mechanism of Relationship Education Effects among Rural African Americans?

PubMed

Barton, Allen W; Beach, Steven R H; Lavner, Justin A; Bryant, Chalandra M; Kogan, Steven M; Brody, Gene H

2017-10-01

Enhancing communication as a means of promoting relationship quality has been increasingly questioned, particularly for couples at elevated sociodemographic risk. In response, the current study investigated communication change as a mechanism accounting for changes in relationship satisfaction and confidence among 344 rural, predominantly low-income African American couples with an early adolescent child who participated in a randomized controlled trial of the Protecting Strong African American Families (ProSAAF) program. Approximately 9 months after baseline assessment, intent-to-treat analyses indicated ProSAAF couples demonstrated improved communication, satisfaction, and confidence compared with couples in the control condition. Improvements in communication mediated ProSAAF effects on relationship satisfaction and confidence; conversely, neither satisfaction nor confidence mediated intervention effects on changes in communication. These results underscore the short-term efficacy of a communication-focused, culturally sensitive prevention program and suggest that communication is a possible mechanism of change in relationship quality among low-income African American couples.

GLOBECOM '89 - IEEE Global Telecommunications Conference and Exhibition, Dallas, TX, Nov. 27-30, 1989, Conference Record. Volumes 1, 2, & 3

NASA Astrophysics Data System (ADS)

The present conference discusses topics in multiwavelength network technology and its applications, advanced digital radio systems in their propagation environment, mobile radio communications, switching programmability, advancements in computer communications, integrated-network management and security, HDTV and image processing in communications, basic exchange communications radio advancements in digital switching, intelligent network evolution, speech coding for telecommunications, and multiple access communications. Also discussed are network designs for quality assurance, recent progress in coherent optical systems, digital radio applications, advanced communications technologies for mobile users, communication software for switching systems, AI and expert systems in network management, intelligent multiplexing nodes, video and image coding, network protocols and performance, system methods in quality and reliability, the design and simulation of lightwave systems, local radio networks, mobile satellite communications systems, fiber networks restoration, packet video networks, human interfaces for future networks, and lightwave networking.

GLOBECOM '85 - Global Telecommunications Conference, New Orleans, LA, December 2-5, 1985, Conference Record. Volumes 1, 2, & 3

NASA Astrophysics Data System (ADS)

Various papers on global telecommunications are presented. The general topics addressed include: multiservice integration with optical fibers, multicompany owned telecommunication networks, softworks quality and reliability, advanced on-board processing, impact of new services and systems on operations and maintenance, analytical studies of protocols for data communication networks, topics in packet radio networking, CCITT No. 7 to support new services, document processing and communication, antenna technology and system aspects in satellite communications. Also considered are: communication systems modelling methodology, experimental integrated local area voice/data nets, spread spectrum communications, motion video at the DS-0 rate, optical and data communications, intelligent work stations, switch performance analysis, novel radio communication systems, wireless local networks, ISDN services, LAN communication protocols, user-system interface, radio propagation and performance, mobile satellite system, software for computer networks, VLSI for ISDN terminals, quality management, man-machine interfaces in switching, and local area network performance.

Different types of Internet use, depression, and social anxiety: the role of perceived friendship quality.

PubMed

Selfhout, Maarten H W; Branje, Susan J T; Delsing, M; ter Bogt, Tom F M; Meeus, Wim H J

2009-08-01

The current study examined the longitudinal associations of time spent on Internet activities for communication purposes (i.e., IM-ing) versus time spent on Internet activities for non-communication purposes (i.e., surfing) with depression and social anxiety, as well as the moderating role of perceived friendship quality in these associations. Questionnaire data were gathered from 307 Dutch middle adolescents (average age 15 years) on two waves with a one-year interval. For adolescents who perceive low friendship quality, Internet use for communication purposes predicted less depression, whereas Internet use for non-communication purposes predicted more depression and more social anxiety. These results support social compensation effects of IM-ing on depression and poor-get-poorer effects of surfing on depression and social anxiety, respectively.

Physician Communication in Pediatric End-of-Life Care: A Simulation Study.

PubMed

Bateman, Lori Brand; Tofil, Nancy M; White, Marjorie Lee; Dure, Leon S; Clair, Jeffrey Michael; Needham, Belinda L

2016-12-01

The objective of this exploratory study is to describe communication between physicians and the actor parent of a standardized 8-year-old patient in respiratory distress who was nearing the end of life. Thirteen pediatric emergency medicine and pediatric critical care fellows and attendings participated in a high-fidelity simulation to assess physician communication with an actor-parent. Fifteen percent of the participants decided not to initiate life-sustaining technology (intubation), and 23% of participants offered alternatives to life-sustaining care, such as comfort measures. Although 92% of the participants initiated an end-of-life conversation, the quality of that discussion varied widely. Findings indicate that effective physician-parent communication may not consistently occur in cases involving the treatment of pediatric patients at the end of life in emergency and critical care units. The findings in this study, particularly that physician-parent end-of-life communication is often unclear and that alternatives to life-sustaining technology are often not offered, suggest that physicians need more training in both communication and end-of-life care. © The Author(s) 2015.

Transforming communication and safety culture in intrapartum care: a multi-organization blueprint.

PubMed

Lyndon, Audrey; Johnson, M Christina; Bingham, Debra; Napolitano, Peter G; Joseph, Gerald; Maxfield, David G; O'Keeffe, Daniel F

2015-01-01

Effective, patient-centered communication facilitates interception and correction of potentially harmful conditions and errors. All team members, including women, their families, physicians, midwives, nurses, and support staff, have a role in identifying the potential for harm during labor and birth. However, the results of collaborative research studies conducted by organizations that represent professionals who care for women during labor and birth indicate that health care providers may frequently witness, but may not always report, problems with safety or clinical performance. Some of these health care providers felt resigned to the continuation of such problems and fearful of retribution if they tried to address them. Speaking up to address safety and quality concerns is a dynamic social process. Every team member must feel empowered to speak up about concerns without fear of put-downs, retribution, or receiving poor-quality care. Patient safety requires mutual accountability: individuals, teams, health care facilities, and professional associations have a shared responsibility for creating and sustaining environments of mutual respect and engaging in highly reliable perinatal care. Defects in human factors, communication, and leadership have been the leading contributors to sentinel events in perinatal care for more than a decade. Organizational commitment and executive leadership are essential to creating an environment that proactively supports safety and quality. The problem is well-known; the time for action is now. © 2015 by the American College of Obstetricians and Gynecologists.

Transforming communication and safety culture in intrapartum care: a multi-organization blueprint.

PubMed

Lyndon, Audrey; Johnson, M Christina; Bingham, Debra; Napolitano, Peter G; Joseph, Gerald; Maxfield, David G; OʼKeeffe, Daniel F

2015-05-01

Effective, patient-centered communication facilitates interception and correction of potentially harmful conditions and errors. All team members, including women, their families, physicians, midwives, nurses, and support staff, have a role in identifying the potential for harm during labor and birth. However, the results of collaborative research studies conducted by organizations that represent professionals who care for women during labor and birth indicate that health care providers may frequently witness, but may not always report, problems with safety or clinical performance. Some of these health care providers felt resigned to the continuation of such problems and fearful of retribution if they tried to address them. Speaking up to address safety and quality concerns is a dynamic social process. Every team member must feel empowered to speak up about concerns without fear of put-downs, retribution, or receiving poor-quality care. Patient safety requires mutual accountability: individuals, teams, health care facilities, and professional associations have a shared responsibility for creating and sustaining environments of mutual respect and engaging in highly reliable perinatal care. Defects in human factors, communication, and leadership have been the leading contributors to sentinel events in perinatal care for more than a decade. Organizational commitment and executive leadership are essential to creating an environment that proactively supports safety and quality. The problem is well-known; the time for action is now.

Transforming communication and safety culture in intrapartum care: a multi-organization blueprint.

PubMed

Lyndon, Audrey; Johnson, M Christina; Bingham, Debra; Napolitano, Peter G; Joseph, Gerald; Maxfield, David G; O'Keeffe, Daniel F

2015-01-01

Effective, patient-centered communication facilitates interception and correction of potentially harmful conditions and errors. All team members, including women, their families, physicians, midwives, nurses, and support staff, have roles in identifying the potential for harm during labor and birth. However, the results of collaborative research studies conducted by organizations that represent professionals who care for women during labor and birth indicate that health care providers may frequently witness, but may not always report, problems with safety or clinical performance. Some of these health care providers felt resigned to the continuation of such problems and fearful of retribution if they tried to address them. Speaking up to address safety and quality concerns is a dynamic social process. Every team member must feel empowered to speak up about concerns without fear of put-downs, retribution, or receiving poor-quality care. Patient safety requires mutual accountability: individuals, teams, health care facilities, and professional associations have a shared responsibility for creating and sustaining environments of mutual respect and engaging in highly reliable perinatal care. Defects in human factors, communication, and leadership have been the leading contributors to sentinel events in perinatal care for more than a decade. Organizational commitment and executive leadership are essential to creating an environment that proactively supports safety and quality. The problem is well-known; the time for action is now. © 2015 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

Rationale and Design of the Lung Cancer Screening Implementation. Evaluation of Patient-Centered Care Study.

PubMed

Miranda, Leah S; Datta, Santanu; Melzer, Anne C; Wiener, Renda Soylemez; Davis, James M; Tong, Betty C; Golden, Sara E; Slatore, Christopher G

2017-10-01

Screening for lung cancer using low-dose computed tomography has been demonstrated to reduce lung cancer-related mortality and is being widely implemented. Further research in this area is needed to assess the impact of screening on patient-centered outcomes. Here, we describe the design and rationale for a new study entitled Lung Cancer Screening Implementation: Evaluation of Patient-Centered Care. The protocol is composed of an interconnected series of studies evaluating patients and clinicians who are engaged in lung cancer screening in real-world settings. The primary goal of this study is to evaluate communication processes that are being used in routine care and to identify best practices that can be readily scaled up for implementation in multiple settings. We hypothesize that higher overall quality of patient-clinician communication processes will be associated with lower levels of distress and decisional conflict as patients decide whether or not to participate in lung cancer screening. This work is a critical step toward identifying modifiable mechanisms that are associated with high quality of care for the millions of patients who will consider lung cancer screening. Given the enormous potential benefits and burdens of lung cancer screening on patients, clinicians, and the healthcare system, it is important to identify and then scale up quality communication practices that positively influence patient-centered care.

An ontology-based telemedicine tasks management system architecture.

PubMed

Nageba, Ebrahim; Fayn, Jocelyne; Rubel, Paul

2008-01-01

The recent developments in ambient intelligence and ubiquitous computing offer new opportunities for the design of advanced Telemedicine systems providing high quality services, anywhere, anytime. In this paper we present an approach for building an ontology-based task-driven telemedicine system. The architecture is composed of a task management server, a communication server and a knowledge base for enabling decision makings taking account of different telemedical concepts such as actors, resources, services and the Electronic Health Record. The final objective is to provide an intelligent management of the different types of available human, material and communication resources.

Trends in NASA communication satellites

NASA Technical Reports Server (NTRS)

Sivo, J. N.; Robbins, W. H.; Stretchberry, D. M.

1972-01-01

Satellite telecommunications can help to satisfy several national needs such as education, health care, cultural opportunities, and data transfer. There are current experiments being conducted with NASA spacecraft ATS 1, 3, and 5 in an attempt to satisfy these national needs. Future experiments are planned for the ATS F/G and CTS spacecrafts. The next generation of communications satellites must provide multiple region coverage, multichannel capability, high quality TV pictures, and must allow low cost ground receivers to be used. The proposed NASA spacecrafts, ATS H/I, will satisfy these requirements. Other countries of the world can benefit from ATS H/I technology.

Virtual Ultrasound Guidance for Inexperienced Operators

NASA Technical Reports Server (NTRS)

Caine, Timothy; Martin, Davis

2012-01-01

Medical ultrasound or echocardiographic studies are highly operator-dependent and generally require lengthy training and internship to perfect. To obtain quality echocardiographic images in remote environments, such as on-orbit, remote guidance of studies has been employed. This technique involves minimal training for the user, coupled with remote guidance from an expert. When real-time communication or expert guidance is not available, a more autonomous system of guiding an inexperienced operator through an ultrasound study is needed. One example would be missions beyond low Earth orbit, in which the time delay inherent with communication will make remote guidance impractical.

Multi-copy entanglement purification with practical spontaneous parametric down conversion sources

NASA Astrophysics Data System (ADS)

Zhang, Shuai-Shuai; Shu, Qi; Zhou, Lan; Sheng, Yu-Bo

2017-06-01

Entanglement purification is to distill the high quality entanglement from the low quality entanglement with local operations and classical communications. It is one of the key technologies in long-distance quantum communication. We discuss an entanglement purification protocol (EPP) with spontaneous parametric down conversion (SPDC) sources, in contrast to previous EPP with multi-copy mixed states, which requires ideal entanglement sources. We show that the SPDC source is not an obstacle for purification, but can benefit the fidelity of the purified mixed state. This EPP works for linear optics and is feasible in current experiment technology. Project supported by the National Natural Science Foundation of China (Grant Nos. 11474168 and 61401222), the Natural Science Foundation of Jiangsu Province, China (Grant No. BK20151502), the Qing Lan Project in Jiangsu Province, China, and a Project Funded by the Priority Academic Program Development of Jiangsu Higher Education Institutions, China.

Opto-mechanical design and gravity-deformation analysis on optical telescope in laser communication system

NASA Astrophysics Data System (ADS)

Fu, Sen; Du, Jindan; Song, Yiwei; Gao, Tianyu; Zhang, Daqing; Wang, Yongzhi

2017-11-01

In space laser communication, optical antennas are one of the main components and the precision of optical antennas is very high. In this paper, it is based on the R-C telescope and it is carried out that the design and simulation of optical lens and supporting truss, according to the parameters of the systems. And a finite element method (FEM) was used to analyze the deformation of the optical lens. Finally, the Zernike polynomial was introduced to fit the primary mirror with a diameter of 250mm. The objective of this study is to determine whether the wave-front aberration of the primary mirror can meet the imaging quality. The results show that the deterioration of the imaging quality caused by the gravity deformation of primary and secondary mirrors. At the same time, the optical deviation of optical antenna increase with the diameter of the pupil.

[Application of THz technology to nondestructive detection of agricultural product quality].

PubMed

Jiang, Yu-ying; Ge, Hong-yi; Lian, Fei-yu; Zhang, Yuan; Xia, Shan-hong

2014-08-01

With recent development of THz sources and detector, applications of THz radiation to nondestructive testing and quality control have expanded in many fields, such as agriculture, safety inspection and quality control, medicine, biochemistry, communication etc. Compared with other detection technique, being a new kind of technique, THz radiation has low energy, good perspectivity, and high signal-to-noise ratio, and thus can obtain physical, chemical and biological information. This paper first introduces the basic concept of THz radiation and the major properties, then gives an extensive review of recent research progress in detection of the quality of agricultural products via THz technique, analyzes the existing shortcomings of THz detection and discusses the outlook of potential application, finally proposes the new application of THz technique to detection of quality of stored grain.

Importance of relationship quality in the success of data warehouse systems

NASA Astrophysics Data System (ADS)

Almabhouh, Alaaeddin; Saleh, Abdul; Ahmad, Azizah

2011-10-01

Increased organizational dependence on data warehouse (DW) systems drives management attention towards improving DW systems success. However, the successful implementation rate of DW systems is low and many firms did not achieve intended goals. A recent studies show that improves and evaluates DW success is one of the top concerns facing IT/DW executives. Existing information system (IS) research has studied DW success more from information quality and system quality. Researchers argue in this study that we should also take the relationship quality, which has significant research and practical implications in that it connects to IS success directly. As our first attempt, this study, referring to both IS and marketing literature, examines how communication, coordination, cooperation, commitment, and trust can be achieved to some degrees by high quality relationships between DW parties.

[Influence of stress factors and socio-demographic characteristics on the sleep quality of nursing students].

PubMed

Benavente, Sonia Betzabeth Ticona; Silva, Rodrigo Marques da; Higashi, Aline Baraldi; Guido, Laura de Azevedo; Costa, Ana Lucia Siqueira

2014-06-01

To analyze the influence of stress factors and socio-demographic characteristics on the sleep quality of nursing students. An analytical cross-sectional and quantitative study, conducted with 151 nursing students in São Paulo between March and April of 2012. A form for socio-demographic characteristics, the Instrument to Evaluate Stress in Nursing Students and the Pittsburgh Sleep Index were applied. High levels of stress was predominant for Time Management (27.8%) and Professional Training (30.5%) and low sleep quality (78.8%). The Professional Communication, Professional Training and Theoretical Activity are positively correlated to sleep quality. Work activity, academic year and time for daily studies contributed to a low quality of sleep. Few stress factors from the academic environment and some socio-demographic characteristics contributed to the reduction of sleep quality in students.

Bigger is better: honeybee colonies as distributed information-gathering systems.

PubMed

Donaldson-Matasci, Matina C; DeGrandi-Hoffman, Gloria; Dornhaus, Anna

2013-03-01

In collectively foraging groups, communication about food resources can play an important role in the organization of the group's activity. For example, the honeybee dance communication system allows colonies to selectively allocate foragers among different floral resources according to their quality. Because larger groups can potentially collect more information than smaller groups, they might benefit more from communication because it allows them to integrate and use that information to coordinate forager activity. Larger groups might also benefit more from communication because it allows them to dominate high-value resources by recruiting large numbers of foragers. By manipulating both colony size and the ability to communicate location information in the dance, we show that larger colonies of honeybees benefit more from communication than do smaller colonies. In fact, colony size and dance communication worked together to improve foraging performance; the estimated net gain per foraging trip was highest in larger colonies with unimpaired communication. These colonies also had the earliest peaks in foraging activity, but not the highest ones. This suggests they may find and recruit to resources more quickly, but not more heavily. The benefits of communication we observed in larger colonies are thus likely a result of more effective informationgathering due to massive parallel search rather than increased competitive ability due to heavy recruitment.

Bigger is better: honeybee colonies as distributed information-gathering systems

PubMed Central

Donaldson-Matasci, Matina C.; DeGrandi-Hoffman, Gloria; Dornhaus, Anna

2015-01-01

In collectively foraging groups, communication about food resources can play an important role in the organization of the group’s activity. For example, the honeybee dance communication system allows colonies to selectively allocate foragers among different floral resources according to their quality. Because larger groups can potentially collect more information than smaller groups, they might benefit more from communication because it allows them to integrate and use that information to coordinate forager activity. Larger groups might also benefit more from communication because it allows them to dominate high-value resources by recruiting large numbers of foragers. By manipulating both colony size and the ability to communicate location information in the dance, we show that larger colonies of honeybees benefit more from communication than do smaller colonies. In fact, colony size and dance communication worked together to improve foraging performance; the estimated net gain per foraging trip was highest in larger colonies with unimpaired communication. These colonies also had the earliest peaks in foraging activity, but not the highest ones. This suggests they may find and recruit to resources more quickly, but not more heavily. The benefits of communication we observed in larger colonies are thus likely a result of more effective informationgathering due to massive parallel search rather than increased competitive ability due to heavy recruitment. PMID:26213412

Technology-enabled management of communication and swallowing disorders in Parkinson's disease: a systematic scoping review.

PubMed

Theodoros, Deborah; Aldridge, Danielle; Hill, Anne J; Russell, Trevor

2018-06-19

Communication and swallowing disorders are highly prevalent in people with Parkinson's disease (PD). Maintenance of functional communication and swallowing over time is challenging for the person with PD and their families and may lead to social isolation and reduced quality of life if not addressed. Speech and language therapists (SLTs) face the conundrum of providing sustainable and flexible services to meet the changing needs of people with PD. Motor, cognitive and psychological issues associated with PD, medication regimens and dependency on others often impede attendance at a centre-based service. The access difficulties experienced by people with PD require a disruptive service approach to meet their needs. Technology-enabled management using information and telecommunications technologies to provide services at a distance has the potential to improve access, and enhance the quality of SLT services to people with PD. To report the status and scope of the evidence for the use of technology in the management of the communication and swallowing disorders associated with PD. Studies were retrieved from four major databases (PubMed, CINAHL, EMBASE and Medline via Web of Science). Data relating to the types of studies, level of evidence, context, nature of the management undertaken, participant perspectives and the types of technologies involved were extracted for the review. A total of 17 studies were included in the review, 15 of which related to the management of communication and swallowing disorders in PD with two studies devoted to participant perspectives. The majority of the studies reported on the treatment of the speech disorder in PD using Lee Silverman Voice Treatment (LSVT LOUD ® ). Synchronous and asynchronous technologies were used in the studies with a predominance of the former. There was a paucity of research in the management of cognitive-communication and swallowing disorders. Research evidence supporting technology-enabled management of the communication and swallowing disorders in PD is limited and predominantly low in quality. The treatment of the speech disorder online is the most developed aspect of the technology-enabled management pathway. Future research needs to address technology-enabled management of cognitive-communication and swallowing disorders and the use of a more diverse range of technologies and management approaches to optimize SLT service delivery to people with PD. © 2018 Royal College of Speech and Language Therapists.

Family Avoidance of Communication about Cancer: A Dyadic Examination

PubMed Central

Shin, Dong Wook; Shin, Jooyeon; Kim, So Young; Yang, Hyung-Kook; Cho, Juhee; Youm, Jung Ho; Choi, Gyu Seog; Hong, Nam Soo; Cho, BeLong; Park, Jong-Hyock

2016-01-01

Purpose This study aimed to examine the following questions: to what extent do patients and caregivers perceive their family members to be avoidant of communication regarding patient’s cancer, and to what extent do these perceptions interrelate; and how do such perceptions influence their own and each other’s communication behaviors, communication outcome, mental health, and quality of life. Materials and Methods A national survey was performed with 990 patient-caregiver dyads (participation rate, 76.2%). To examine the dyadic interaction, we developed linked patient and family member questionnaires, including the Family Avoidance of Communication about Cancer (FACC) scale. Results The mean scores (standard deviations) of patient- and caregiver-perceived FACC were low at 10.9 (15.5) and 15.5 (17.5), respectively (p < 0.001), and concordance was low, a well (Spearman’s rho, 0.23). Patient-perceived FACC was associated with lower levels of disclosure and behaviors of holding back communication, as well as lower levels of mental health outcome and quality of life. The same was true for caregivers (all p < 0.05). Patient-perceived FACC was associated with caregiver holding back, caregiver’s depression level, and caregiver quality of life (all p < 0.05). Both patient- and caregiver-perceived FACC were independently associated with communication difficulty within the family. Conclusion Future research would benefit from the measurement of FACC from both patients and caregivers, and promote family intervention to enhance openness to communication, which would be helpful for improving mental health and quality of life for both patients and caregivers. PMID:25779366

Modeling the dyadic effects of parenting, stress, and coping on parent-child communication in families tested for hereditary breast-ovarian cancer risk.

PubMed

Hamilton, Jada G; Mays, Darren; DeMarco, Tiffani; Tercyak, Kenneth P

2016-10-01

Genetic testing for BRCA genes, associated with hereditary breast-ovarian cancer risk, is an accepted cancer control strategy. BRCA genetic testing has both medical and psychosocial implications for individuals seeking testing and their family members. However, promoting open and adaptive communication about cancer risk in the family is challenging for parents of minor children. Using prospective data collected from mothers undergoing BRCA genetic testing and their untested co-parents (N = 102 parenting dyads), we examined how maternal and co-parent characteristics independently and conjointly influenced the overall quality of parent-child communication with minor children. Statistical associations were tested in accordance with the Actor-Partner Interdependence Model. Significant Actor effects were observed among mothers, such that open parent-child communication prior to genetic testing was positively associated with open communication 6 months following receipt of genetic test results; and among co-parents, more open parent-child communication at baseline and greater perceived quality of the parenting relationship were associated with more open parent-child communication at follow-up. Partner effects were also observed: co-parents' baseline communication and confidence in their ability to communicate with their minor children about genetic testing was positively associated with open maternal parent-child communication at follow-up. These results demonstrate that for families facing the prospect of cancer genetic testing, perceptions and behaviors of both members of child-rearing couples have important implications for the overall quality of communication with their minor children, including communication about cancer risk.

Modeling the dyadic effects of parenting, stress, and coping on parent–child communication in families tested for hereditary breast-ovarian cancer risk

PubMed Central

Hamilton, Jada G.; Mays, Darren; DeMarco, Tiffani; Tercyak, Kenneth P.

2016-01-01

Genetic testing for BRCA genes, associated with hereditary breast-ovarian cancer risk, is an accepted cancer control strategy. BRCA genetic testing has both medical and psychosocial implications for individuals seeking testing and their family members. However, promoting open and adaptive communication about cancer risk in the family is challenging for parents of minor children. Using prospective data collected from mothers undergoing BRCA genetic testing and their untested co-parents (N = 102 parenting dyads), we examined how maternal and co-parent characteristics independently and conjointly influenced the overall quality of parent–child communication with minor children. Statistical associations were tested in accordance with the Actor–Partner Interdependence Model. Significant Actor effects were observed among mothers, such that open parent–child communication prior to genetic testing was positively associated with open communication 6 months following receipt of genetic test results; and among co-parents, more open parent–child communication at baseline and greater perceived quality of the parenting relationship were associated with more open parent–child communication at follow-up. Partner effects were also observed: co-parents’ baseline communication and confidence in their ability to communicate with their minor children about genetic testing was positively associated with open maternal parent– child communication at follow-up. These results demonstrate that for families facing the prospect of cancer genetic testing, perceptions and behaviors of both members of child-rearing couples have important implications for the overall quality of communication with their minor children, including communication about cancer risk. PMID:26848859

Communication in healthcare: a narrative review of the literature and practical recommendations.

PubMed

Vermeir, P; Vandijck, D; Degroote, S; Peleman, R; Verhaeghe, R; Mortier, E; Hallaert, G; Van Daele, S; Buylaert, W; Vogelaers, D

2015-11-01

Effective and efficient communication is crucial in healthcare. Written communication remains the most prevalent form of communication between specialised and primary care. We aimed at reviewing the literature on the quality of written communication, the impact of communication inefficiencies and recommendations to improve written communication in healthcare. Narrative literature review. A search was carried out on the databases PubMed, Web of Science and The Cochrane Library by means of the (MeSH)terms 'communication', 'primary health care', 'correspondence', 'patient safety', 'patient handoff' and 'continuity of patient care'. Reviewers screened 4609 records and 462 full texts were checked according following inclusion criteria: (1) publication between January 1985 and March 2014, (2) availability as full text in English, (3) categorisation as original research, reviews, meta-analyses or letters to the editor. A total of 69 articles were included in this review. It was found that poor communication can lead to various negative outcomes: discontinuity of care, compromise of patient safety, patient dissatisfaction and inefficient use of valuable resources, both in unnecessary investigations and physician worktime as well as economic consequences. There is room for improvement of both content and timeliness of written communication. The delineation of ownership of the communication process should be clear. Peer review, process indicators and follow-up tools are required to measure the impact of quality improvement initiatives. Communication between caregivers should feature more prominently in graduate and postgraduate training, to become engraved as an essential skill and quality characteristic of each caregiver. © 2015 The Authors. International Journal of Clinical Practice Published by John Wiley & Sons Ltd.

Assessment of immigrant certified nursing assistants' communication when responding to standardized care challenges.

PubMed

Massey, Meredith; Roter, Debra L

2016-01-01

Certified nursing assistants (CNAs) provide 80% of the hands-on care in US nursing homes; a significant portion of this work is performed by immigrants with limited English fluency. This study is designed to assess immigrant CNA's communication behavior in response to a series of virtual simulated care challenges. A convenience sample of 31 immigrant CNAs verbally responded to 9 care challenges embedded in an interactive computer platform. The responses were coded with the Roter Interaction Analysis System (RIAS), CNA instructors rated response quality and spoken English was rated. CNA communication behaviors varied across care challenges and a broad repertoire of communication was used; 69% of response content was characterized as psychosocial. Communication elements (both instrumental and psychosocial) were significant predictors of response quality for 5 of 9 scenarios. Overall these variables explained between 13% and 36% of the adjusted variance in quality ratings. Immigrant CNAs responded to common care challenges using a variety of communication strategies despite fluency deficits. Virtual simulation-based observation is a feasible, acceptable and low cost method of communication assessment with implications for supervision, training and evaluation of a para-professional workforce. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

An Intervention to Enhance Goals-of-Care Communication Between Heart Failure Patients and Heart Failure Providers.

PubMed

Doorenbos, Ardith Z; Levy, Wayne C; Curtis, J Randall; Dougherty, Cynthia M

2016-09-01

Heart failure patients contend with a markedly impaired quality of life, experiencing emotional distress and severe physical discomfort that increases in frequency in the last months of life. Improving communication between patients and providers about goals of care has the potential to improve patient-provider communication and patient outcomes. To determine the effects of a goals-of-care (GoC) intervention compared to usual care on the number of GoC conversations, quality of communication between patients and providers, referrals to palliative care services and completion of advance care directives. A two-group randomized study (n = 40/group) compared a GoC intervention to usual care, conducted in an academic heart failure (HF) clinic. The GoC intervention was a previsit patient activation-education, telephone-based intervention delivered by a nurse. The primary outcome of the study was number of GoC conversations between HF patients and HF providers. Secondary outcomes were quality of communication, number of referrals to palliative care, and completion of advance directives. Patients averaged 58.15 ± 11.26 years of age, with mean left ventricular ejection fraction = 30.31 ± 9.72% and Seattle Heart Failure Model scores = 95.1 ± 1.60. There was a significant increase in goals-of-care conversations (58% vs. 2.6%, P < 0.001) and quality of end-of-life communication (P = 0.03) in the GoC group compared to usual care after the intervention. There were no differences between groups on the other outcomes. The GoC intervention resulted in more GoC conversations and higher quality communication between HF patients and providers without increased anxiety or depression. Further studies are needed to assess impact on longer term quality of care and patient outcomes. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Provider Difficulties With Spiritual and Forgiveness Communication at the End of Life.

PubMed

Wittenberg, Elaine; Ferrell, Betty; Goldsmith, Joy; Buller, Haley

2016-11-01

Due to an absence of communication training, provider responses to patient/family spiritual distress are highly variable. Assessing spiritual and forgiveness concerns are important to ensuring quality holistic care. Cross-sectional survey data were collected from providers attending 1 of 2 continuing education courses. The survey measured the frequency and initiation of communication about spirituality and forgiveness with patients/families, the perceived difficulty in communication across topics, and preparation and resources for these discussions. Most participants (n = 124) were nurses followed by social workers with over half of providers having 10 years or more of clinical experience. Participants reported the highest level of difficulty in spiritual communication when talking with family after the death of a patient, followed by conducting a spiritual history with a patient. Facilitating forgiveness communication between parent and adult child, followed by facilitating forgiveness between partners was most difficult for all participants. Social workers reported much lower difficulty than nurses on all items of spiritual and forgiveness communication. The majority of participants indicated they were involved in spiritual and forgiveness communication. The most difficult communication included talking with family after death and facilitating forgiveness between patients and families. These findings support the importance of spiritual communication in clinical practice, and the need for clinician training in communicating about spirituality and forgiveness with patients and families. © The Author(s) 2015.

A systematic review of the factors that influence the quality and effectiveness of telesupervision for health professionals.

PubMed

Martin, Priya; Lizarondo, Lucylynn; Kumar, Saravana

2018-05-01

Introduction Whilst telesupervision (clinical supervision undertaken using communication technology) is being used more frequently, there is limited information on what factors influence its effectiveness and quality. We undertook this systematic review to address this gap. Methods Eligible telesupervision studies were identified following targeted search of electronic databases and the grey literature. Data were synthesised thematically, resulting in development of core themes. Results We identified 286 papers for initial relevancy screening by title and abstract. The full text of 36 papers were then retrieved and assessed for further relevance. A total of 11 papers were included in the final analysis. We identified eight themes that contribute to effective and high-quality telesupervision: supervisee characteristics, supervisor characteristics, supervision characteristics, supervisory relationship, communication strategies, prior face-to-face contact, environmental factors and technological considerations. Conclusion From the available evidence, telesupervision can be a feasible and acceptable form of clinical supervision if set up well. Further studies with robust designs are required to strengthen the existing evidence on what makes telesupervision effective, as well as to examine its cost-effectiveness.

Asan medical information system for healthcare quality improvement.

PubMed

Ryu, Hyeon Jeong; Kim, Woo Sung; Lee, Jae Ho; Min, Sung Woo; Kim, Sun Ja; Lee, Yong Su; Lee, Young Ha; Nam, Sang Woo; Eo, Gi Seung; Seo, Sook Gyoung; Nam, Mi Hyun

2010-09-01

This purpose of this paper is to introduce the status of the Asan Medical Center (AMC) medical information system with respect to healthcare quality improvement. Asan Medical Information System (AMIS) is projected to become a completely electronic and digital information hospital. AMIS has played a role in improving the health care quality based on the following measures: safety, effectiveness, patient-centeredness, timeliness, efficiency, privacy, and security. AMIS CONSISTED OF SEVERAL DISTINCTIVE SYSTEMS: order communication system, electronic medical record, picture archiving communication system, clinical research information system, data warehouse, enterprise resource planning, IT service management system, and disaster recovery system. The most distinctive features of AMIS were the high alert-medication recognition & management system, the integrated and severity stratified alert system, the integrated patient monitoring system, the perioperative diabetic care monitoring and support system, and the clinical indicator management system. AMIS provides IT services for AMC, 7 affiliated hospitals and over 5,000 partners clinics, and was developed to improve healthcare services. The current challenge of AMIS is standard and interoperability. A global health IT strategy is needed to get through the current challenges and to provide new services as needed.

Diabetes quality of care and outpatient utilization associated with electronic patient-provider messaging: a cross-sectional analysis.

PubMed

Harris, Lynne T; Haneuse, Sebastien J; Martin, Diane P; Ralston, James D

2009-07-01

To test the hypothesis that electronic patient-provider messaging is associated with high care quality for diabetes and lower outpatient utilization. We conducted a cross-sectional analysis of electronic patient-provider messaging over a 15-month period between 1 January 2004 and 31 March 2005. The study was set at Group Health Cooperative--a consumer-governed, nonprofit health care system that operates in Washington and Idaho. Participants included all patients aged >or=18 years with a diagnosis of diabetes. In addition to usual care, all patients had the option to use electronic messaging to communicate with their care providers. The primary outcome measures were diabetes-related quality-of-care indicators (A1C, blood pressure, and LDL cholesterol) and outpatient visits (primary care, specialty care, and emergency). Nineteen percent of patients with diabetes used electronic messaging to communicate with their care providers during the study period (n = 2,924) (overall study cohort: 15,427 subjects). In multivariate models, frequent use of electronic messaging was associated with A1C <7% (relative risk [RR] 1.36 [95% CI 1.16-1.58]). Contrary to our hypothesis, frequent use of electronic messaging was also associated with a higher rate of outpatient visits (1.39 [1.26-1.53]). Frequent use of electronic secure messaging is associated with better glycemic control and increased outpatient utilization. Electronic patient-provider communication may represent one strategy to meet the health care needs of this unique population. More research is necessary to assess the effect of electronic messaging on care quality and utilization.

Men in Midlife and the Quality of Father-Adolescent Communication.

ERIC Educational Resources Information Center

Montemayor, Raymond; And Others

1993-01-01

Thirty-seven men with adolescent children had their testosterone levels measured and then responded to questionnaires on marriage, parent-child relationships, and midlife crises. Results indicated a significant inverse correlation between male midlife stress and the quality of father-adolescent communication. (MDM)

URBAN SPRAWL MODELING, AIR QUALITY MONITORING AND RISK COMMUNICATION: THE NORTHEAST OHIO PROJECT

EPA Science Inventory

The Northeast Ohio Urban Sprawl, Air Quality Monitoring, and Communications Project (hereafter called the Northeast Ohio Project) provides local environmental and health information useful to residents, local officials, community planners, and others in a 15 county region in the ...

Nurse and patient interaction behaviors' effects on nursing care quality for mechanically ventilated older adults in the ICU.

PubMed

Nilsen, Marci L; Sereika, Susan M; Hoffman, Leslie A; Barnato, Amber; Donovan, Heidi; Happ, Mary Beth

2014-01-01

The study purposes were to (a) describe interaction behaviors and factors that may effect communication and (b) explore associations between interaction behaviors and nursing care quality indicators among 38 mechanically ventilated patients (age ≥60 years) and their intensive care unit nurses (n = 24). Behaviors were measured by rating videorecorded observations from the Study of Patient-Nurse Effectiveness with Communication Strategies (SPEACS). Characteristics and quality indicators were obtained from the SPEACS dataset and medical chart abstraction. All positive behaviors occurred at least once. Significant (p < 0.05) associations were observed between (a) positive nurse and positive patient behaviors, (b) patient unaided augmentative and alternative communication (AAC) strategies and positive nurse behaviors, (c) individual patient unaided AAC strategies and individual nurse positive behaviors, (d) positive nurse behaviors and pain management, and (e) positive patient behaviors and sedation level. Findings provide evidence that nurse and patient behaviors effect communication and may be associated with nursing care quality. Copyright 2014, SLACK Incorporated.

Nurse and Patient Interaction Behaviors Effects on Nursing Care Quality for Mechanically Ventilated, Older Adults in the ICU

PubMed Central

Nilsen, Marci; Sereika, Susan M.; Hoffman, Leslie A.; Barnato, Amber; Donovan, Heidi; Happ, Mary Beth

2014-01-01

The study purposes were to 1) describe interaction behaviors and factors that may impact communication and 2) explore associations between interaction behaviors and nursing care quality indicators between 38 mechanically ventilated patients (≥60 years) and their intensive care unit nurses (n=24). Behaviors were measured by rating videotaped observations from the Study of Patient-Nurse Effectiveness with Communication Strategies (SPEACS). Characteristics and quality indicators were obtained from the SPEACS dataset and medical chart abstraction. All positive behaviors occurred at least once. Significant (p<.05) associations were observed between: 1) positive nurse and positive patient behaviors, 2) patient unaided augmentative and alternative communication (AAC) strategies and positive nurse behaviors, 3) individual patient unaided AAC strategies and individual nurse positive behaviors and 4) positive nurse behaviors and pain management, and 5) positive patient behaviors and sedation level. Findings provide evidence that nurse and patient behaviors impact communication and may be associated with nursing care quality. PMID:24496114

The effect of jitter on the performance of space coherent optical communication system with Costas loop

NASA Astrophysics Data System (ADS)

Li, Xin; Hong, Yifeng; Wang, Jinfang; Liu, Yang; Sun, Xun; Li, Mi

2018-01-01

Numerous communication techniques and optical devices successfully applied in space optical communication system indicates a good portability of it. With this good portability, typical coherent demodulation technique of Costas loop can be easily adopted in space optical communication system. As one of the components of pointing error, the effect of jitter plays an important role in the communication quality of such system. Here, we obtain the probability density functions (PDF) of different jitter degrees and explain their essential effect on the bit error rate (BER) space optical communication system. Also, under the effect of jitter, we research the bit error rate of space coherent optical communication system using Costas loop with different system parameters of transmission power, divergence angle, receiving diameter, avalanche photodiode (APD) gain, and phase deviation caused by Costas loop. Through a numerical simulation of this kind of communication system, we demonstrate the relationship between the BER and these system parameters, and some corresponding methods of system optimization are presented to enhance the communication quality.

The "TRAUMA LIFE" initiative: The impact of a multidisciplinary checklist process on outcomes and communication in a Trauma Intensive Care Unit.

PubMed

Joseph, Kimberly; Gupta, Sameer; Yon, James; Partida, Renee; Cartagena, Lee; Kubasiak, John; Buie, Vanessa; Miller, Jared; Wiley, Dorion; Nagy, Kimberly; Starr, Frederic; Dennis, Andrew; Kaminsky, Matthew; Bokhari, Faran

2018-03-09

Checklists have been advocated to improve quality outcomes/communication in the critical care setting, but results have been mixed. A new checklist process, "TRAUMA LIFE", was implemented in our Trauma Intensive Care Unit (TICU) to replace prior checklists. The purpose of this study was to evaluate the impact of the "TRAUMA LIFE" process implementation on quality metrics and on patient/family communication in the TICU. "TRAUMA LIFE" was considered maturely implemented by 2016. Multiple quality metrics, including restraint order compliance, were compared between 2013 and 2016 (pre- and post-implementation). Compliance with the "Family Message" (FM), a part of the "TRAUMA LIFE" communication process, was analyzed in 2016. Improvement was seen in CAUTI, VAE, and IUCU; CLABSI rates increased. Restraint order compliance increased significantly. FM delivery compliance was inconsistent; improvement was noted in concordance between update content and FM documented in Electronic Medical Record. Implementation of "TRAUMA LIFE" was well integrated into the rounding process and was associated with some improvement in quality metrics and communication. Additional evaluation is required to assess sustainability. Copyright © 2018 Elsevier Inc. All rights reserved.

Effect of communication style and physician-family relationships on satisfaction with pediatric chronic disease care.

PubMed

Swedlund, Matthew P; Schumacher, Jayna B; Young, Henry N; Cox, Elizabeth D

2012-01-01

Over 8% of children have a chronic disease and many are unable to adhere to treatment. Satisfaction with chronic disease care can impact adherence. We examine how visit satisfaction is associated with physician communication style and ongoing physician-family relationships. We collected surveys and visit videos for 75 children ages 9-16 years visiting for asthma, diabetes, or sickle cell disease management. Raters assessed physician communication style (friendliness, interest, responsiveness, and dominance) from visit videos. Quality of the ongoing relationship was measured with four survey items (parent-physician relationship, child-physician relationship, comfort asking questions, and trust in the physician), while a single item assessed satisfaction. Correlations and chi square were used to assess association of satisfaction with communication style or quality of the ongoing relationship. Satisfaction was positively associated with physician to parent (p < 0.05) friendliness. Satisfaction was also associated with the quality of the ongoing parent-physician (p < 0.001) and child-physician relationships (p < 0.05), comfort asking questions (p < 0.001), and trust (p < 0.01). This shows that both the communication style and the quality of the ongoing relationship contribute to pediatric chronic disease visit satisfaction.

Iranian Nursing Student-patient Health Communication in Medical Surgical Wards.

PubMed

Abdolrahimi, Mahbobeh; Ghiyasvandian, Shahrzad; Zakerimoghadam, Masoumeh; Ebadi, Abbas

2018-01-01

Health communication (HC) is considered an important task of nurses to provide high quality and holistic care as well as to improve patient health. The nursing student-patient HC is an abstract concept and needs to be clarified. Therefore, this study was conducted to increase the knowledge about nursing students' HC with patients by considering various participants' viewpoints. In this conventional qualitative content analysis, 18 semi-structured interviews were conducted with six nursing students, six nursing instructors, and six patients in educational hospitals affiliated to the University of Medical Sciences. Credibility, confirmability, dependability, and transferability were established to validate the trustworthiness of the data. The process of data collection and analysis lasted 9 months. After data analysis, two categories were generated: (A) "junior nursing student-patient communication," with two subcategories of "performing social communication with patients" and "failure to build therapeutic relationships with patients," and (B) "senior nursing student-patient communication" with two subcategories of "establishing effective communication with patients" and "performing one-way communication with patients." More attention should be paid to improve HC through shifting towards student-centered approaches in nursing curriculum. Further, role model nurses and clinical educators should guide nursing students for institutionalizing HC in future nurses.

Change-related expectations and commitment to change of nurses: the role of leadership and communication.

PubMed

Portoghese, Igor; Galletta, Maura; Battistelli, Adalgisa; Saiani, Luisa; Penna, Maria Pietronilla; Allegrini, Elisabetta

2012-07-01

The purpose of this study was to test a theoretical model linking the impact of expectations on commitment to change and to explore whether change-related communication is a mediating variable between leader-member exchange and expectations. Expectations for change outcomes are an important condition to increase nurses' commitment to change. To understand the role of leadership and communication in expectations development is crucial to promote commitment to change. A predictive, non-experimental design was used in a random sample of 395 nurses. Structural equation modelling was used to analyse the hypothesized model. Positive expectations had a direct effect on affective commitment to change, whereas negative expectation had a direct effect on continuance commitment to change. Leader-member exchange and communication influenced nurse's expectations about change. Communication partially mediated the relationship between Leader-member exchange and expectations. These findings suggested that nurses' expectation about change were strongly linked to commitment to change. Furthermore, the enhancement of communication and relationship with leader contributed to the development of positive and negative expectations. Strategies to promote commitment to change include developing positive expectations about change outcomes and building high-quality leadership style oriented to the communication. © 2011 Blackwell Publishing Ltd.

Association Between Dentist-Dental Hygienist Communication and Dental Treatment Outcomes.

PubMed

Hamasaki, Tomoko; Kato, Hiroaki; Kumagai, Takashi; Hagihara, Akihito

2017-03-01

Communication between physician and patient is critical in all fields of medicine, and various types of communication exist in healthcare settings. Cooperation among healthcare professionals is thought to be essential in providing high-quality services. Dental hygienists are key team members in the provision of dental care, and are known to play an important role in the health of their patients. This study aimed to determine the effect of communication between dentists and hygienists on patient satisfaction. Study subjects were dentists, patients, and dental hygienists, and we examined how dentist-dental hygienist communication affected patient outcome indices. A significant difference was observed only for satisfaction in terms of meeting expectations (p = 0.035). Results for patient satisfaction indicated significant differences in explanatory behavior in dentist-dental hygienist evaluations (p = 0.001). The results showed improved health and reduced fear, indicating significant differences for the dentist-dental hygienist evaluations in explanation behavior (p = 0.016). Our evaluation of the effects of dentist-dental hygienist communication on patient outcomes indicated a significant correlation, suggesting that inter-professional communication in the field of dentistry affects patient satisfaction.

The End-of-Life Phase of High-Grade Glioma Patients: Dying With Dignity?

PubMed Central

Taphoorn, Martin J.B.; Uitdehaag, Bernard; Heimans, Jan J.; Deliens, Luc; Reijneveld, Jaap C.; Pasman, H. Roeline W.

2013-01-01

Background. In the end-of-life (EOL) phase, high-grade glioma (HGG) patients have a high symptom burden and often lose independence because of physical and cognitive dysfunction. This might affect the patient's personal dignity. We aimed to (a) assess the proportion of HGG patients dying with dignity as perceived by their relatives and (b) identify disease and care factors correlated with dying with dignity in HGG patients. Methods. We approached relatives of a cohort of 155 deceased HGG patients for the study. Participants completed a questionnaire concerning the EOL phase of the patient, covering several subthemes: (a) symptoms and signs, (b) health-related quality of life, (c) decision making, (d) place and quality of EOL care, and (e) dying with dignity. Results. Relatives of 81 patients participated and 75% indicated that the patient died with dignity. These patients had fewer communication deficits, experienced fewer transitions between health care settings in the EOL phase, and more frequently died at their preferred place of death. Relatives were more satisfied with the physician providing EOL care and reported that the physician adequately explained treatment options. Multivariate analysis identified satisfaction with the physician, the ability to communicate, and the absence of transitions between settings as most predictive of a dignified death. Conclusions. Physicians caring for HGG patients in the EOL phase should timely focus on explaining possible treatment options, because patients experience communication deficits toward death. Physicians should strive to allow patients to die at their preferred place and avoid transitions during the last month of life. PMID:23335620

Uncertainty and Motivation to Seek Information from Pharmacy Automated Communications.

PubMed

Bones, Michelle; Nunlee, Martin

2018-05-28

Pharmacy personnel often answer telephones to respond to pharmacy customers (subjects) who received messages from automated systems. This research examines the communication process in terms of how users interact and engage with pharmacies after receiving automated messages. No study has directly addressed automated telephone calls and subjects' interactions. The purpose of this study is to test the interpersonal communication (IC) process of uncertainty in subjects in receipt of automated telephone calls ATCs from pharmacies. Subjects completed a survey of validated scales for Satisfaction (S); Relevance (R); Quality (Q); Need for Cognitive Closure (NFC). Relationships between S, R, Q, NFC, and subject preference to ATCs were analyzed to determine whether subjects contacting pharmacies display information seeking behavior. Results demonstrated that seeking information occurs if subjects: are dissatisfied with the content of the ATC; perceive that the Q of ATC is high and like receiving the ATC, or have a high NFC and do not like receiving ATCs. Other interactions presented complexities amongst uncertainty and tolerance of NFC within the IC process.

Radiation Hardened, Modulator ASIC for High Data Rate Communications

NASA Technical Reports Server (NTRS)

McCallister, Ron; Putnam, Robert; Andro, Monty; Fujikawa, Gene

2000-01-01

Satellite-based telecommunication services are challenged by the need to generate down-link power levels adequate to support high quality (BER approx. equals 10(exp 12)) links required for modem broadband data services. Bandwidth-efficient Nyquist signaling, using low values of excess bandwidth (alpha), can exhibit large peak-to-average-power ratio (PAPR) values. High PAPR values necessitate high-power amplifier (HPA) backoff greater than the PAPR, resulting in unacceptably low HPA efficiency. Given the high cost of on-board prime power, this inefficiency represents both an economical burden, and a constraint on the rates and quality of data services supportable from satellite platforms. Constant-envelope signals offer improved power-efficiency, but only by imposing a severe bandwidth-efficiency penalty. This paper describes a radiation- hardened modulator which can improve satellite-based broadband data services by combining the bandwidth-efficiency of low-alpha Nyquist signals with high power-efficiency (negligible HPA backoff).

Integrated Communications at America's Leading Total Quality Management Corporations.

ERIC Educational Resources Information Center

Gronstedt, Anders

1996-01-01

Examines how to create organizational processes that allow communication professionals with a variety of expertise to support each other through coordination and integration. Studies eight of America's leading total quality management corporations, including AT&T, Federal Express, Saturn, and Xerox. Explores how various total quality…

OPALS: Mission System Operations Architecture for an Optical Communications Demonstration on the ISS

NASA Technical Reports Server (NTRS)

Abrahamson, Matthew J.; Sindiy, Oleg V.; Oaida, Bogdan V.; Fregoso, Santos; Bowles-Martinez, Jessica N.; Kokorowski, Michael; Wilkerson, Marcus W.; Konyha, Alexander L.

2014-01-01

In spring 2014, the Optical PAyload for Lasercomm Science (OPALS) will launch to the International Space Station (ISS) to demonstrate space-to-ground optical communications. During a 90-day baseline mission, OPALS will downlink high quality, short duration videos to the Optical Communications Telescope Laboratory (OCTL) in Wrightwood, California. To achieve mission success, interfaces to the ISS payload operations infrastructure are established. For OPALS, the interfaces facilitate activity planning, hazardous laser operations, commanding, and telemetry transmission. In addition, internal processes such as pointing prediction and data processing satisfy the technical requirements of the mission. The OPALS operations team participates in Operational Readiness Tests (ORTs) with external partners to exercise coordination processes and train for the overall mission. The tests have provided valuable insight into operational considerations on the ISS.

Transparent graphene microstrip filters for wireless communications

NASA Astrophysics Data System (ADS)

Wang, Jinchen; Guan, Yifei; Yu, Hua; Li, Na; Wang, Shuopei; Shen, Cheng; Dai, Zhijiang; Gan, Decheng; Yang, Rong; He, Songbai; Zhang, Guangyu

2017-08-01

A microstrip is an indispensable component for wireless communication circuits. With the development of 5G technology, optically transparent microstrip filters urgently need to be developed. In this work, we have theoretically and experimentally demonstrated the immense potential of graphene microstrips for transparent wireless communication circuits in the 5G era. Both wideband and dual-band transparent graphene microstrip filters have shown more than 80% optical transmissivity in the region from 250 nm to 2000 nm with good frequency responses. S and C band microwave signals can transmit along the graphene microstrip lines effectively while coupling excitations produce relatively large insertion losses. Our results show that transparent microstrips designed with high-quality graphene will largely scale down the size of the wireless devices and thus play an irreplaceable role in the 5G era.

The Expression of Emotion Through Nonverbal Behavior in Medical Visits

PubMed Central

Roter, Debra L; Frankel, Richard M; Hall, Judith A; Sluyter, David

2006-01-01

Relationship-centered care reflects both knowing and feeling: the knowledge that physician and patient bring from their respective domains of expertise, and the physician's and patient's experience, expression, and perception of emotions during the medical encounter. These processes are conveyed and reciprocated in the care process through verbal and nonverbal communication. We suggest that the emotional context of care is especially related to nonverbal communication and that emotion-related communication skills, including sending and receiving nonverbal messages and emotional self-awareness, are critical elements of high-quality care. Although nonverbal behavior has received far less study than other care processes, the current review argues that it holds significance for the therapeutic relationship and influences important outcomes including satisfaction, adherence, and clinical outcomes of care. PMID:16405706

Machine-Learning Based Channel Quality and Stability Estimation for Stream-Based Multichannel Wireless Sensor Networks.

PubMed

Rehan, Waqas; Fischer, Stefan; Rehan, Maaz

2016-09-12

Wireless sensor networks (WSNs) have become more and more diversified and are today able to also support high data rate applications, such as multimedia. In this case, per-packet channel handshaking/switching may result in inducing additional overheads, such as energy consumption, delays and, therefore, data loss. One of the solutions is to perform stream-based channel allocation where channel handshaking is performed once before transmitting the whole data stream. Deciding stream-based channel allocation is more critical in case of multichannel WSNs where channels of different quality/stability are available and the wish for high performance requires sensor nodes to switch to the best among the available channels. In this work, we will focus on devising mechanisms that perform channel quality/stability estimation in order to improve the accommodation of stream-based communication in multichannel wireless sensor networks. For performing channel quality assessment, we have formulated a composite metric, which we call channel rank measurement (CRM), that can demarcate channels into good, intermediate and bad quality on the basis of the standard deviation of the received signal strength indicator (RSSI) and the average of the link quality indicator (LQI) of the received packets. CRM is then used to generate a data set for training a supervised machine learning-based algorithm (which we call Normal Equation based Channel quality prediction (NEC) algorithm) in such a way that it may perform instantaneous channel rank estimation of any channel. Subsequently, two robust extensions of the NEC algorithm are proposed (which we call Normal Equation based Weighted Moving Average Channel quality prediction (NEWMAC) algorithm and Normal Equation based Aggregate Maturity Criteria with Beta Tracking based Channel weight prediction (NEAMCBTC) algorithm), that can perform channel quality estimation on the basis of both current and past values of channel rank estimation. In the end, simulations are made using MATLAB, and the results show that the Extended version of NEAMCBTC algorithm (Ext-NEAMCBTC) outperforms the compared techniques in terms of channel quality and stability assessment. It also minimizes channel switching overheads (in terms of switching delays and energy consumption) for accommodating stream-based communication in multichannel WSNs.

Machine-Learning Based Channel Quality and Stability Estimation for Stream-Based Multichannel Wireless Sensor Networks

PubMed Central

Rehan, Waqas; Fischer, Stefan; Rehan, Maaz

2016-01-01

Wireless sensor networks (WSNs) have become more and more diversified and are today able to also support high data rate applications, such as multimedia. In this case, per-packet channel handshaking/switching may result in inducing additional overheads, such as energy consumption, delays and, therefore, data loss. One of the solutions is to perform stream-based channel allocation where channel handshaking is performed once before transmitting the whole data stream. Deciding stream-based channel allocation is more critical in case of multichannel WSNs where channels of different quality/stability are available and the wish for high performance requires sensor nodes to switch to the best among the available channels. In this work, we will focus on devising mechanisms that perform channel quality/stability estimation in order to improve the accommodation of stream-based communication in multichannel wireless sensor networks. For performing channel quality assessment, we have formulated a composite metric, which we call channel rank measurement (CRM), that can demarcate channels into good, intermediate and bad quality on the basis of the standard deviation of the received signal strength indicator (RSSI) and the average of the link quality indicator (LQI) of the received packets. CRM is then used to generate a data set for training a supervised machine learning-based algorithm (which we call Normal Equation based Channel quality prediction (NEC) algorithm) in such a way that it may perform instantaneous channel rank estimation of any channel. Subsequently, two robust extensions of the NEC algorithm are proposed (which we call Normal Equation based Weighted Moving Average Channel quality prediction (NEWMAC) algorithm and Normal Equation based Aggregate Maturity Criteria with Beta Tracking based Channel weight prediction (NEAMCBTC) algorithm), that can perform channel quality estimation on the basis of both current and past values of channel rank estimation. In the end, simulations are made using MATLAB, and the results show that the Extended version of NEAMCBTC algorithm (Ext-NEAMCBTC) outperforms the compared techniques in terms of channel quality and stability assessment. It also minimizes channel switching overheads (in terms of switching delays and energy consumption) for accommodating stream-based communication in multichannel WSNs. PMID:27626429

The Operational Use of an Automated High Frequency Radio System Incorporating Automatic Link Establishment and Single-Tone Serial Modem Technology for U.S. Navy Ship-Shore Communications

DTIC Science & Technology

1993-10-01

between the link chronologically in the following sections. quality analysis ( LQA ) score measured by ALE and single- tone serial modem performance. A...receiving ends in turn and (propagation permitting), pass traffic and terminate the are used to calculate a combined link quality analysis ( LQA ...score. The LQA score is displayed to the operator NCCOSC RDTE DIV installation team accomplished the as a number on an arbitrary scale of 0 to 120, with a

[The impact of ethical and moral competence in decision making on rationalism and rationing nursing interventions].

PubMed

Schwerdt, R

2005-08-01

The intraprofessional discourse about economical aspects in nursing from an ethical point of view has not taken place yet. To cope with the increasing restriction of resources, some preconditions have to be met: It is necessary to communicate issues in rationalizing and rationing in nursing openly. Person-oriented criteria in the nursing process indicate a high level of competence and user-oriented quality in nursing care. But nursing professionals do not decide in favor or against resources to perform this task on a high or poor quality level. Democratic decision-making on providing nursing services depends on a continuous societal discourse about allocation criteria.

Otitis Media, the Quality of Child Care, and the Social/Communicative Behavior of Toddlers: A Replication and Extension

ERIC Educational Resources Information Center

Vernon-Feagans, Lynne; Manlove, Elizabeth E.

2005-01-01

The purpose of this study was to examine the effects of otitis media (OM) and the quality of child care on the social and communicative behaviors of toddlers, using a cumulative risk framework that included moderation. The study followed 72 children who began child care in infancy. Both process and structural aspects of the quality of 11 child…

Coaching to improve the quality of communication during briefings and debriefings.

PubMed

Kleiner, Catherine; Link, Terri; Maynard, M Travis; Halverson Carpenter, Katherine

2014-10-01

Communication breakdowns have been identified as a root cause of many medical errors. Sentinel events occurring in surgery comprise a significant number of these events. Despite the addition of briefings and debriefings in the OR and the introduction of crew resource management principles, communication problems continue to occur in the surgical setting. The purpose of this research was to evaluate coaching as an intervention to improve the quality of OR briefings and debriefings. A retired orthopedic surgeon conducted coaching that included all members of the perioperative team. The quality of both briefings and debriefings significantly improved after the coaching intervention. Analysis of the results of this study suggests that coaching should be considered as an intervention to improve communication during surgical procedures, especially during briefings and debriefings. Copyright © 2014 AORN, Inc. Published by Elsevier Inc. All rights reserved.

The Quality of Written Feedback by Attendings of Internal Medicine Residents.

PubMed

Jackson, Jeffrey L; Kay, Cynthia; Jackson, Wilkins C; Frank, Michael

2015-07-01

Attending evaluations are commonly used to evaluate residents. Evaluate the quality of written feedback of internal medicine residents. Retrospective. Internal medicine residents and faculty at the Medical College of Wisconsin from 2004 to 2012. From monthly evaluations of residents by attendings, a randomly selected sample of 500 written comments by attendings were qualitatively coded and rated as high-, moderate-, or low-quality feedback by two independent coders with good inter-rater reliability (kappa: 0.94). Small group exercises with residents and attendings also coded the utterances as high, moderate, or low quality and developed criteria for this categorization. In-service examination scores were correlated with written feedback. There were 228 internal medicine residents who had 6,603 evaluations by 334 attendings. Among 500 randomly selected written comments, there were 2,056 unique utterances: 29% were coded as nonspecific statements, 20% were comments about resident personality, 16% about patient care, 14% interpersonal communication, 7% medical knowledge, 6% professionalism, and 4% each on practice-based learning and systems-based practice. Based on criteria developed by group exercises, the majority of written comments were rated as moderate quality (65%); 22% were rated as high quality and 13% as low quality. Attendings who provided high-quality feedback rated residents significantly lower in all six of the Accreditation Council for Graduate Medical Education (ACGME) competencies (p <0.0005 for all), and had a greater range of scores. Negative comments on medical knowledge were associated with lower in-service examination scores. Most attending written evaluation was of moderate or low quality. Attendings who provided high-quality feedback appeared to be more discriminating, providing significantly lower ratings of residents in all six ACGME core competencies, and across a greater range. Attendings' negative written comments on medical knowledge correlated with lower in-service training scores.

Couples Communication Skills and Anxiety of Pregnancy: A Narrative Review.

PubMed

Malary, Mina; Shahhosseini, Zohreh; Pourasghar, Mehdi; Hamzehgardeshi, Zeinab

2015-08-01

physical problems during pregnancy including Anxiety disorders form a large share of health problems. On the other hand, healthy relationship and communication skills are vital to raise a family. For couples who enjoy communication skills, parenthood will be the best and most pleasant experiences in their lives. High levels of positive communication will lead to couples and their children's mental health and couples' good relationship can have a protective effect against stressors including anxiety of pregnancy. The current study reviewed the studies on the relationship between communication skills and the anxiety of pregnancy. The current study is a review where the researcher browsed the available databases like Google Scholar, Pubmed, Magiran, SID, and Science Direct and using key words of Communication skills, marital satisfaction, and the anxiety of pregnancy, & the researcher has searched the articles of 2000-2014 & read 150 abstracts & 93 full papers and ultimately, chose 50 to write this study. By reviewing the findings literature in three general categories as Communication Skills as the Significant Component to Get Marital Satisfaction, Improving Marital Satisfaction as Pregnancy Anxiety Reducing Factor, and Communication Skills Quality as Component Influencing Pregnancy Anxiety. Having communication skills will lead to promotion of marital satisfaction and increased mental health in life. It is, therefore, recommended that communication skills be trained in routine programs for pre-marriage counseling, pre-pregnancy cares and pregnancy so that the mental health of community can be improved.

The management service company's expectation of the customer.

PubMed

Kuykendall, R D

1992-02-01

The one constant factor in health care today is change. Choose your management support company carefully, expect high quality results, and communicate both positive and negative feedback immediately. This formula will give you excellent results as well as a long-term productive partnership in which cost, risk, and the end objectives can be balanced for maximum benefit.

ATEE Interactive Co-ordination and Educational Monitoring of Socrates Comenius Action 3 Projects.

ERIC Educational Resources Information Center

Libotton, Arno; Van Braak, Johan; Garofalo, Mara

2002-01-01

Asserts that although the Comenius Action 3 courses were well-accepted and high quality, there is a need for a structure for easily monitoring and evaluating these projects. This article presents a pilot project designed with this purpose, which may be useful in implementing a system of coordination and communication among the different projects…

Using Relationships as a Tool: Early Childhood Educators' Perspectives of the Child-Caregiver Relationship in a Childcare Setting

ERIC Educational Resources Information Center

Brebner, Chris; Hammond, Lauren; Schaumloffel, Nicole; Lind, Christopher

2015-01-01

Children's early years are critical for development and many children access out-of-home care during this time. Services offering high-quality childcare afford an opportunity to impact positively on children's development, including acquisition of communication skills. A strong, responsive relationship between child and carer is important in…

Beyond Legal: Crafting High-Quality IEPs for Children With Complex Communication Needs

ERIC Educational Resources Information Center

Rowland, Charity Mary; Quinn, Emily Dayle; Steiner, Sandra A. M.

2015-01-01

The Individualized Education Program (IEP) is a legal document developed for each student with a disability. The IEP outlines the student's learning needs and associated educational goals, as well as the program placement and services required to support the attainment of these goals in the least restrictive environment. Most IEPs include all…

Integrating ICT into Teaching-Learning Practices: Promise, Challenges and Future Directions of Higher Educational Institutes

ERIC Educational Resources Information Center

Alemu, Birhanu Moges

2015-01-01

Education is a very socially oriented activity and quality education has traditionally been associated with strong teachers having high degrees of personal contact with students and technologies. Information and Communication Technologies (ICTs) have become commonplace entities in all aspects of life. The use of ICT has fundamentally changed the…

Antenna Technologies for Future NASA Exploration Missions

NASA Technical Reports Server (NTRS)

Miranda, Felix A.

2006-01-01

NASA s plans for the manned exploration of the moon and Mars will rely heavily on the development of a reliable communications infrastructure on the surface and back to Earth. Future missions will thus focus not only on gathering scientific data, but also on the formation of the communications network. In either case, unique requirements become imposed on the antenna technologies necessary to accomplish these tasks. For example, surface activity applications such as robotic rovers, human extravehicular activities (EVA), and probes will require small size, lightweight, low power, multi-functionality, and robustness for the antenna elements being considered. Trunk-line communications to a centralized habitat on the surface and back to Earth (e.g., surface relays, satellites, landers) will necessitate wide-area coverage, high gain, low mass, deployable antennas. Likewise, the plethora of low to high data rate services desired to guarantee the safety and quality of mission data for robotic and human exploration will place additional demands on the technology. Over the past year, NASA Glenn Research Center has been heavily involved in the development of candidate antenna technologies with the potential for meeting these strict requirements. This technology ranges from electrically small antennas to phased array and large inflatable structures. A summary of this overall effort is provided, with particular attention being paid to small antenna designs and applications. A discussion of the Agency-wide activities of the Exploration Systems Mission Directorate (ESMD) in forthcoming NASA missions, as they pertain to the communications architecture for the lunar and Martian networks is performed, with an emphasis on the desirable qualities of potential antenna element designs for envisioned communications assets. Identified frequency allocations for the lunar and Martian surfaces, as well as asset-specific data services will be described to develop a foundation for viable antenna technologies which might address these requirements and help guide future technology development decisions.

A Review of Antenna Technologies for Future NASA Exploration Missions

NASA Technical Reports Server (NTRS)

Miranda, Felix A.; Nessel, James A.; Romanofsky, Robert R.; Acostia, Roberto J.

2006-01-01

NASA s plans for the manned exploration of the Moon and Mars will rely heavily on the development of a reliable communications infrastructure from planetary surface-to-surface, surface-to-orbit and back to Earth. Future missions will thus focus not only on gathering scientific data, but also on the formation of the communications network. In either case, unique requirements become imposed on the antenna technologies necessary to accomplish these tasks. For example, proximity (i.e., short distance) surface activity applications such as robotic rovers, human extravehicular activities (EVA), and probes will require small size, lightweight, low power, multi-functionality, and robustness for the antenna elements being considered. In contrast, trunk-line communications to a centralized habitat on the surface and back to Earth (e.g., relays, satellites, and landers) will necessitate high gain, low mass antennas such as novel inflatable/deployable antennas. Likewise, the plethora of low to high data rate services desired to guarantee the safety and quality of mission data for robotic and human exploration will place additional demands on the technology. Over the last few years, NASA Glenn Research Center has been heavily involved in the development and evaluation of candidate antenna technologies with the potential for meeting the aforementioned requirements. These technologies range from electrically small antennas to phased arrays and large inflatable antenna structures. A summary of these efforts will be discussed in this paper. NASA planned activities under the Exploration Vision as they pertain to the communications architecture for the Lunar and Martian scenarios will be discussed, with emphasis on the desirable qualities of potential antenna element designs for envisioned communications assets. Identified frequency allocations for the Lunar and Martian surfaces, as well as asset-specific data services will be described to develop a foundation for viable antenna technologies which might address these requirements and help guide future technology development decisions

A Review of Antenna Technologies for Future NASA Exploration Missions

NASA Technical Reports Server (NTRS)

Miranda, Felix A.; Nessel, James A.; Romanofsky, Robert R.; Acosta, J.

2007-01-01

NASA's plans for the manned exploration of the Moon and Mars will rely heavily on the development of a reliable communications infrastructure from planetary surface-to-surface, surface-to-orbit and back to Earth. Future missions will thus focus not only on gathering scientific data, but also on the formation of the communications network. In either case, unique requirements become imposed on the antenna technologies necessary to accomplish these tasks. For example, proximity (i.e., short distance) surface activity applications such as robotic rovers, human extravehicular activities (EVA), and probes will require small size, lightweight, low power, multi-functionality, and robustness for the antenna elements being considered. In contrast, trunk-line communications to a centralized habitat on the surface and back to Earth (e.g., relays, satellites, and landers) will necessitate high gain, low mass antennas such as novel inflatable/deployable antennas. Likewise, the plethora of low to high data rate services desired to guarantee the safety and quality of mission data for robotic and human exploration will place additional demands on the technology. Over the last few years, NASA Glenn Research Center has been heavily involved in the development and evaluation of candidate antenna technologies with the potential for meeting the aforementioned requirements. These technologies range from electrically small antennas to phased arrays and large inflatable antenna structures. A summary of these efforts will be discussed in this paper. NASA planned activities under the Exploration Vision as they pertain to the communications architecture for the Lunar and Martian scenarios will be discussed, with emphasis on the desirable qualities of potential antenna element designs for envisioned communications assets. Identified frequency allocations for the Lunar and Martian surfaces, as well as asset-specific data services will be described to develop a foundation for viable antenna technologies which might address these requirements and help guide future technology development decisions.

Communicative Access Measures for Stroke: Development and Evaluation of a Quality Improvement Tool.

PubMed

Kagan, Aura; Simmons-Mackie, Nina; Victor, J Charles; Chan, Melodie T

2017-11-01

To (1) develop a systems-level quality improvement tool targeting communicative access to information and decision-making for stroke patients with language disorders; and (2) evaluate the resulting tool-the Communicative Access Measures for Stroke (CAMS). Survey development and evaluation was in line with accepted guidelines and included item generation and reduction, survey formatting and composition, pretesting, pilot testing, and reliability assessment. Development and evaluation were carried out in hospital and community agency settings. The project used a convenience sample of 31 participants for the survey development, and 63 participants for the CAMS reliability study (broken down into 6 administrators/managers, 32 frontline staff, 25 participants with aphasia). Eligible participants invited to the reliability study included individuals from 45 community-based organizations in Ontario as well as 4400 individuals from communities of practice. Not applicable. Data were analyzed using kappa statistics and intraclass correlations for each item score on all surveys. A tool, the CAMS, comprising 3 surveys, was developed for health facilities from the perspectives of (1) administrators/policymakers, (2) staff/frontline health care providers, and (3) patients with aphasia (using a communicatively accessible version). Reliability for items on the CAMS-Administrator and CAMS-Staff surveys was moderate to high (kappa/intraclass correlation coefficients [ICCs], .54-1.00). As expected, reliability was lower for the CAMS-Patient survey, with most items having ICCs between 0.4 and 0.6. These findings suggest that CAMS may provide useful quality improvement information for health care facilities with an interest in improving care for patients with stroke and aphasia. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Use of Failure Mode and Effects Analysis to Improve Emergency Department Handoff Processes.

PubMed

Sorrentino, Patricia

2016-01-01

The purpose of this article is to describe a quality improvement process using failure mode and effects analysis (FMEA) to evaluate systems handoff communication processes, improve emergency department (ED) throughput and reduce crowding through development of a standardized handoff, and, ultimately, improve patient safety. Risk of patient harm through ineffective communication during handoff transitions is a major reason for breakdown of systems. Complexities of ED processes put patient safety at risk. An increased incidence of submitted patient safety event reports for handoff communication failures between the ED and inpatient units solidified a decision to implement the use of FMEA to identify handoff failures to mitigate patient harm through redesign. The clinical nurse specialist implemented an FMEA. Handoff failure themes were created from deidentified retrospective reviews. Weekly meetings were held over a 3-month period to identify failure modes and determine cause and effect on the process. A functional block diagram process map tool was used to illustrate handoff processes. An FMEA grid was used to list failure modes and assign a risk priority number to quantify results. Multiple areas with actionable failures were identified. A majority of causes for high-priority failure modes were specific to communications. Findings demonstrate the complexity of transition and handoff processes. The FMEA served to identify and evaluate risk of handoff failures and provide a framework for process improvement. A focus on mentoring nurses to quality handoff processes so that it becomes habitual practice is crucial to safe patient transitions. Standardizing content and hardwiring within the system are best practice. The clinical nurse specialist is prepared to provide strong leadership to drive and implement system-wide quality projects.

Surgeon-Therapist Communication: Do All Members See Eye-to-Eye?

PubMed

Longstaffe, Robert; Slade Shantz, Jesse; Leiter, Jeff; Peeler, Jason

2015-11-01

Poor interprofessional collaboration has been shown to negatively affect patient care within many fields of medicine. Growing evidence is suggesting that improved interprofessional collaboration can positively affect patient care. Postoperative rehabilitation of many orthopedic conditions necessitates the combined efforts of surgeons, and therapists. There is a paucity of literature examining collaboration among orthopedic surgeons and therapists regarding postoperative rehabilitation. The following study examines the perceived quality of communications between orthopedic surgeons and therapists employing an online survey. We hypothesized that collaborative practice patterns result in improved perceptions of communication. Ethics board approval was obtained. Subjects consisted of orthopedic surgeons, licensed physiotherapists and certified athletic therapists. The online survey was distributed through the Canadian Orthopaedic Association (COA), the Canadian Physiotherapy Association (CPA) and the Canadian Athletic Therapists Association (CATA). Data analysis was performed using Stata/IC 12.1 (Stata Corp, College Station, TX, USA). Descriptive statistics were calculated to determine the median responses and ranges. Median responses were compared using the Kruskal-Wallis one-way analysis of variance. Qualitative analysis regarding text responses was performed by three reviewers. Responses were received from all specialties (COA 164, CPA 524, CATA 163). There were significant differences in the perceived quality of communication by quantitative and qualitative analysis (p < 0.001). Analysis of communication within practice patterns of stand-alone versus collaborative revealed improved perception of communication quality with increased contact. 65.6% of responders that practiced as stand-alone had a negative view of interprofessional communication. 48.4% of responders in a collaborative practice had a positive view of interprofessional communication. Analysis of the preferred form of communication found that orthopedic surgeons felt the most useful referral information was a pre-printed consult sheet (odds ratio [OR] = 1.56, p < 0.001), whereas therapists were more likely to rank consult notes (OR = 1.27, p < 0.042) and operative reports (OR = 1.20, p < 0.092) as a more useful form of communication. Collaborative practice shows improved perceptions of communication between specialties. Orthopedic surgeons perceive a higher quality of communication than therapists. Therapists and orthopedic surgeons also do not agree on the information that should be relayed between the specialties regarding postoperative rehabilitation.

Trends in internet search activity, media coverage, and patient-centered health information after the FDA safety communications on surgical mesh for pelvic organ prolapse.

PubMed

Stone, Benjamin V; Forde, James C; Levit, Valerie B; Lee, Richard K; Te, Alexis E; Chughtai, Bilal

2016-11-01

In July 2011, the US Food and Drug Administration (FDA) issued a safety communication regarding serious complications associated with surgical mesh for pelvic organ prolapse, prompting increased media and public attention. This study sought to analyze internet search activity and news article volume after this FDA warning and to evaluate the quality of websites providing patient-centered information. Google Trends™ was utilized to evaluate search engine trends for the term "pelvic organ prolapse" and associated terms between 1 January 2004 and 31 December 2014. Google News™ was utilized to quantify the number of news articles annually under the term "pelvic organ prolapse." The search results for the term "pelvic organ prolapse" were assessed for quality using the Health On the Net Foundation (HON) certification. There was a significant increase in search activity from 37.42 in 2010 to 57.75 in 2011, at the time of the FDA communication (p = 0.021). No other annual interval had a statistically significant increase in search activity. The single highest monthly search activity, given the value of 100, was August 2011, immediately following the July 2011 notification, with the next highest value being 98 in July 2011. Linear regression analysis of news articles per year since the FDA communication revealed r 2  = 0.88, with a coefficient of 186. Quality assessment demonstrated that 42 % of websites were HON-certified, with .gov sites providing the highest quality information. Although the 2011 FDA safety communication on surgical mesh was associated with increased public and media attention, the quality of relevant health information on the internet remains of poor quality. Future quality assurance measures may be critical in enabling patients to play active roles in their own healthcare.

Hablamos juntos (together we speak): a brief patient-reported measure of the quality of interpretation.

PubMed

Talamantes, Efrain; Moreno, Gerardo; Guerrero, Lourdes R; Mangione, Carol M; Morales, Leo S

2014-01-01

This study evaluates the psychometric properties of three newly developed items assessing the quality of interpretation from the patient's perspective among Spanish-speaking limited English proficient Latino patients. The authors examined the psychometric properties of a patient-reported measure of quality of interpretation using a cross-sectional survey study of 1,590 adult Spanish-speaking limited English proficient Latinos in the United States. Quality of interpretation, doctor communication, and satisfaction with care were assessed using a three survey-item, an independent multiple-item measure, and a single-item measure, respectively. Sixty-nine percent (1,104) of patients surveyed used interpreters. Cronbach's alpha for the three items assessing interpreter quality was 0.31, while dropping item three resulted in an alpha of 0.56. Items one and two were moderately correlated with doctor communication (r=0.39) and satisfaction with care scores (r=0.21) supporting construct validity. Two out of three survey items can be scaled to measure quality of interpretation from the patient's perspective. Quality of interpretation reported by patients is moderately associated with doctor communication and satisfaction with care.

Stress, Communication, and Marital Quality in Couples

ERIC Educational Resources Information Center

Ledermann, Thomas; Bodenmann, Guy; Rudaz, Myriam; Bradbury, Thomas N.

2010-01-01

The association between daily stress outside and inside of the relationship and marital functioning in the form of communication in conflict situations and marital quality was examined. We hypothesized that relationship stress mediates the association between external stress and marital functioning at the individual level, and that the association…

Evaluating, interpreting, and communicating performance of hydrologic/water quality models considering intended use: A review and recommendations

USDA-ARS?s Scientific Manuscript database

Previous publications have outlined recommended practices for hydrologic and water quality (H/WQ) modeling, but none have formulated comprehensive guidelines for the final stage of modeling applications, namely evaluation, interpretation, and communication of model results and the consideration of t...

Self-Evaluation Instrument: Awards Program for Indoor Air Quality Management in Schools.

ERIC Educational Resources Information Center

Maryland State Dept. of Education, Baltimore.

This self-evaluation instrument is used to nominate and evaluate schools for the Indoor Air Quality Management in Schools award. The evaluation contains three categories: Communications/Training; Design; and Operations/Maintenance. Each principle is detailed along with the required criteria used to meet that principle. Communications/Training…

Perception on Ideal Qualities of a Communication Student

ERIC Educational Resources Information Center

Pelayo, Jose Maria G., III; Mallari, Shaedy Dee C.; Manio, Joana C.; Pelayo, Jose Juancho S.

2015-01-01

This research study focused on the opinions and contemporary perceptions of Bachelor of Arts in Communication students in Systems Plus College Foundation. The researchers determined the acuity of the students perse on ideal qualities that the respondents should possess or acquire. It addressed with the opinions, insights and also thoughts about…

Re-engineering Nascom's network management architecture

NASA Technical Reports Server (NTRS)

Drake, Brian C.; Messent, David

1994-01-01

The development of Nascom systems for ground communications began in 1958 with Project Vanguard. The low-speed systems (rates less than 9.6 Kbs) were developed following existing standards; but, there were no comparable standards for high-speed systems. As a result, these systems were developed using custom protocols and custom hardware. Technology has made enormous strides since the ground support systems were implemented. Standards for computer equipment, software, and high-speed communications exist and the performance of current workstations exceeds that of the mainframes used in the development of the ground systems. Nascom is in the process of upgrading its ground support systems and providing additional services. The Message Switching System (MSS), Communications Address Processor (CAP), and Multiplexer/Demultiplexer (MDM) Automated Control System (MACS) are all examples of Nascom systems developed using standards such as, X-windows, Motif, and Simple Network Management Protocol (SNMP). Also, the Earth Observing System (EOS) Communications (Ecom) project is stressing standards as an integral part of its network. The move towards standards has produced a reduction in development, maintenance, and interoperability costs, while providing operational quality improvement. The Facility and Resource Manager (FARM) project has been established to integrate the Nascom networks and systems into a common network management architecture. The maximization of standards and implementation of computer automation in the architecture will lead to continued cost reductions and increased operational efficiency. The first step has been to derive overall Nascom requirements and identify the functionality common to all the current management systems. The identification of these common functions will enable the reuse of processes in the management architecture and promote increased use of automation throughout the Nascom network. The MSS, CAP, MACS, and Ecom projects have indicated the potential value of commercial-off-the-shelf (COTS) and standards through reduced cost and high quality. The FARM will allow the application of the lessons learned from these projects to all future Nascom systems.

A study on family communication pattern and parenting styles with quality of life in adolescent.

PubMed

Sanavi, Fariba Shahhraki; Baghbanian, Abdolvahab; Shovey, Mehdi Faraji; Ansari-Moghaddam, Alireza

2013-11-01

To investigate the relationship between parenting styles and family communication patterns with adolescent's quality of life. The cross-sectional study was carried out on 439 randomly selected adolescents in the city of Zahedan, Iran, from January to July 2011.The subjects were asked to complete the KIDSCREEN-52 health-related quality of life questionnaire, while their parents were asked to complete the Diana Brinder's Test to show their parenting styles. SPSS 15 was used to analyse data. Most parents had 'authoritative' parenting style (n = 380; 86.6%). Pluralistic (n = 170; 38.7%) and consensual (n = 152; 34.6%) patterns were the most frequent styles of communication in families. Data suggested a significant relationship between parenting style and some dimensions of quality of life, including physical well-being, psychological well-being, social support and peers, and autonomy (p < 0.05). There was also a significant relationship between family communication patterns and parent relation and home life (p < 0.001) as well as autonomy (p < 0.006). Families play a critical role in increasing adolescents' health-related quality-of-life. Effort should be made to address problems facing parents while raising their children.

Factor structure of the Communicator Styles Measure (CSM) when used with undergraduate health science students.

PubMed

Brown, Ted; Boyle, Malcolm; Williams, Brett; Molloy, Andrew; McKenna, Lisa; Palermo, Claire; Molloy, Liz

2013-06-01

It is important for educators to consider the communication skills of students enrolled in health science programmes. To date, research into this area is limited, and having measures that are valid and reliable would assist educators and researchers to complete high-quality investigations. The purpose of this study was to investigate the factor structure of Communicator Styles Measure. Data from the Communicator Styles Measure completed by 860 undergraduate health science students enrolled in eight different courses at an Australian university (response rate of 59%) were analysed using principal component analysis with varimax rotation and a cluster analysis using elementary linkage analysis. The Communicator Styles Measure is a self-report scale consisting of 40 items designed to assess ten communication styles and one's perception of his/her ability to communicate. Communicator Styles Measure items loaded onto five new viable factors labelled personable, energetic, confident, open and confronting. Six items of the original 40 from the Communicator Styles Measure did not load onto any factor and were therefore considered redundant. The original factor structure proposed by the Communicator Styles Measure's author was not supported, which calls into question its construct validity. However, the five new factors identified in this study may be useful for researchers and educators when assessing the communication skills of students and practitioners. Further investigation into the construct validity and reliability of the five new Communicator Styles Measure factors is recommended. © 2012 Nordic College of Caring Science.

A Cross-Lingual Mobile Medical Communication System Prototype for Foreigners and Subjects with Speech, Hearing, and Mental Disabilities Based on Pictograms

PubMed Central

Wołk, Agnieszka; Glinkowski, Wojciech

2017-01-01

People with speech, hearing, or mental impairment require special communication assistance, especially for medical purposes. Automatic solutions for speech recognition and voice synthesis from text are poor fits for communication in the medical domain because they are dependent on error-prone statistical models. Systems dependent on manual text input are insufficient. Recently introduced systems for automatic sign language recognition are dependent on statistical models as well as on image and gesture quality. Such systems remain in early development and are based mostly on minimal hand gestures unsuitable for medical purposes. Furthermore, solutions that rely on the Internet cannot be used after disasters that require humanitarian aid. We propose a high-speed, intuitive, Internet-free, voice-free, and text-free tool suited for emergency medical communication. Our solution is a pictogram-based application that provides easy communication for individuals who have speech or hearing impairment or mental health issues that impair communication, as well as foreigners who do not speak the local language. It provides support and clarification in communication by using intuitive icons and interactive symbols that are easy to use on a mobile device. Such pictogram-based communication can be quite effective and ultimately make people's lives happier, easier, and safer. PMID:29230254

The intended and unintended consequences of communication systems on general internal medicine inpatient care delivery: a prospective observational case study of five teaching hospitals

PubMed Central

Wu, Robert C; Lo, Vivian; Morra, Dante; Wong, Brian M; Sargeant, Robert; Locke, Ken; Cavalcanti, Rodrigo; Quan, Sherman D; Rossos, Peter; Tran, Kim; Cheung, Mark

2013-01-01

Background Effective clinical communication is critical to providing high-quality patient care. Hospitals have used different types of interventions to improve communication between care teams, but there have been few studies of their effectiveness. Objectives To describe the effects of different communication interventions and their problems. Design Prospective observational case study using a mixed methods approach of quantitative and qualitative methods. Setting General internal medicine (GIM) inpatient wards at five tertiary care academic teaching hospitals. Participants Clinicians consisting of residents, attending physicians, nurses, and allied health (AH) staff working on the GIM wards. Methods Ethnographic methods and interviews with clinical staff (doctors, nurses, medical students, and AH professionals) were conducted over a 16-month period from 2009 to 2010. Results We identified four categories that described the intended and unintended consequences of communication interventions: impacts on senders, receivers, interprofessional collaboration, and the use of informal communication processes. The use of alphanumeric pagers, smartphones, and web-based communication systems had positive effects for senders and receivers, but unintended consequences were seen with all interventions in all four categories. Conclusions Interventions that aimed to improve clinical communications solved some but not all problems, and unintended effects were seen with all systems. PMID:23355461

A Cross-Lingual Mobile Medical Communication System Prototype for Foreigners and Subjects with Speech, Hearing, and Mental Disabilities Based on Pictograms.

PubMed

Wołk, Krzysztof; Wołk, Agnieszka; Glinkowski, Wojciech

2017-01-01

People with speech, hearing, or mental impairment require special communication assistance, especially for medical purposes. Automatic solutions for speech recognition and voice synthesis from text are poor fits for communication in the medical domain because they are dependent on error-prone statistical models. Systems dependent on manual text input are insufficient. Recently introduced systems for automatic sign language recognition are dependent on statistical models as well as on image and gesture quality. Such systems remain in early development and are based mostly on minimal hand gestures unsuitable for medical purposes. Furthermore, solutions that rely on the Internet cannot be used after disasters that require humanitarian aid. We propose a high-speed, intuitive, Internet-free, voice-free, and text-free tool suited for emergency medical communication. Our solution is a pictogram-based application that provides easy communication for individuals who have speech or hearing impairment or mental health issues that impair communication, as well as foreigners who do not speak the local language. It provides support and clarification in communication by using intuitive icons and interactive symbols that are easy to use on a mobile device. Such pictogram-based communication can be quite effective and ultimately make people's lives happier, easier, and safer.

Factors affecting family satisfaction with inpatient end-of-life care.

PubMed

Sadler, Erin; Hales, Brigette; Henry, Blair; Xiong, Wei; Myers, Jeff; Wynnychuk, Lesia; Taggar, Ru; Heyland, Daren; Fowler, Robert

2014-01-01

Little data exists addressing satisfaction with end-of-life care among hospitalized patients, as they and their family members are systematically excluded from routine satisfaction surveys. It is imperative that we closely examine patient and institution factors associated with quality end-of-life care and determine high-priority target areas for quality improvement. Between September 1, 2010 and January 1, 2012 the Canadian Health care Evaluation Project (CANHELP) Bereavement Questionnaire was mailed to the next-of-kin of recently deceased inpatients to seek factors associated with satisfaction with end-of-life care. The primary outcome was the global rating of satisfaction. Secondary outcomes included rates of actual versus preferred location of death, associations between demographic factors and global satisfaction, and identification of targets for quality improvement. Response rate was 33% among 275 valid addresses. Overall, 67.4% of respondents were very or completely satisfied with the overall quality of care their relative received. However, 71.4% of respondents who thought their relative did not die in their preferred location favoured an out-of-hospital location of death. A common location of death was the intensive care unit (45.7%); however, this was not the preferred location of death for 47.6% of such patients. Multivariate Poisson regression analysis showed respondents who believed their relative died in their preferred location were 1.7 times more likely to be satisfied with the end-of-life care that was provided (p = 0.001). Items identified as high-priority targets for improvement included: relationships with, and characteristics of health care professionals; illness management; communication; and end-of-life decision-making. Nearly three-quarters of recently deceased inpatients would have preferred an out-of-hospital death. Intensive care units were a common, but not preferred, location of in-hospital deaths. Family satisfaction with end-of-life care was strongly associated with their relative dying in their preferred location. Improved communication regarding end-of-life care preferences should be a high-priority quality improvement target.

Open-source telemedicine platform for wireless medical video communication.

PubMed

Panayides, A; Eleftheriou, I; Pantziaris, M

2013-01-01

An m-health system for real-time wireless communication of medical video based on open-source software is presented. The objective is to deliver a low-cost telemedicine platform which will allow for reliable remote diagnosis m-health applications such as emergency incidents, mass population screening, and medical education purposes. The performance of the proposed system is demonstrated using five atherosclerotic plaque ultrasound videos. The videos are encoded at the clinically acquired resolution, in addition to lower, QCIF, and CIF resolutions, at different bitrates, and four different encoding structures. Commercially available wireless local area network (WLAN) and 3.5G high-speed packet access (HSPA) wireless channels are used to validate the developed platform. Objective video quality assessment is based on PSNR ratings, following calibration using the variable frame delay (VFD) algorithm that removes temporal mismatch between original and received videos. Clinical evaluation is based on atherosclerotic plaque ultrasound video assessment protocol. Experimental results show that adequate diagnostic quality wireless medical video communications are realized using the designed telemedicine platform. HSPA cellular networks provide for ultrasound video transmission at the acquired resolution, while VFD algorithm utilization bridges objective and subjective ratings.

Open-Source Telemedicine Platform for Wireless Medical Video Communication

PubMed Central

Panayides, A.; Eleftheriou, I.; Pantziaris, M.

2013-01-01

An m-health system for real-time wireless communication of medical video based on open-source software is presented. The objective is to deliver a low-cost telemedicine platform which will allow for reliable remote diagnosis m-health applications such as emergency incidents, mass population screening, and medical education purposes. The performance of the proposed system is demonstrated using five atherosclerotic plaque ultrasound videos. The videos are encoded at the clinically acquired resolution, in addition to lower, QCIF, and CIF resolutions, at different bitrates, and four different encoding structures. Commercially available wireless local area network (WLAN) and 3.5G high-speed packet access (HSPA) wireless channels are used to validate the developed platform. Objective video quality assessment is based on PSNR ratings, following calibration using the variable frame delay (VFD) algorithm that removes temporal mismatch between original and received videos. Clinical evaluation is based on atherosclerotic plaque ultrasound video assessment protocol. Experimental results show that adequate diagnostic quality wireless medical video communications are realized using the designed telemedicine platform. HSPA cellular networks provide for ultrasound video transmission at the acquired resolution, while VFD algorithm utilization bridges objective and subjective ratings. PMID:23573082

[Marketing orientation in rehabilitation--exemplified by image analysis of a rehabilitation clinic for addictions].

PubMed

Altenhöner, T; Schönhoff, T; Wehmeier, D

2001-06-01

This article presents the findings of an image analysis carried out for a rehabilitation clinic for addictive diseases. The cross-sectional study was designed as an anonymous survey sent to relevant (regional) referral agencies (n = 90), e.g. counselling services for addictive diseases. The study covers the clinic's actual and ideal image, discriminating frequency of referrals, diagnostic categories, region, and type of institution. Results concerning the real profile indicate that on average the dimensions cooperation, communication with regard to personal contact, and reputation of the clinic were more critically judged than the issues information, communication with regard to discharge reports, standards of quality, and consideration of patients' needs. Cooperation, communication with regard to personal contact, and quality standards turned out to be the most important criteria from the referring agencies' perspective (ideal profile). A statistical comparison between those with high and low assignment rates suggested that customers rated the clinic more favourably than non-customers. Thus, it seems that the clinic's image has considerable influence on referral decisions. Particularly interesting is the additional finding that the referring institutions perceive pension insurers' directives to be of secondary relevance.

A Randomized Trial to Improve Communication About End-of-Life Care Among Patients With COPD

PubMed Central

Udris, Edmunds M.; Engelberg, Ruth A.; Diehr, Paula H.; Bryson, Christopher L.; Reinke, Lynn F.; Curtis, J. Randall

2012-01-01

Objective: Patients with COPD consistently express a desire to discuss end-of-life care with clinicians, but these discussions rarely occur. We assessed whether an intervention using patient-specific feedback about preferences for discussing end-of-life care would improve the occurrence and quality of communication between patients with COPD and their clinicians. Methods: We performed a cluster-randomized trial of clinicians and patients from the outpatient clinics at the Veterans Affairs Puget Sound Health Care System. Using self-reported questionnaires, we assessed patients’ preferences for communication, life-sustaining therapy, and experiences at the end of life. The intervention clinicians and patients received a one-page patient-specific feedback form, based on questionnaire responses, to stimulate conversations. The control group completed questionnaires but did not receive feedback. Patient-reported occurrence and quality of end-of-life communication (QOC) were assessed within 2 weeks of a targeted visit. Intention-to-treat regression analyses were performed with generalized estimating equations to account for clustering of patients within clinicians. Results: Ninety-two clinicians contributed 376 patients. Patients in the intervention arm reported nearly a threefold higher rate of discussions about end-of-life care (unadjusted, 30% vs 11%; P < .001). Baseline end-of-life communication was poor (intervention group QOC score, 23.3; 95% CI, 19.9-26.8; control QOC score, 19.2; 95% CI, 15.9-22.4). Patients in the intervention arm reported higher-quality end-of-life communication that was statistically significant, although the overall improvement was small (Cohen effect size, 0.21). Conclusions: A one-page patient-specific feedback form about preferences for end-of-life care and communication improved the occurrence and quality of communication from patients’ perspectives. Trial registry: ClinicalTrials.gov; No.: NCT00106080; URL: www.clinicaltrials.gov PMID:21940765

Tailored Communication Within Mobile Apps for Diabetes Self-Management: A Systematic Review.

PubMed

Holmen, Heidi; Wahl, Astrid Klopstad; Cvancarova Småstuen, Milada; Ribu, Lis

2017-06-23

The prevalence of diabetes is increasing and with the requirements for self-management and risk of late complications, it remains a challenge for the individual and society. Patients can benefit from support from health care personnel in their self-management, and the traditional communication between patients and health care personnel is changing. Smartphones and apps offer a unique platform for communication, but apps with integrated health care personnel communication based on patient data are yet to be investigated to provide evidence of possible effects. Our goal was to systematically review studies that aimed to evaluate integrated communication within mobile apps for tailored feedback between patients with diabetes and health care personnel in terms of (1) study characteristics, (2) functions, (3) study outcomes, (4) effects, and (5) methodological quality. A systematic literature search was conducted following our International Prospective Register of Systematic Reviews (PROSPERO) protocol, searching for apps with integrated communication for persons with diabetes tested in a controlled trial in the period 2008 to 2016. We searched the databases PubMed, Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Central, Excerpta Medica database (EMBASE), ClinicalTrials.gov, and the World Health Organization (WHO) International Clinical Trials Registry Platform. The search was closed in September 2016. Reference lists of primary articles and review papers were assessed. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and we applied the Cochrane risk of bias tool to assess methodological quality. We identified 2822 citations and after duplicate removal, we assessed 1128 citations. A total of 6 papers were included in this systematic review, reporting on data from 431 persons participating in small trials of short duration. The integrated communication features were mostly individualized as written non-real-time feedback. The number of functions varied from 2 to 9, and blood glucose tracking was the most common. HbA 1c was the most common primary outcome, but the remaining reported outcomes were not standardized and comparable. Because of both the heterogeneity of the included trials and the poor methodological quality of the studies, a meta-analysis was not possible. A statistically significant improvement in the primary measure of outcome was found in 3 of the 6 included studies, of which 2 were HbA 1c and 1 was mean daytime ambulatory blood pressure. Participants in the included trials reported positive usability or feasibility postintervention in 5 out of 6 trials. The overall methodological quality of the trials was, however, scored as an uncertain risk of bias. This systematic review highlights the need for more trials of higher methodological quality. Few studies offer an integrated function for communication and feedback from health care personnel, and the research field represents an area of heterogeneity with few studies of highly rigorous methodological quality. This, in combination with a low number of participants and a short follow-up, is making it difficult to provide reliable evidence of effects for stakeholders. ©Heidi Holmen, Astrid Klopstad Wahl, Milada Cvancarova Småstuen, Lis Ribu. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 23.06.2017.

Active tracking system for visible light communication using a GaN-based micro-LED and NRZ-OOK.

PubMed

Lu, Zhijian; Tian, Pengfei; Chen, Hong; Baranowski, Izak; Fu, Houqiang; Huang, Xuanqi; Montes, Jossue; Fan, Youyou; Wang, Hongyi; Liu, Xiaoyan; Liu, Ran; Zhao, Yuji

2017-07-24

Visible light communication (VLC) holds the promise of a high-speed wireless network for indoor applications and competes with 5G radio frequency (RF) system. Although the breakthrough of gallium nitride (GaN) based micro-light-emitting-diodes (micro-LEDs) increases the -3dB modulation bandwidth exceptionally from tens of MHz to hundreds of MHz, the light collected onto a fast photo receiver drops dramatically, which determines the signal to noise ratio (SNR) of VLC. To fully implement the practical high data-rate VLC link enabled by a GaN-based micro-LED, it requires focusing optics and a tracking system. In this paper, we demonstrate an active on-chip tracking system for VLC using a GaN-based micro-LED and none-return-to-zero on-off keying (NRZ-OOK). Using this novel technique, the field of view (FOV) was enlarged to 120° and data rates up to 600 Mbps at a bit error rate (BER) of 2.1×10 -4 were achieved without manual focusing. This paper demonstrates the establishment of a VLC physical link that shows enhanced communication quality by orders of magnitude, making it optimized for practical communication applications.

Safe swallowing and communicating for ventilated intensive care patients with tracheostoma: implementation of the Passy Muir speaking valve

PubMed

Fröhlich, Martin R; Boksberger, Heidi; Barfuss-Schneider, Claudia; Liem, Esther; Petry, Heidi

2017-01-01

Background: Between 4 to 45 % of intensive care patients suffer from prolonged ventilator dependence. Due to impeded weaning, verbal communication is impossible. The tracheal cannula affects breathing and swallowing. The Passy Muir speaking valve (PMV) allows patients on ventilators to speak. It counteracts pharyngeal as well as laryngeal desensitization and prevents an insufficient swallowing reflex. Aim and methods: To implement the PMV, we conducted a multiprofessional practice- and quality development project. The objective was to ensure safe swallowing and communicating for ventilated patients with tracheostoma. Results: Intensive care nurses, doctors and physiotherapists assessed patient safety as being high. In nine patients with 51 PMV applications, we observed three undesirable events in terms of dyspnea and oxygen desaturation. On one occasion, it was necessary to remove the PMV. Conclusion: A combination of mandatory training for the entire treatment team, presence of two professionals during PMV application, and a newly developed guiding document resulted in a high level of patient safety. By means of PMV, ventilated intensive care patients are able to communicate verbally and to swallow better. Complications can be identified early and solved effectively.